Medial calcaneal neuropathy: a missed etiology of chronic plantar heel pain

Abstract

Introduction Medial calcaneal neuropathy had been implicated as a source of chronic plantar heel pain. Aim The aim was to determine the presence of medial calcaneal neuropathy as a cause of chronic plantar heel pain. Patients and methods The present study included 43 heels obtained from 38 patients with chronic plantar heel pain and 30 apparently healthy volunteers as a control group. Clinical examination was done. Sensory nerve conduction study of the medial calcaneal nerve was performed. This was a single-center, public hospital-based study. It was designed as a cross-sectional examination of consecutive patients with chronic plantar heel pain. Results There were 27 (62.79%) heels, from 23 (60.52%) patients, who had medial calcaneal neuropathy. From them, unobtainable medial calcaneal nerve response was present in 10 (37.03%) heels of nine (39.13%) patients. Medial calcaneal neuropathy was the solitary cause of chronic plantar heel pain in 10 (37.03%) heels from 10 (43.48%) patients. However, it was associated with other local heel pathologies in the remaining patients. The majority of them were having plantar fasciitis in nine (33.34%) heels from five (21.73%) patients. Conclusion Medial calcaneal neuropathy is present in a considerable number of patients with chronic plantar heel pain. It should be taken into consideration during the assessment of any patient with chronic plantar heel pain.

Keywords

• chronic heel pain
• medial calcaneal nerve
• medial calcaneal neuropathy
• plantar heel pain
• tarsal tunnel syndrome