Because plantar fasciitis is the most common type of heel pain, other causes of heel pain are sometimes misdiagnosed as plantar fasciitis. 1 Furey JG. Plantar fasciitis: the painful heel syndrome. J Bone Joint Surg Am 1975;57:672-673. As cited in Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med 2004;350:2159-2166. A doctor must rule out other problems that can cause foot pain, such as a broken heel (calcaneus fracture), nerve entrapment, and Achilles tendonitis.
Patient interview. A doctor will ask a patient about his/her medical history and to describe the onset of his or her symptoms, the pattern of pain, and how symptoms affect lifestyle.
Physical exam. A doctor will examine the patient’s foot, noting any swelling, tenderness and pain points, and range of motion. As well as evaluating their gait for signs of excessive or late stage pronation.
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Medical imaging. Imaging can help confirm plantar fasciitis, while also helping to rule out other causes of heel pain such as a broken heel, heel spurs, or Achilles tendonitis. For example, a doctor may order an x-ray if a fractured bone, such as a broken heel bone (calcaneus), is suspected. More still, an ultrasound or MRI may be used to identify other soft tissue injuries.
Lab testing (e.g. testing a patient’s blood sample) is not considered routine, but it may be done to rule out systemic illness, such as rheumatoid arthritis. Some experts also suggest nerve testing, such as an electromyography (EMG), to rule out nerve disorders such as Baxter’s Neuropathy that may cause heel pain.
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- 1 Furey JG. Plantar fasciitis: the painful heel syndrome. J Bone Joint Surg Am 1975;57:672-673. As cited in Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med 2004;350:2159-2166.