Conditions and procedures

●Plantar fascitis
●Fat pad syndrome
●Bone stress fractures
●Nerve irritation or impingement
●Infection of the bone or the soft tissue
●Referred pain from the spine

Plantar fascia is a sheet-like structure extending from the heel bone to the forefoot bones(toes). Plantar fasciitis is a common painful condition caused by an overuse of the plantar fascia. It is common in runners; individuals who stand from prolonged periods of time; people who have high BMI and have coexisting chronic inflammation in the body. It is also commonly seen in the general population in the age group between 40-60 years.

Heel pad is a layer of fat packed in small compartments and plays a role to provide cushioning while weight bearing on the feet. Inflammation of this heel fat pad results in moderate to severe heel pain especially on weight bearing. The pain is commonly felt on the outside of the heel unlike Plantar fasciitis which presents with pain on the inside of the heel.

Heel bone is the largest of the foot bones and is the second most common region in the foot to have stress fractures. These fractures are commonly seen in runners, dancers, military recruits, individuals having osteoporosis and jumping athletes. Patients generally have pain on weight bearing but in advanced cases the pain is present even at rest and disturbs their sleep at night. These can be diagnosed with X-ray scan in late stages but are easily picked up in early stages on MRI scans.

In very unusual circumstances, patients can have heel pain which is referred from the spine or structures proximal to the foot. A very vigilant assessment is required to diagnose these cases and commonly, the patients can have pain or numbness/tingling on the outer aspect of foot and heel. This may or may not be associated with other signs and symptoms of nerve irritation locally or from the spine.