Looking for some wisdom of crowds to solve a tough problem…
I’ve been dealing with heel pain for the last 4-5 months. My podiatrist diagnosed plantar fasciitis (X ray did show small heel spur) about six weeks ago. I’ve dutifully done all exercises prescribed and spent months icing but pain remains as bad as ever. I’ve stretched and improved mobility of plantar fascia, achilles and calf muscles, but the heel still hurts. Something else must be going on.
The details:
The classic symptoms of PF like early morning pain/tightness in heel have subsided. But I still have considerable pain in the heel, especially on impact and when pushing off toes.
There is pain underneath heel, but seems further to rear than heel spur/PF attachment. At its worst, it feels like stepping on a nail.
There is no pain in arch itself.
There is pain around back of heelbone/low achilles but this seems harder to pinpoint. Location and sensation vary. Sometimes it feels like needles, other times like burning sensation.
My heel/ankle is swollen and feels hot to touch–much warmer than other healthy ankle.
I can cause pain by pinching heel, especially low on calcaneus and soft tissues below.
I stopped running about a month ago because the pain got so severe. Time off and PF exercises have not cured it. Biking and XC skiing/rollerskiing (my main winter sport) don’t seem to bother it as much.
I will see podiatrist again tomorrow. But I would appreciate input so I can ask better questions and hopefully he and I can solve this mystery.
I have begun to wonder if this may be stress fracture or bursitis…but what do I know? Thanks for any input!
It does sound like Plantar Fascitis (heel spur, toe off pain morning etc…and you may be ready to get more aggressive with your treatment. You said your heel was swollen …where? toward the bottom of the differential diagnosis list would be retrocalcaneal bursitis.
If you can cause pain by “sqeezing the heel”, I would not rule out a fracture… “calcaneal sqeeze test” is a common PT special test performed if stress Fx (or any Fx) is suspected. Also, Ottawa Foot/Ankle Rules are pretty sensitive rules to use to rule out a fracture…
Stress fracture was one of my early suspicions. But they took X rays a few weeks ago and presumably (I hope) looked for this. Can conventional X ray miss stress fracture, contusion or other bone injury?
Many thanks to everybody for input so far. I can’t even begin to say how much more mature this crowd is compared to letsrun.com!
I’d definitely be considering a Calcaneal Stressy. See if you can get a bone scan or CT.
A stress fracture wont be visible on xray early in the injury, if ever.
Get yourself into a moon boot and start healing by off loading the region.
Keep us posted on your progress
I just made an account so I could post. I have been a lurker for a few weeks though. I had a calcaneal stress fracture in June. I had had PF for months, and like you had done PT and all the other remedies I could try. I had a steroid injection in my heel and 6 weeks later I got out of bed and had bad pain directly in the back of the heel. No arch pain. There was ankle pain and a pins and needles feeling. Even my toes had a bit of a stinging sensation. The doctor did the squeeze test after an xray revealed nothing. My doctor diagnosed me with the stress fracture based on my description of symptoms and the squeeze test. He put me into a walking boot for 4 weeks, and told me I could swim, but no running, walking or cycling. After 4 weeks he told me I could ride my bike in an easy gear only. It was 8 weeks before I could start walking again and I gave it another 4 weeks before I added running to the mix. I hope you find out what’s going on. Heel pain is awful!