Plantar and medial heel pain: diagnosis and management

J Am Acad Orthop Surg. 2014 Jun;22(6):372-80. doi: 10.5435/JAAOS-22-06-372.

Abstract

Heel pain is commonly encountered in orthopaedic practice. Establishing an accurate diagnosis is critical, but it can be challenging due to the complex regional anatomy. Subacute and chronic plantar and medial heel pain are most frequently the result of repetitive microtrauma or compression of neurologic structures, such as plantar fasciitis, heel pad atrophy, Baxter nerve entrapment, calcaneal stress fracture, and tarsal tunnel syndrome. Most causes of inferior heel pain can be successfully managed nonsurgically. Surgical intervention is reserved for patients who do not respond to nonsurgical measures. Although corticosteroid injections have a role in the management of select diagnoses, they should be used with caution.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Imaging
  • Fasciitis, Plantar / diagnosis
  • Fasciitis, Plantar / therapy
  • Foot Diseases / diagnosis*
  • Foot Diseases / therapy*
  • Fractures, Stress / diagnosis
  • Fractures, Stress / therapy
  • Heel*
  • Humans
  • Nerve Compression Syndromes / diagnosis
  • Nerve Compression Syndromes / therapy
  • Tarsal Tunnel Syndrome / diagnosis
  • Tarsal Tunnel Syndrome / therapy