[46F] Experiencing heel pain with weight-bearing

Patient Description

A 46-year-old female presents with a 4-month history of heel pain, which is tender and sore, particularly when bearing weight during walking. The pain was first noticed following a run and has persisted since. It is localized under the heel and sometimes improves with rest. The patient reports increased pain intensity during the first steps in the morning or after prolonged sitting, suggesting a possible plantar fasciitis pattern. There is minor swelling but no numbness, tingling, or discoloration. The pain also throbs when at rest and has limited the patient's ability to perform normal activities. No other systemic symptoms were reported. The patient has no known pre-existing conditions, allergies, or current medications.

Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

Plantar Fasciitis: This is a common cause of heel pain that occurs when the band of tissue that supports the arch of your foot (plantar fascia) becomes irritated and inflamed. The pain is usually worse with the first few steps in the morning or after sitting for a long time, and it may improve with mild activity.
- Treatment typically involves rest, ice, over-the-counter pain relievers, and physical therapy. In some cases, your doctor may recommend wearing a splint at night or using orthotic devices.
Heel Spur: This is a bony growth on the underside of your heel bone that can occur when the plantar fascia is pulled away from the heel. This can cause pain when walking or standing, and the pain is often worse in the morning.
- Treatment can include rest, ice, over-the-counter pain relievers, and physical therapy. In some cases, your doctor may recommend wearing a splint at night or using orthotic devices.
Stone Bruise: This is a deep bruise of the fat pad of the heel or ball of the foot. It's often from an impact injury, but it can also occur after stepping on a hard object. The pain feels like you're walking on a pebble.
- Treatment typically involves rest, ice, over-the-counter pain relievers, and sometimes padding the heel to relieve pressure.

What you can do

In the meantime, you can try the following to alleviate your symptoms:

Rest your foot as much as possible.
Apply ice to the heel for 15 minutes twice a day.
Take over-the-counter pain relievers such as ibuprofen or naproxen.
Wear shoes with good support and cushioning.
Try gentle stretching exercises, especially for your calf muscles and the bottom of your foot.

What you should look out for

Reasons to see a doctor more urgently:

If your pain becomes severe or unbearable.
If you notice redness or warmth over the heel, which could suggest an infection.
If you develop a fever.
If your symptoms do not improve after two weeks of home treatment.

Please remember, I'm an AI and this advice is based on the symptoms you've told me. It's important to consult with a healthcare professional who can evaluate your symptoms in person and provide a formal diagnosis and appropriate treatment.

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1 yr ago

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