Not all heel pain will actually be plantar fasciitis, so it is important to seek professional help to rule out other possibilities.
Fat Pad Impingement (Bruised Heel Syndrome)
With fat pad impingement syndrome, pain is felt under the weight-bearing part of heel (calcaneus), due to one major or multiple minor traumatic episodes, which disrupt the soft tissues. Obese, elderly, or younger athletes training on hard surfaces are prone to this condition. The problem is easily treated with therapy and sometimes special heel cups or pads.
Calcaneal & subcalcaneal bursitis
Inflammation of the bursa under and or behind the heel causes pain located in these regions. The area is often swollen and tender.
(A bursa is a fluid filled sack, usually sited near a tendon attachment to the bone. It’s purpose is to cushion the tendon and ease friction).
Commonly caused by repetitive overuse and cumulative trauma, as seen in runners wearing tight-fitting shoes, but in rare cases, may also be associated with conditions such as gout and rheumatoid arthritis.
In some cases, calcaneal bursitis may be caused by impingement (trapping) between the Achilles tendon and a prominent piece of bone at the back of the heel (Haglund’s deformity). The patient has usually had a hard lump in this region for many years.
Tarsal tunnel syndrome
This is similar to carpal tunnel syndrome and commonly mistaken for plantar fasciitis.
The posterior tibial nerve which runs along the inside of the ankle into the foot, becomes impinged (compressed).
Pain, burning and numbness can be felt along the inside of foot, ankle and sometimes up the calf. The discomfort is usually worse at rest and at night.
Can be associated with a pronated gait, diabetes, inflammatory arthritis & similar conditions.
Calcaneal fracture (Broken heel bone)
The Calcaneus is the bone at the back of the foot which forms your heel.
Fractures to this bone are usually the result of an impact injury, such as falling or jumping from a height.
Stress fractures of the calcaneus are also quite common in athletes who run or jump. Young athletes are most at risk from this type of fracture.
There is usually a lot of swelling and pain of the back of the foot. (A stress fracture may only produce pain when bearing weight). Bruising may be evident and it is usually not possible to put weight on the heel.
Diabetes
People who suffer from diabetes should always consult a medical practitioner if they experience foot pain.
Long term complications of Diabetes such as cardiovascular disease and nerve damage, can often affect the limbs and feet. The body may also have a slower healing rate, which means that any damage to the soft tissue and joints will require a longer period of time to repair.
This list is not exhaustive and any pain lasting longer than a couple of weeks, should be investigated by a qualified professional.