In this condition, which is believed to be inflammatory, there is pain beneath the anterior part of the calcaneus.

Pathology

The lesion affects the soft tissues at the site of attachment of the plantar aponeurosis to the inferior aspect of the tuberosity of the calcaneus.

Clinical features

The complaint is of pain beneath the heel on standing or walking; the pain extends medially and into the sole. The disability is sometimes severe.
When the condition is part of a widespread inflammatory disorder both heels may be affected.

On examination there is marked tenderness over the site of attachment of the plantar fascia to the calcaneus.

Radiographs usually do not show any abnormality. A sharp spur projecting forwards from the tuberosity of the calcaneus is sometimes found, but its significance is doubtful because such spurs may be present in patient without heel symptoms.

Treatment　

Conservative treatment usually suffices if pursued energetically, though recovery may be slow. A course of non-steroidal anti-inflammatory drugs is usually prescribed. The heel should be protected by a resilient cushion on an insole. If these measures fail, local injection inflammatory disorder treatment appropriate to the underlying condition should be instituted.