Heel pain is one of the most common things we see in podiatry. Plantar fasciopathy is usually the top suspect, but it’s not the only one. Fat pad syndrome, nerve entrapment, Achilles tendinopathy, calcaneal stress injuries, and inflammatory conditions can all cause similar symptoms, so it’s important we don’t jump to conclusions too quickly.
We start with a good history: where the pain is, when it started, what makes it worse, activity levels, and any relevant medical background. Then a clinical exam looks at foot posture, range of motion, strength, gait, and palpation to narrow things down. One quick note for patients: a heel spur on X-ray doesn’t automatically mean plantar fasciitis is the cause. Spurs show up in plenty of people with no heel pain at all, so we always weigh imaging findings against what’s actually going on clinically.
From there, treatment is tailored to the diagnosis and might include footwear advice, activity changes, stretching and strengthening, taping, orthoses, shockwave therapy, or education. The earlier we intervene, the better things tend to go.
Ultrasound is a great tool for checking soft tissue in real time, but again, it’s only ever part of the picture. If symptoms are severe, unusual, or not improving, we’ll refer for further imaging or specialist review.
){kind=link}