Diagnosis of Plantar Fasciitis
After observing the medical examination, your healthcare provider will perform a physical exam of your foot. Plantar fasciitis may be the culprit if applying pressure to the plantar facia causes pain. You should be concerned if it’s difficult to lift your toes or you feel a tingling or loss of feeling in your foot. You will be asked questions such as “is the pain worse in the morning?” and “does it normally decrease throughout the day and when you use your feet?”. These questions and others that are positive can help your healthcare provider determine if the condition is plantar fasciitis.
Elimination is the first step in diagnosing plantar faciitis. When you say foot pain, the most common conditions that are considered include: stress fractures, arthritis, tendonitis or fractures, cysts, and nerve entrapment. Your healthcare provider may order imaging tests that include:
- Ultrasound
- X-rays
- Magnetic resonance imaging (MRI).
- Bone scans
Your healthcare provider will perform a physical exam to determine the exact location of pain and any tenderness on the foot. It is important to rule out other foot problems as the cause of your pain. They may ask you to flex your foot while they are examining the plantar fascia in order to see if it gets worse when you flex or better when you point your toes. The doctor will note any mild swelling or redness. By examining:
- Coordination
- Muscle tone
- Reflexes
- Touch and sight
- Balance
- Image tests
Imaging tests can also reveal important information about the tissues and structures in your toes. A MRI scan or X-ray may be necessary to ensure that there is no other cause of your heel pain, such as a fractured bone. You cannot see the soft tissue on an X ray. However, it is still useful for ruling out other causes of heel pain, such as bone fractures and heel spurs. Research suggests that an MRI will show any thickening in tissue or swelling.
A ultrasound may also be necessary to determine if there is any thickening or calcification. Diagnostic testing is not a good indication to begin treatment for plantar fasciitis. This is a misnomer, as plantar fasciitis can also be called “heel-spurs”. However, only 15 to 25% of people without symptoms will have these spurs.
The bony osteophytes on the anterior calcaneus can be seen in radiographs as heel spurs. Diagnostic testing is done in cases of atypical Plantar Fasciitis, when there is no other cause for heel pain or when the patient is not responding to treatment. The diagnosis is what defines your health status, and allows you to receive treatment based on that condition.
