What if Your Heel Pain Isn’t Plantar Fasciitis?

Although plantar fasciitis is the most common cause of heel pain, and the most common problem we treat, it is by no means the only cause of heel pain.

There are many causes of heel pain. These include bone problems such as fractures and bone bruises, tendonitis, nerve problems and much more. If you have heel pain, you can ensure you get the right heel pain diagnosis by making an appointment at the Seattle Heel Pain Center. Only with the correct diagnosis can you achieve the correct treatment.

Other causes of Heel Pain

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is an entrapment of the nerve that travels on the inside of the ankle. This condition can cause heel pain that feels very much like plantar fasciitis. You can learn more about tarsal tunnel syndrome here.

Calcaneal Stress Fracture

A calcaneal stress fracture is a tiny fracture of the heel bone. It often occurs on the bottom of the heel or the back of the heel. If on the bottom of the heel it is often mistaken for plantar fasciitis and if on the back of the heel is often mistaken for Achilles tendonitis.

Baxter’s Nerve Entrapment

Baxter’s nerve (also called the first branch of the lateral plantar nerve) runs direction under the bottom of the heel. If this nerve gets irritated or entrapped it can mimic plantar fasciitis. Thus it is one of the primary diagnoses that is often mistaken for plantar fasciitis.

Calcaneal Bursitis

A bursa is a small fluid filled sac that occurs throughout our bodies in areas of increased pressure. A bursa under the heel can be mistaken for plantar fasciitis. Often we can visualize bursas on ultrasound examination.

Calcaneal Cyst

A bone cyst is a weak or thin area of bone. This can lead to both dull and sharp heel pain. Bone cysts can be be diagnosed with x-ray, CT scans or MRI scans.


A radiculopathy is a nerve entrapment in the back. In some patients this can result in pain that presents under the bottom of the heel.

Rheumatoid Arthritis, Psoriatic Arthritis and Other Systemic Arthridities

There are a number of diseases that can present with heel pain. Often patients spend years being treated for plantar fasciitis when the problem is actually a systemic condition. Besides those listed above these can include conditions such as ulcerative colitis, reactive arthritis and Sjogren’s syndrome.

Plantar Fascial Tear

A tear or rupture of the plantar fascia can occur near the heel bone. While the area of the is the same as plantar fasciitis the pain itself is usually more substantial and it can even be difficult to bear weight. Sometimes bruising can be seen after the injury occurs.


While many people think gout primarily affects the big toe joint it can, in fact, cause pain at the heel. Usually causes severe pain with redness and increased temperature in the area. You can learn about gout in the feet here.

Soft Tissue Mass

There are a number of different soft tissue masses that can occur under the heel or just in front of it.  These include fatty cysts, ganglion cysts, varicose veins and tumors.

Make Sure You have the Correct Diagnosis for Your Heel Pain

As you can see plantar fasciitis is by no means the only cause of heel pain. Listed above are just a few of the many causes of heel pain. Getting the correct diagnosis is key to resolving symptoms.

We have developed strict protocols for treatment of all types of heel pain based on recommendations in the medical literature and our own experience over 20+ years.

Our goal in every case is to get you better as quickly as possible, provide a plan that will give you longer term relief and avoid surgery if at all possible. In fact, surgery is always our last resort and we are very successful at treating almost all heel pain non-surgically.

Contact us for an appointment in our Seattle clinic.

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