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Heel Pad Syndrome vs. Plantar Fasciitis

Hello, I've been dealing with some heel pain, and the symptoms seem to mimic both "Heel Pad Syndrome" and Plantar Fasciitis.  I'm an avid runner, and this is obviously a result of my training.  First thing in the morning, my first steps are painful, but the pain goes away within minutes and I'm mostly pain free for the majority of the day.  Towards the evening, the pain comes back and the cycle begins again.  Ice and Ibuprofen help greatly.  Also, if I have pain while running, it only lasts for the first minute or two and then i'm good.  These symptoms all seem consistent with Plantars.  However, after reading about Heel Pad Syndrome, I realized that the pain in my heel is more consistent with this.  Meaning, if I push my thumb into the middle of the heel its extremely sore.  The pain isn't at the edge of the heel near the arch.  I also have pain on the outer edge of my heel, and the Achilles is slightly sore.  Lastly, I've had gout attacks in the past which have to some degree caused me to alter my gait running as to not "hammer" the first metatarsal head and cause aggravation.  When my heel does start to hurt on a run, I also feel pain on the bottom of that joint, so something makes me think that the fascia from my big toe to the heel is tight.  

Thoughts?

Thanks!
1 Responses
351246 tn?1379685732
MEDICAL PROFESSIONAL
Hi!
Well, yes, there could be various causes of the pain you are experiencing. The pain can be due to plantar fasciitis, or due to inflammation of a tendon inserted into big toe or due to heel pad syndrome or tarsal tunnel syndrome. The latter can be diagnosed by your doctor by tapping at the tibial nerve at the ankle. This will cause pain and tingling along the nerve distribution in your foot.  
Pain or soreness in the foot, that eases with time during the day, is generally indicative of plantar fasciitis. The first step you take generally after sitting or standing for a long time or when you get up from the bed is painful. As you start walking the pain clears up. You appear to be having this type of pain.
You could dip your feet in warm water at the end of the day. Also, start running shorter distances and slowly increase the run time. Consult a sports injury center or an ortho specialist. There are various other things you can try such as especially designed insoles, night splints and wraps. Besides this there are various massage therapies, stretch exercises, and pressure point stimulation by trained specialists. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
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