Burning in plantar fascia region

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Hi Everyone,

I have a patient who is experiencing similar symptoms to plantar fasciitis, except when they go for a run, the pain gets worse and turns into a burning sensation to which they state "my feet feel like they are on fire!". Pain is 10/10 on VAPS.
They have tried all conservative methods of treatment and taping seems to help.
Biomechanics are relatively neutral (calc position), however, talo-navicular bulging would be a +2.

In terms of further treatment, the pt does not want orthotics due to cost factor, however, prothotics could be tried. Should I be sending the pt off for imaging just to clarify there is no nerve impingement etc?
Pt experiences some sciatica and so could the pain be, in actual fact, from an impinged spinal nerve?
Just a bit stuck on where to go from here.

Thanks!

M

 

Slump test?

 

Diagnostic ultrasound - if her fascia isn't thickened or heterogenous might be worth thinking of an issue higher or at the lumbar segments. You also need to check for intrasubstance tears of the fascia as well as fibromas. The patient could have lateral plantar nerve entrapment in combination with any plantar fascia issues/fasciosis also which may need to be further evaluated. Just as a side I cannot fathom why clinically patients such as this are not thoroughly evaluated with diagnostic US prior to any intervention.....