PREFERRED PRACTICE PATTERN
4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation1
Patient reports gradual worsening of heel pain. It is worst with first step of the day and after prolonged sitting. The pain feels better after 2 to 3 minutes of walking. Pain also increases at the end of the day after she has been on her feet at work. Patient states no radicular leg symptoms. When asked, patient states she likes to walk barefoot at home on the tile floors. Patient has had 2 injections into the heel with pain returning. The patient has tried a night splint and continues to have pain.
Diagnosis usually made by clinical examination3
Can be an independent diagnosis, not associated with a disease process
May not be fasciitis, but inflamed flexor digitorum brevis or tibialis posterior4
(A) Plantar fascia taping technique. (B) Heel pad for treating plantar fasciitis. (C) Plantar fascia arch support padding. (D) Stretches for plantar fasciitis. (From Simon RR, Sherman SC. Emergency Orthopedics. 6th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
SIGNS AND SYMPTOMS
Stabbing pain in heel with
Burning sensation underneath mid arch indicates tibial nerve entrapment3,5
Heel pain with palpation at origin of the fascia where heel spur can occur...