Look at your foot and ankle, without them you would not be able to walk to the store, dance to your favorite tune or drive a car. The foot and ankle are at times our only contact point with the earth and the things we do on earth. If something goes wrong with these important body parts, your whole world can fall apart.
Notice how complicated your foot is from heel to toes. Each foot has 28 bones and 30 joints; now that is one complicated piece of equipment! Just above your foot is the ankle joint where the shinbone (tibia) rests on top of the talus (the uppermost foot bone). Because of the complicated anatomy and high degree of stress on the foot and ankle complex, this area has a frequent amount of over-diagnosed, under-diagnosed, and misdiagnosed conditions. You and your doctor need to understand that certain conditions can masquerade as others. Falling into a trap of an imposter can give you a never-ending cycle of unhappy feet.
Plantar Fasciitis is an over-diagnosed condition of the foot. Yes, the inflammation of the plantar fascia is common; however, there is a laundry list of conditions that can masquerade as plantar fasciitis. Those who wear improper shoes, those who run and dance, and those who are obese are all prone to pain in the soles of the feet. Typically, the pain of plantar fasciitis is worst in the morning with the first few steps. Sometimes a heel spur is found on x-ray, but that too represents a common pitfall leading one to believe that the spur is the cause of pain when often it is not. Sometimes foot pain is worst after prolonged standing or walking. In those cases, plantar fasciitis may not be the correct diagnosis because Tarsal Tunnel Syndrome (see below) might be the actual cause of pain at the bottom of the foot.
Other conditions of nerve sensitivity or entrapment are also possible causes of a so-called "plantar fasciitis". Sciatica is another common nerve pain that can be felt in the feet. Your nerves must be closely examined before you should be thrown into the "plantar fasciitis" wastebasket. Furthermore, the bones, especially the heel bone (calcaneous bone) must be felt for tenderness because sometimes a calcaneal stress fracture can masquerade as plantar fasciitis. The entire dance card of possibilities must be considered because misdirected treatment delays healing.
Tarsal Tunnel Syndrome was already mentioned as a painful foot condition that can masquerade as plantar fasciitis. Because of the similarities between these two different causes of foot pain, Tarsal Tunnel Syndrome is often under-diagnosed. This painful foot condition is the foot's equivalent to the hand's carpal tunnel syndrome. The foot has a tunnel on the inside portion of the arch in which a nerve (the posterior tibial nerve) passes through. When that nerve is trapped or pinched, abnormal sensations like pain, numbness, burning, itching and tingling can all be felt on the inside, sole and heel of the foot. Those with diabetes or hypothyroidism are highly susceptible to this potential cause of foot pain. Again, if you have foot pain, especially if you have abnormal sensations, your nerves must be examined thoroughly. You may even need a nerve specialist who can catch this masquerader.