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Differential diagnosis of inferior heel pain

Authoring team

Causes relating to plantar fascia:

  • plantar fasciitis - by far the most common cause of pain below the heel
  • rupture
  • enthesopathies

Causes relating to soft tissues:

  • fat pad atrophy
  • heel bruise - bruised heel syndrome
  • subcalcaneal bursitis

Causes relating to bone:

  • calcaneal stress fracture
  • primary and secondary tumours
  • Paget's disease
  • infection
  • gout may rarely present as otherwise typical plantar fasciitis (1)

Causes relating to nerves:

  • tarsal tunnel syndrome
  • trapped abductor digitii quinti nerve
  • sciatica radiculopathy (S1)

Reference:

  1. ARC (February 2004). Hands On - Practical advice on management of rheumatic disease, 2.

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