Heel pain can be caused by a number of different disorders. Narrowing down the diagnosis begins with a history and physical examination to pinpoint the origin of the heel pain. The most common cause of heel pain in adults in plantar fasciitis*. Tendonitis** may also cause heel pain.

Here are some common techniques used by our podiatrists to determine the root cause of our patients’ pain:

Asking Questions

Before any physical examinations occur in our office, we make sure to ask questions to help us get to the root cause of our patients’ problems. Some general questions we ask are:

-When does the pain occur?

In the morning? After a long day? After a run? After rest? At night? Different heel pain issues will arise based on the time of day or depending upon certain physical activity. Knowing when the pain is at its worst can help us determine its cause.

-What makes your heel pain feel better?

If you’ve tried any at-home remedies, which (if any) provide relief: Anti-inflammatories? Stretching? Rest? Activity? Nothing? Knowing the treatments that alleviate your pain will help us in making a proper diagnosis.

After we better understand your symptoms, we’ll begin the physical examination. This can include the following techniques:

Hands-On Physical Examination

A physical examination begins with the calf muscle, Achilles and ankle. We observe the range of motion (ROM) of each part of the foot, in addition to giving a full foot exam around the heel and the surrounding tendons and ligaments.

What are we looking for? Pressure points. Certain spots are specific for plantar fasciitis, nerve damage, painful tendons, painful bones and joints, etc.


X-rays are the most commonly used imaging technique in podiatry. They are the best form of diagnosis when a patient’s main complaint could potentially involve their bones or joints. Fractures, foot malalignment, bone spurs, foreign bodies, and arthritis can be diagnosed with simple x-rays. It may even be necessary to get an x-ray with a severely infected ingrown toenail to see if the infection has gotten into the bone.

There may be some patients who express concern over the radiation associated with x-rays. Please be assured that the radiation received by the foot is very small. In fact, an x-ray exposes you to the same amount of radiation you would receive by spending about 5 minutes in the sun. X-rays are avoided if the patient is currently pregnant.

Even though x-rays show bones and joints, they do not show much in terms of muscles, tendons, ligaments, or blood flow.  In some cases, it may be hard to determine the extent of the fracture with only an x-ray. In these cases, an ultrasound is used.


Ultrasounds allow our podiatrists to visualize and examine the heel from the inside. It’s a great way to help diagnose issues that can’t been seen on x-rays. This allows our staff to accurately diagnose foot conditions that might otherwise be hard to catch. Ultrasounds are painless with zero side effects. It’s even safer than a traditional x-ray, since it doesn’t involve any radiation.

Ultrasound diagnostics are used for a variety of conditions. It can identify bursitis or capsulitis around joints, and can even determine the size of a tumor or cyst. It’s commonly used to evaluate tendon or ligament injuries, particularly if there is a tear. Ultrasounds can also help identify the extent of a condition like plantar fasciitis by determining how thick the injured plantar fascia has become.

The ability to accurately diagnose your pain is important. It helps us form a targeted plan to treat your condition. Don’t ignore foot pain because you’re afraid of what it could be! Contact the Heel Pain Center of Tampa BayI*** for an appointment or more information about diagnosing and eliminating uncomfortable conditions.