What does pain in the heel during palpation suggest?

• A. Possible Achilles tendon rupture
• B. Possible plantar fasciitis
• C. Possible ankle sprain
• D. Possible nerve impingement

Answer: (B)

Pain in the heel during palpation is most commonly associated with plantar fasciitis. This condition is characterized by inflammation of the plantar fascia, which is the thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. When palpating the heel, particularly at the point where the plantar fascia attaches to the heel bone, tenderness is frequently noted in individuals suffering from plantar fasciitis.

This is because the inflammation of the plantar fascia is typically more pronounced in the area of attachment to the heel. Patients often report a sharp pain during activities like walking or standing, especially upon taking the first steps in the morning or after prolonged periods of rest.

In contrast, while an Achilles tendon rupture might present with pain in the heel, the primary symptom would be sudden, severe pain in the back of the ankle, and it is less likely to be specifically triggered by heel palpation. An ankle sprain generally involves pain and swelling around the ankle joint itself rather than the heel, and nerve impingement typically manifests with symptoms such as numbness or tingling rather than isolated heel pain. Thus, heel pain during palpation strongly points to plantar fasciitis.