Diagnose Your Heel Pain with this 7 Question Quiz! | Next Step Foot & Ankle Clinic

Answer these 7 questions to diagnose your heel pain. Please keep track of your answers.

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1. Is your heel pain worse when getting up after a period of rest or with the first steps of the morning?

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Yes Sometimes Rarely No

2. Do you have pain in both heels?

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Yes Sometimes Rarely No

3. Do you have burning pain in your heels?

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Yes Sometimes Rarely No

4. You have pain at night or when you’re off your feet?

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Yes Sometimes Rarely No

5. Does your heel pain increase in relation to the amount of time you’re on your feet?

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Yes Sometimes Rarely No

6. Does your heel pain worsen throughout the day?

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Yes Sometimes Rarely No

7. Does arch support therapy or orthotics make your heel pain worse?

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Yes Sometimes Rarely No

Tally your score. Yes = 3, Sometimes = 2, Rarely = 1, No = 0

Total point score?______________

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If your heel pain score is less than 12 then most likely you have isolated Plantar Fasciitis.

If your heel pain is 12-15 them it is quite likely you have both Plantar Fasciitis and Neurologic Problems causing your heel pain.

If your heel pain score is 15 or greater then you probably have Neurologic Heel Pain.

There are other causes of heel pain but they’re quite unusual. Most heel pain can be categorized into either plantar fasciitis or neurologic heel pain.

What your heel pain score tells you:

Plantar Fasciitis:

The first is the typical heel pain called heel spur syndrome or plantar fasciitis. The incidence of plantar fasciitis in the United States has been estimated at about 10%. This pain usually has its onset in the 40s and 50s. It is usually worse when getting up in the morning or getting up after a period of sitting. This kind of heel pain is notoriously undertreated by the general medical community. Oftentimes patients will see a physician and be told to stretch, ice, and take nonsteroidal anti-inflammatories. These treatments can be helpful over a long period of time. Many studies are performed measuring outcomes after 6 months of this therapy. Who wants to suffer for several months while getting over the heel pain?? One study comparing patients taking nonsteroidal anti-inflammatory drugs to patients treated without nonsteroidal anti-inflammatories showed no difference. I personally only use them as an adjunct to more effective treatments. The bottom line with plantar fasciitis is that most of the time, this can be treated with conservative care. Our goal in our clinic is to make the patient’s 85% better in 2 weeks with this condition. We use several modalities to achieve this goal and we are able to achieve this goal about 90% of the time.

Neurologic heel pain:

In my experience patients with neurologic heel pain generally have had their pain for a much longer time. This is the heel pain that has burning, radiating sensation, pain when sitting down, and sometimes sensory loss. This heel pain is much more difficult to treat conservatively. Remarkably, this type of heel pain is often not even diagnosed. Many doctors don’t even recognize or look for this condition. Patient’s tell me stories of going to see a doctor with the complaint of heel pain and the doctor performs an exam that consists of poking twice on the foot and then beginning the treatment. I even have patients who have come to see me for a second opinion who have gone so far as to have surgery on the plantar fascia and the heel pain remains virtually unchanged because the previous doctor missed the diagnosis of neurologic heel pain. Only a careful patient history, and a careful examination can sort out whether or not heel pain is being caused by the nerves or the plantar fascia or both. Nerve related heel pain needs a different treatment than plantar fasciitis, but it can be treated successfully.

So if you have heel pain and would like to get rid of it quickly we would love to try and help you. Some give us a call at the Next Step Foot and Ankle Clinic.

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