Heel Pain: Diagnosis and Management

Area of Science:

• Orthopedics
• Sports Medicine
• Podiatry

Background:

• Heel pain is a prevalent condition, accounting for 2 million annual office visits.
• Associated factors include higher body mass index, manual labor, and sedentary habits.
• Specific conditions like retrocalcaneal bursitis, calcaneal apophysitis, os trigonum syndrome, and peroneal tendon injuries have distinct demographics and risk factors.

Purpose of the Study:

• To provide a comprehensive overview of common causes of heel pain.
• To discuss diagnostic modalities and risk factors associated with various heel pain etiologies.
• To highlight treatment principles and prognostic indicators for heel pain.

Main Methods:

• Review of common heel pain conditions including retrocalcaneal bursitis, calcaneal apophysitis (Sever disease), os trigonum syndrome, and peroneal tendon injuries.
• Discussion of associated risk factors such as body mass index, occupation, lifestyle, and specific medical conditions.
• Evaluation of diagnostic tools including magnetic resonance imaging (MRI) and ultrasonography.
• Consideration of conservative and surgical treatment approaches.
• Assessment of psychological factors like pain catastrophizing and kinesiophobia.

Main Results:

• Heel pain has diverse causes, affecting various age groups and activity levels.
• Risk factors are multifactorial, encompassing biomechanical, lifestyle, and medical elements.
• Advanced imaging like MRI and point-of-care ultrasonography aid diagnosis.
• Conservative management is typically effective, with surgery reserved for refractory cases.
• Pain catastrophizing and kinesiophobia negatively influence outcomes.

Conclusions:

• Heel pain is a common complaint with varied etiologies requiring tailored diagnostic and treatment strategies.
• Understanding risk factors and utilizing appropriate imaging are crucial for effective management.
• Conservative treatment is the mainstay, while psychological factors warrant consideration for prognosis.