Heel Pain

• Heel pain is an extremely common complaint.  The problem can be as simple as a nail or foreign object in the shoe or as complicated as a bone tumour.
  
  
• All age groups can be affected, although heel pain is rarely seen below age 8.
  
  
• Onset can be insidious or rapid and the course may be acute or chronic.
  
  
• Symptoms can include pain located at the inferior aspect of the heel either medial, central, or lateral, retro-calcaneally, surrounding the plantar periphery, or radiating up the medial or lateral aspects of the calcaneous.
  
  
• Pain can be intense following rest or improved with rest and becoming progressively worse with activity.
  
  
• The range of pathological entities that can produce heel pain is vast, and includes inflammatory and degenerative arthropathies, metabolic disturbances, nerve entrapments, trauma, and overuse syndromes.
  
  
• These underlying entities can be divided into two basic etiologies, metabolic and mechanical.
  
  
• Although heel complaints usually fall distinctly into one of these two categories according to the clinical appearance and history, it is certainly possible to find cases where both etiologies are present simultaneously and the symptoms superimposed.

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