Systemic causes of heel pain.

The clinical course of heel pain can be frustrating to the clinician and the patient. Most heel pain responds to conservative care in a short period of time. However, other causes should be considered, especially if the heel pain is recalcitrant to treatment. A detailed history and physical examination, along with appropriate laboratory tests and radiological studies, can direct the physician toward the correct diagnosis. There are many systemic causes of heel pain, some common and others uncommon. Regardless of the incidence, a strong index of suspicion is raised whenever the heel pain fails to respond as routine plantar fasciitis should.