Heel pain: a practical approach

Abstract

Background: Heel pain is a common presentation in primary care and the risk of developing pain is higher with increasing body mass index and age.1 This is troubling given the increasing prevalence of obesity and an ageing population.

Objective: This article aims to assist with differential diagnosis of heel pain, which is critical as there are many structures in the heel area that can cause pain, and each requires a tailored treatment.

Discussion: Structures affected by pain vary with age, although the more common diagnoses such as Achilles insertional tendinopathy and plantar fascia pain can occur at any age. The use of diagnostic imaging must be considered in the context of clinical presentation as asymptomatic pathology occurs in many tissues. Evidence-based treatment for common causes of heel pain are limited. As with all presentations to clinicians, the potential for non-musculoskeletal, more sinister causes of pain and systemic disease must be considered.