Summary
- Plantar heel pain which may radiate up the calf.
- Caused by entrapment of the lateral plantar nerve, often at the fibrous opening in the abductor hallucis muscle.
- May be confused or exist concurrently with plantar fasciitis and heel spur
Diagnostic tips
- Pain on palpation around the proximal abductor hallucis muscle.
- Pain shoots laterally under the heel.
- No pain on rising unless there is concurrent fasciitis.
Tests and Imaging
- Plain x-rays of the foot may rule out other pathologies.
Immediate Treatment
- Advise use of comfort shoe wear.
- Advise period of activity modification to decrease or eliminate activities which maybe exacerbating the patient’s symptoms.
- Short course NSAIDs, padding, stretching exercises.
Possible Referral
- Podiatry for padding, insoles or orthotics to offload the involved area of the heel.
- Surgery for nerve resection, radio frequency ablation, or release tissue around the nerve after failure of nonoperative management.
