The pain is increased with running or local trauma at the heel.
Pain radiates to the medial inferior aspect of the heel and proximally into the medial ankle region.
The pain may even radiate across the plantar aspect of the heel to the lateral aspect of the foot. A recent article by Park and Del Toro found that while the specific sensory nerve study is unreliable, the mixed nerve study and EMG study into the affected intrinsic foot muscles yield more consistent results. NCS and EMG can also help rule out tarsal tunnel syndrome, which is a more proximal injury to the tibial trunk of this nerve and is also capable of reproducing chronic heel pain. Percussion of the nerve along the tarsal tunnel can produce the patient's symptoms, including pain, burning, or tingling on the bottom of the plantar aspect of the foot. Electrodiagnostic studies can also rule out a lumbar radiculopathy or peripheral neuropathy, which can also present with diffuse heel pain.