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Heel pain: a practical approach.

Ebonie Rio1, Sue Mayes, Jill Cook

  • 1BApp Sci (Human Movement), BA Phys (Hons), Masters in Sports Physiology, PhD candidate, Department of Physiotherapy, Faculty of Medicine, Nursing and health Sciences, Monash University, Frankston, VIC.

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Heel pain is common, especially with higher body mass index and age. Accurate diagnosis is key, as treatments vary for different heel pain causes like Achilles tendinopathy and plantar fasciitis.

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Area of Science:

  • Podiatry
  • Musculoskeletal Medicine
  • Primary Care

Background:

  • Heel pain is a frequent complaint in primary care settings.
  • Increased body mass index and advanced age are associated with a higher risk of developing heel pain.
  • The rising prevalence of obesity and an aging population exacerbate this issue.

Purpose of the Study:

  • To aid in the differential diagnosis of heel pain.
  • To highlight the importance of accurate diagnosis for tailored treatment.
  • To address the complexity of heel pain due to numerous anatomical structures.

Main Methods:

  • Clinical assessment and patient history.
  • Consideration of age-related structural changes.
  • Evaluation of diagnostic imaging in conjunction with clinical presentation.

Main Results:

  • Painful structures in the heel can differ based on age.
  • Common conditions like Achilles insertional tendinopathy and plantar fasciitis can affect individuals of all ages.
  • Asymptomatic pathology is frequently observed in various tissues, necessitating careful interpretation of imaging.

Conclusions:

  • Differential diagnosis of heel pain is crucial for effective management.
  • Treatment strategies must be individualized based on the specific cause of heel pain.
  • Clinicians must remain vigilant for non-musculoskeletal and systemic conditions presenting as heel pain.