Painful heel syndrome: radiographic and treatment assessment.

From July 1980 to January 1986, 170 patients who had unilateral heel pain were examined, x-ray filmed, and treated in a similar fashion. Radiographs of painful and nonpainful heels were measured. There was a statistically significant increased thickness of the heel fat pad and subfascial area compared with that of the control subject (the nonpainful side). A tightness of the Achilles tendon and a new sign, which the authors are designating as the "saddle" sign, were other prominent features. A treatment program of stretching exercises and walking seemed to be effective in relief of symptoms.