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The back of the heel is never swollen or red, unless there has been shoe rubbing. When the back of the heel is squeezed from the inside and outside, children with calcaneal apophysitis will report pain. Foot radiographs are not needed to diagnose calcaneal apophysitis as the growth plate can look similar with or without pain.
Middle age is the most common age of affection, females are more affected than males, and the occurrence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund's syndrome. [2]
After a few hours, the pain does subside but can return after prolonged periods of standing. Plantar fasciitis is most common in runners, obese individuals, women who are pregnant and those who wear shoes with inadequate heel support. The treatment of this agonizing disorder involves pain control, steroid injections, proper foot wear and rest.
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If this is not sufficient, physiotherapy, orthotics, splinting, or steroid injections may be options. [4] If these measures are not effective, additional measures may include extracorporeal shockwave therapy or surgery. [4] Between 4% and 7% of the general population has heel pain at any given time: about 80% of these are due to plantar fasciitis.