Plantar Fasciitis… or is it?
Have you ever taken a step first thing in the morning and felt like you had a sharp knife stabbing you in the heel? Have you gone on a long walk to find hours later you have a burning or aching pain along the bottom or backside of your heel? Heel pain is by far the most common foot problem we see in the clinic. It can be debilitating and can greatly affect your quality of life. Differential diagnosis of heel pain is essential, as treating the correct tissue is incredibly important to ensure proper healing and faster results.
More often than not, patients with heel pain come into the clinic with a diagnosis of “plantar fasciitis.” However, this is not the only cause of heel pain. The plantar fascia is a fibrous tissue that runs along the bottom of your foot, originating at the inferior surface of the heel and ending at the toes. Typically, when this tissue is involved, the pain is sharp and intense, located directly at the bottom of the heel and sometimes into the arch of the foot. Pain is usually only present when weight-bearing through the foot and almost always painful with the first few steps in the morning.
The inferior calcaneal nerve (ICN), otherwise known as “Baxter’s Nerve,” also runs in the same area as the plantar fascia. Baxter’s nerve can cause burning, aching, or numbness and tingle in the heel or foot. Initially, this pain is present hours after activity, but when highly aggravated, the pain can be constant. Baxter’s nerve will also be painful at rest, unlike the plantar fascia, which will be painful only when the foot is in use.
If you have heel pain, call Austin Manual Therapy Associates to make an appointment today. Our expert physical therapists are fellowship trained and can help correctly diagnose the underlying cause of your heel pain.
Leeda Rasoulian, PT, DPT, FAAOMPT