Heel pain can be excruciating, disrupting your daily activities and making even simple tasks daunting. When faced with this discomfort, many people turn to "Dr. Google" for answers, often finding that most sources attribute heel pain to plantar fasciitis.
However, not all heel pain is the same, and assuming it’s always plantar fasciitis can lead to ineffective treatments and prolonged discomfort. Heel pain can stem from various causes, including weight gain, prolonged standing, biomechanical factors, or sudden increases in physical activity. At Oran Park Podiatry, we specialise in diagnosing and treating different types of heel pain to ensure you receive the most appropriate care.
Common Causes of Heel Pain
Weight Gain: Rapid weight gain, such as during pregnancy, can place additional stress on the feet, leading to heel pain.
Prolonged Standing: People who spend long hours on their feet, like hospitality workers, teachers, tradies, and nurses, are prone to heel pain due to the constant pressure.
Biomechanical Factors: Conditions like flat feet or high arches can alter how weight is distributed across the feet, causing heel pain.
Sudden Increase in Activity: Physically active individuals or those who suddenly increase their activity levels may experience heel pain due to overuse or strain on the foot muscles and ligaments.
Inappropriate footwear: Wearing soft, flexible footwear might be very comfortable, but in the long term, it can put a lot of stress on the muscles and ligaments in your feet, leading to heel pain.
Comprehensive Assessment at Oran Park Podiatry
When you visit Oran Park Podiatry, we conduct a thorough assessment to identify the root cause of your heel pain. Our approach includes:
Detailed History: We start by taking a comprehensive history of your heel pain, understanding what exacerbates and alleviates it, and how it began.
Biomechanical Assessment includes evaluating your ankles and joints' range of motion, muscle testing to identify any compensations or affected muscles, and nerve impingement testing to determine if the pain originates from a nerve.
Limb Length and Hip Range of Motion: We check for limb length discrepancies and hip range of motion to see if compensations from these areas contribute to your heel pain.
Standing Assessment: Observing your feet while standing helps us see if they roll in or out, which can impact your heel.
Muscle and Joint Testing: We examine the first metatarsophalangeal joint (MPJ) and assess the activation of the plantar fascia and other muscles that may be tight and causing pain.
Gait analysis: We watch the way you walk or jog to identify how pressure is affecting your heel pain. This helps us understand your movement patterns and how they might be contributing to your discomfort.
Based on our findings, we may recommend further diagnostic tests such as ultrasound or X-ray to confirm the diagnosis and tailor the treatment plan accordingly.
Differential Diagnoses Beyond Plantar Fasciitis
While plantar fasciitis is a common cause of heel pain, other conditions can present similar symptoms:
Posterior Tibialis Tendinopathy: This involves inflammation of the Posterior Tibialis tendon, causing pain similar to plantar fasciitis but typically higher up the arch and sometimes extending into the leg. Clinical examination and ultrasound help distinguish this condition.
2. Accessory Navicular Syndrome: Up to 2.5% of people have an accessory navicular bone. While usually asymptomatic, injury can trigger pain near the heel, often mistaken for plantar fasciitis. This condition is diagnosed through clinical examination and confirmed with X-rays and ultrasounds if necessary.
3. Muscle Trigger Points: Pain from trigger points in muscles like the abductor hallucis or quadratus plantae can mimic heel pain. The location of pain differs, with the quadratus plantae affecting the upper center of the heel and the abductor hallucis affecting the medial arch. Clinical examination can identify these points, with ultrasounds used for further clarification if needed.
4. Baxter’s Nerve Entrapment: This condition involves entrapment of Baxter’s nerve, causing sharp, radiating, or shooting pain, often at night. Unlike plantar fasciitis, this pain is more widespread and not confined to a single spot on the medial heel. Tests like Tinel's sign and Windlass test help differentiate it from plantar fasciitis. Ultrasound may be used, though not all nerve entrapments are visible on imaging.
Conclusion
Heel pain is not a one-size-fits-all diagnosis, and it’s crucial to understand the various potential causes to receive the most effective treatment. At Oran Park Podiatry, we are committed to providing a thorough assessment and accurate diagnosis to ensure you get the best care for your specific condition. Don’t assume all heel pain is plantar fasciitis—visit us for a comprehensive evaluation and start your journey toward pain-free living.
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