Why do heels hurt, how to treat them at home - these questions can only be answered after a correct diagnosis has been made. If there are no visible injuries (punctures, cuts), and the feeling of discomfort and pain intensifies every day, most likely you have a heel spur - a bone growth in the heel area. It is impossible to see it on your own. That is why this modification can only be detected using x-rays.
There are several reasons for bone growth in the heel area:
As mentioned, the main symptom of a spur is severe pain. It only appears when the foot is under load, for example, in a standing position, and there is a feeling that the skin and muscles are damaged by a nail or needle. The most severe pain is felt in the morning (during the first exercise) and in the evening (after constant walking). During the day, pain may either disappear or appear periodically. Their main cause is inflammation of the plantar aponeurosis due to irritation by a sharp spur. This is why your heel hurts.
Treatment of a spur in the initial stages using folk recipes allows you to stop its further growth, relieve inflammation and pain. At the beginning of treatment, it is important to recognize this disease and not confuse it with a plantar wart. So, you have decided on the diagnosis: you have a spur. The heel aches and hurts unbearably. How to treat and what methods to give preference to: heating, compresses, self-massage?
Warming up relieves internal inflammation and swelling caused by constant irritation of the bone and reduces pain.
If your heel hurts, how can you treat it at home so that the pain subsides quickly and there are no side effects? The best option is compresses. They come in two types: night and 24-hour. This procedure warms up well, relieves pain and inflammation, and prevents further growth of bone tissue.
If compresses and warming did not help, and the heel still hurts, what else can you treat? In this case, self-massage using improvised means can help. For example, salt, heated and scattered on a flat surface, will not only soothe the pain, but also prevent further growth of the spur. It is enough to “walk” on it with your sore heel every day. An old washboard will also help. If you “wash” your heels twice a day for at least 15 minutes, the spurs will disappear within a few weeks. You can also massage your feet with a corn cob, aspen log or potato.
Severe pain in the heel (inside it) in the morning, when walking and running is caused by plantar fasciitis. This is the most common cause of the problem and usually goes away on its own over time. This can happen to people of different ages - a child, an elderly person, and a representative of the middle age group. What to do, how to treat?
Restorative procedures and the use of simple aids speed up treatment. This includes rest, wearing good shoes, heel cushions, painkillers and specific exercises. In more severe cases, steroid injections as well as other procedures are recommended.
This is an inflammation of the plantar fascia, a band of tissue (ligament) that runs from the heel to the bones of the midfoot area. It supports the arch of the foot and also acts as a shock absorber.
This is caused by repeated minor injuries to the fascia (with or without inflammation). These injuries (micro tears), as a rule, occur in places near which the fascia is attached to the heel bone. Overnight they grow together a little, and the strip of tissue shortens. After sleeping and getting out of bed with the first steps, stretching and tearing occurs. That's why your heels hurt especially bad in the morning (then less).
Situations in which you may receive this type of damage:
Interestingly, there is often no obvious reason for the occurrence of the painful condition, especially in older people. A common misconception is that pain is caused by tissue growth or a “spur” in the heel bone.
Plantar fasciitis is not a rare occurrence. It happens to every tenth person. It is most often encountered by people over the age of forty. However, this can happen to a middle-aged person or a child. Women suffer from the problem much more often than men. Athletes are also at risk.
As a rule, the pain subsides over time when using only auxiliary means and reducing stress. It should be noted that the healing process is not fast. This process may take months. How to speed it up? It is better to practice a combination of several healing methods.
You need to give your feet rest as much as possible. Avoid extra strain, walking or standing, or overextending your feet. Calm walking and the exercises described below are recommended.
You should not walk on the floor barefoot. Choose shoes with comfortable, soft heels and good arch support. Athletic shoes are better than open sandals. Avoid wearing well-worn boots - boots that do not provide enough cushion to the heel.
Heel inserts and instep supports
To alleviate heel pressure and support your arch, invest in soft shoe lasts and insoles. The maximum benefit from them will be if you place them in your shoes and wear them constantly. The goal is to raise the heel about 1 cm. If there is a particularly sensitive area, cut a small hole in the corresponding area on the insole. This way, part of your heel will not touch the shoe. Place inserts in both shoes, even if only one foot hurts.
The condition is relieved by painkillers such as paracetamol. Anti-inflammatory drugs such as ibuprofen are sometimes helpful. Compared to the first ones, they not only relieve pain, but also reduce inflammation, which is, of course, better. Thus, it is considered especially useful to rub a cream or gel into the problem area that contains an anti-inflammatory medicine.
Also helping to relieve pain is such a simple and accessible remedy as applying cold to the leg for 15-20 minutes (for example, a bag of frozen legumes wrapped in a towel).
Regular, gentle stretching of the Achilles tendon and plantar fascia can help relieve symptoms. When you sleep, they heal, tighten and shorten, and when you move, they are injured again (which is why the most painful moment is when you wake up in the morning). The goal of these exercises is to gently release tension in the tendon and fascia above and below the heel. For exercise guidance, the doctor refers the patient to a physical therapist.
If the above procedures do not help relieve your symptoms, or if you are, for example, an athlete who needs to recover quickly, other procedures are gentle. There is no one specific treatment that can be identified as the best.
Steroid (cortisone) injections are given if the pain does not go away despite taking the above “conservative” measures. This may provide relief for a few weeks, but does not always cure the problem. Steroids reduce inflammation, but their use is not always successful. Sometimes, if the first one does not help, 2 or 3 injections are given within a week. They do carry some risks, including (although rarely) tearing the plantar fascia.
Extracorporeal shock wave therapy
In extracorporeal shock wave therapy, the therapeutic effect is achieved through the use of special medical equipment, which produces high-energy sound waves through the skin on the painful area. It is not known exactly how it works, but the therapy is thought to stimulate healing in the plantar fascia. One or more treatment sessions are required.
This procedure is safe, but it is unclear how well it helps. This state of affairs is mainly due to the lack of large, well-designed clinical trials. You should discuss the potential benefits and risks with your doctor.
According to studies, most people who had the procedure had no problems associated with it. However, a number of undesirable effects may occur, including pain during treatment, redness of the skin and swelling of the leg, and bruising. Another theoretical concern is deterioration due to tearing of the plantar fascia or damage to tissue in the leg. Thus, the method requires additional research.
Various studies and trials have been conducted regarding other possible treatment methods for plantar fasciitis. Such procedures include botulinum toxin injections and radiation therapy. These funds are not widely available.
Application of a special splint
In some cases, there is benefit from wearing a special splint applied at night to keep the Achilles tendon and fascia slightly stretched. The goal is to prevent micro-tears in the fascia from healing overnight and causing shortening. In very difficult cases, sometimes a plaster cast is applied or a special removable brace is placed on the shins to allow walking. This provides rest, protection, shock absorption and mild stretch to the fascia and Achilles tendon. However, there is very limited data on the effect of using a splint for treatment.
Its use is considered appropriate in very complex cases. Surgery is usually only recommended if heel pain has persisted for a year, despite other treatments that have been tried. The surgery may also include removing a spur on the heel bone, if there is one. Surgery is not always successful. It can cause complications, so it should be considered as a last resort. Complications include infection, increased pain, injury to adjacent nerves, or even rupture.
Most people recover completely from this disease within a year. However, a number of treatments described above can speed recovery.
There are the following preventative measures that you can practice to avoid heel problems. Moreover, you should pay attention to them if you have already had this before. These include:
Heel pain is a rather unpleasant symptom; this disease can bother patients at any age. The reasons for this phenomenon are quite varied. And only by learning why the heel hurts can we understand how we can help ourselves and alleviate the condition. And in some cases, only a doctor can relieve pain.
Pain inside the heel can be bothersome for many reasons. Most often, unpleasant sensations are a consequence of heavy physical exertion, when a person is forced to spend the whole day on his feet, is overweight, due to improperly selected shoes or the presence of microtraumas. Symptoms such as numbness of the toes are also possible.
In addition, if your right heel or left heel hurts, this may be a sign of various diseases that need to be treated under the guidance of a doctor. If heel pain does not go away for a long time, a mandatory consultation with a doctor is necessary.
What to do if your leg hurts as a result of some disease? Of course, consult a doctor. But first you need to determine which disease caused the discomfort in the heel area. You can try to cope with this task yourself.
If the pain is caused by heavy stress on the heel or wearing the wrong shoes, here you can help yourself.
If you are overweight, and this puts a lot of stress on the bone and muscles of the heel, you need to get rid of those extra pounds. The most optimal diet is proper nutrition. And don’t forget about movement: walking or playing your favorite sport will help you lose weight and get rid of pain.
If you have problems with your heels due to wearing the wrong shoes, you need to choose comfortable shoes with a small, stable heel (up to 5 cm). Completely flat soles are not recommended. Wear orthotics or heel pads if necessary (good for fasciitis).
What to do if your heel hurts? You can apply cold to the sore spot for 20 minutes, rub with an anesthetic or anti-inflammatory gel.
In case of prolonged pain, it is better to consult a doctor.
The first thing the doctor will do is conduct a full examination and find out the exact cause of the pain. To relieve unpleasant symptoms, the doctor will prescribe anti-inflammatory and painkillers of local or general action.
Another good method for relieving heel pain is physical therapy. Electrophoresis, magnetic and radiation therapy, and laser are used.
If the cause of the pain lies in joint disease or infection, the main fight will be aimed at getting rid of this disease.
To relieve pain and relieve inflammation in tissues, you can resort to traditional methods of treatment.
If you spend a lot of time on your feet, try to rest more and do leg exercises. This will help reduce heel pain. If there is no positive effect after using folk remedies, you need to go to the doctor.
In veterinary medicine, bloating in a rabbit is called gastrointestinal stasis (GIS). This disease bothers animals quite often, since their digestive system has its own characteristics.
The rose is often called the queen of flowers for its beautiful delicate buds and persistent tart aroma. There are garden and indoor varieties of this plant, but all of them are distinguished by lush green foliage and a long flowering period.
We often encounter heel pain when walking, since our feet are subject to heavy loads throughout the day. Both adults and children can suffer from this disease.
There are many reasons for the appearance of pain in the heel area: from simple fatigue to the development of serious diseases. Therefore, if heel pain when walking does not go away for several days, despite a relaxing foot massage and the use of steam baths, you should consult a doctor for medical advice. And remember, the sooner the reason why your heel hurts and why it hurts to step is diagnosed, the sooner you can cure the disease.
Pain in the heels while walking may indicate the presence of serious diseases in the body.
The persistent feeling of pain in the heels knocks us out of the usual rhythm of life and work. Rarely does it go away on its own after a while. Taking a painkiller will only soothe the discomfort for a while, but will not relieve you of the disease. First of all, you need to understand that pain is a natural signal from the body that something is wrong and you need to pay attention to the painful area. People often think that their heels hurt when they walk, but this is only one of many reasons why their heels hurt.
Your heel hurts when walking - this could be a sign of:
If the pain does not subside within several days, this is a reason to consult a traumatologist or surgeon.
Corns are one of the most common causes of pain while walking.
If you feel that it hurts to step on your heel, you first need to examine the heel area for external damage.
Heels often hurt from walking. If there is no external damage, the pain is aching, dull, without localization in any specific place, accompanied by a slight burning sensation - these may be signs of fatigue.
In such cases, you need to steam your feet in a warm bath, clean them with a pumice stone, moisturize with cream and give a relaxing massage to your heels. For a while, give up high heels, pressing, hard shoes. If after two or three days the pain has not gone away, it means that the body is signaling not just fatigue, but also the presence of an inflammatory process or illness.
If the skin on the heel has become rough, has taken on a slightly yellowish or grayish color, has peeled off, the skin pattern is pronounced, the heel is burning or itching - this indicates a fungal infection. If there is no itching, most likely the cause of the pain is the formed corns - thickening of the top layer of skin due to the accumulation of keratinized, dead skin on the heel.
The formation of a convex, painful skin lump at the back of the heel can signal inflammation of the soft tissues, tendons, or the formation of a thorn (bone growth). If the bulge looks like a watery blister, this is a clear sign of a wet callus.
If the pain in the heel is localized mainly in one place, is sharp and is felt inside the heel when pressing, this may be a sign of the formation of a spur (a bone growth that grows on top of the heel bone and has a hook-shaped appearance, slightly raised towards the toes). In this case, the heel hurts when walking because the spur presses on the connective tissue (fascia), causing irritation and inflammation of the soft tissues. Usually the pain intensifies in the morning, sometimes reaching such a level that it is simply impossible to get up. The heel hurts every time you step after resting - also a clear sign of the formation of a growth.
If you are bothered by piercing pain of a localized nature, you need to undergo diagnostics for the presence of a bone growth on the heel
Very severe pain in the heel, redness, and swelling indicate inflammation of the soft tissues and fascia of the heel.
The feeling that the heel bone is “twisting” is one of the symptoms of arthrosis.
A burning sensation in the heel (usually in the bone area), worsening in the morning, redness, swelling, and an increase in local temperature may indicate a disruption in the functioning of blood vessels (erythromelalgia). The heel hurts when stepping, as well as at rest. There is increased sweating.
The most basic and most common causes and symptoms of heel pain are described above, but in reality there are many more of them. In addition, pain in the heels can be caused not only by a disease of this part of the body, but also provoked by other diseases, for example: flat feet, injury, curvature of the spine, diseases that are accompanied by poor circulation. It should also be understood that many diseases have similar symptoms; only a doctor can accurately determine the diagnosis, and the effectiveness of treatment depends on this. Self-medication may not only not help, but also cause irreparable harm to health.
The first need of any person is to relieve pain.
If burning and pain occur, first apply ice to the heel. This will immediately help block the sensitivity of the nerve endings for a while.
In most cases (except for the formation of watery calluses), a warm steaming foot bath will help to relax the heels, relieve inflammation and calm the pain.
To make a bath, you need to pour approximately 4 liters of warm water into a container, add shavings (or a piece) of soap to it and steam the legs. Decoctions of chamomile, St. John's wort, thyme, rose hips, sea salt, and baking soda have very good calming abilities - they can be added to the bath. You can also use fir and juniper essential oils. They help improve blood circulation and soften the skin of the heels.
Steaming baths with a decoction of medicinal herbs are not only a good cosmetic product, they are also widely used in the treatment of heel pain
After taking a bath, the heel must be cleaned and dried with a towel. After applying an anti-inflammatory pain relieving ointment, it will help relieve severe pain, inflammation and swelling. The following have a good effect in this area:
Among the folk remedies, honey, propolis, and gruel from fresh potatoes and beets have good anti-inflammatory and analgesic properties.
To soften keratinized skin, the following folk remedies are suitable:
To help deal with corns:
In addition, pedicure devices will help get rid of corns.
Also, during the treatment process, it is imperative to walk only in soft, comfortable shoes, preferably with orthopedic insoles.
If your heel hurts very much when walking, a relaxing massage will help, if the reason for this is fatigue and heavy workload.
You shouldn’t get up suddenly in the morning, as your muscles relax during the night and they need time to tone up.
If the pain does not go away, you should seek medical advice. The cause of painful sensations in the heels can be diagnosed using a simple examination, palpation, as well as X-ray diagnostics and tomography. Only with the help of the last two methods can you accurately determine why your heel hurts.
If the cause of pain is the formation of a bone growth, baths and ointments will help only in the first stage of the disease. For treatment in such cases, physiotherapy methods are widely used in the field of medicine:
Today, shock wave therapy is one of the most popular methods of treating bone growths on the heels.
In our time, surgical intervention is rarely resorted to, only in advanced cases, when other methods have failed to get rid of the growth or neutralize it. Therefore, the sooner you seek medical help, the sooner and more painlessly the treatment will take place, and you will walk again without pain.
Particular attention should be paid to the child. Since the child’s body is just developing, and the presence of inflammatory processes and injuries can lead to curvature of the gait and irreversible deformations of bone tissue.
It is better to prevent any disease than to spend time, considerable money and nerves on its treatment.
To prevent the appearance of painful sensations in the heels, you should try to adhere to the following rules:
Massage with a moisturizing cream helps relieve fatigue from the heels and prevent pain.
Heel pain is a fairly common symptom that has many possible causes.
Cause not caused by disease:
1. “Heel pain syndrome” can be caused by constant overstrain of the foot structures, which manifests itself as pain in the heel when walking. It can be caused by shoes with unusually high heels.
2. In addition, heel pain can appear as a result of thinning of the subcutaneous fat on the plantar surface of the foot in the heel area with a sharp increase in physical activity.
3. Stay on your feet for long periods of time during the day.
4. Recent rapid weight gain, obesity.
Heel pain should not be underestimated. In addition to the fact that they cause significant suffering and worsen the patient’s quality of life, heel pain can be one of the first symptoms of serious illnesses.
Ankylosing spondylitis (ankylosing spondylitis) is a chronic inflammatory disease of the spine and joints. The cause of ankylosing spondylitis is the aggressiveness of the immune system towards its own tissues of joints and ligaments. With this disease, “ossification” of the spinal ligaments, intervertebral joints and discs occurs. There is a gradual process of “fusion” of the vertebrae with each other, the spine loses its flexibility and mobility. In some cases, the very first symptoms of ankylosing spondylitis are pain in the heels, which makes standing on a hard floor very unpleasant. Without proper treatment, complete immobility of the spine can occur over several years, when almost all vertebrae fuse into one rigid bone structure.
Rheumatoid arthritis is one of the most severe joint diseases, occurring with many complications. The main symptoms of rheumatoid arthritis are pain, swelling and, as a result, limited joint mobility (including the joints of the foot, although this is an atypical location of the lesion). Pain may initially appear only when moving. In case of severe inflammation, pain can occur at rest, and it can even wake up the patient. In addition to joint pain, the patient complains of general weakness, fatigue, and loss of appetite.
Gout is a joint disease that is caused by the deposition of uric acid salts (urates). Acute pain, swelling and redness of a joint (usually one or two) occurs. A gout attack can last for several days or weeks (if no treatment is given). It occurs more often at night, the joint becomes hot to the touch and very sensitive even to light touches. The joints of the big toe are very often affected, but other joints (ankle, knee, foot, fingers and hand) can also be involved. In some cases, the tendons of the joint become inflamed at the same time.
2. Infectious diseases , including urogenital (such as chlamydia, gonorrhea, ureaplasmosis, etc.) and intestinal (dysentery, yersineosis, salmonellosis), occurring latently, can lead to reactive arthritis (including the joints of the heel bones). At the same time, heel pain often occurs not only when walking. In patients with reactive arthritis, the heels may hurt even at rest, at night. And sometimes it is at night that they hurt the most.
In addition, inflammation of the heels with reactive arthritis is often accompanied by inflammation of a number of joints and eyes, as well as discomfort in the genital area. Patients may note a connection between arthritis and a previous genitourinary or intestinal infection.
Bone tuberculosis (including the calcaneus). The disease begins either with the melting of the bone substance of the bone, or with the necrosis of large areas of the skin, and this process over time begins to spread over a larger and larger area. Regardless of the initial manifestations, tuberculosis of bones and joints causes the formation of a purulent fistula or cavity that opens outward. It should be noted that after a few weeks the inflammatory process can stabilize, and the patient enters a stable remission.
Osteomyelitis of the calcaneus is a purulent-necrotic process that develops in the bone and bone marrow, as well as in the surrounding soft tissues, caused by bacteria. At the beginning of the disease, a person may complain of weakness and muscle pain. Then the temperature rises sharply to 39-40 degrees. Pain, clearly localized in the affected area of the bone, occurs almost immediately. Sharp, boring or bursting from the inside, intensifying with the slightest movement - such pain is difficult to confuse with anything. The heel is swollen, the skin takes on a stagnant red color, and the veins are dilated.
Tendon sprain or rupture . The causes may be direct trauma (a blow to the tendon with a hard object) and indirect effects of a sharp contraction of the lower leg muscles. Usually, acute pain in the Achilles tendon area appears first. There is swelling in the tendon area. By palpation, a defect in the integrity of the tendon can be determined. Active plantar flexion is difficult or even impossible.
Bruising of the heel bone with further inflammation of adjacent tissues (for example, as a result of landing on your heels after jumping from a height). Such patients, as a rule, complain of burning pain under the heel, “as if a nail had been stuck there,” and the pain increases with weight on the heel.
Heel bone fractures are characterized by pain in the area of injury and the inability to put weight on the foot. The heel is deformed on the outer or inner side, the heel area is expanded, the foot is swollen, there are bruises in the heel area and on the plantar surface of the foot. The arches of the feet are flattened. Active movements in the ankle joint are sharply limited due to swelling of the soft tissues and tension of the heel tendon, and are impossible in the subtalar joint.
Sever's disease, or calcaneal epiphysitis , is a painful gap between the apophysis of the calcaneus and the body of the calcaneus. This condition usually develops during the period when complete ossification of the heel bone has not yet been completed. Typically, manifestations of this disease occur in people actively involved in sports, aged 9–14 years. Heel pain intensifies when running or fast walking. Standing on tiptoes is painful. In addition, there is a limitation of movements in the calf muscle of the leg. There is often some swelling and a local increase in temperature in the area of the avulsion.
4. Inflammatory diseases
Plantar fasciitis (sometimes called a heel spur) is a painful inflammation of the plantar fascia (the fibrous ligament on the bottom of the foot that helps support the arch of the foot). Plantar fasciitis occurs when there is stress or excessive stretching of the plantar fascia. The leading symptom is pain in the heel area, which occurs or worsens with exertion. Pain is more pronounced in the morning. The diagnosis of plantar fasciitis is established after analyzing the patient's complaints and physical examination. X-rays can rule out a stress fracture of the calcaneus and also identify the presence of heel spurs.
Osteochondropathy of the calcaneal tuberosity (Gaglund-Schinz disease). The basis of the disease is aseptic (sterile) necrosis (death) of areas of spongy bone that are under conditions of the greatest mechanical load. Pain in the heel appears when the patient is in an upright position immediately or a few minutes after resting on the tubercle of the heel bone; walking with support on the heel bone becomes impossible due to the unbearable nature of the pain. Patients are forced to walk, loading the fore and middle parts of the foot, using a cane or crutches. In most patients, skin atrophy, moderate swelling of soft tissues, and increased tactile sensitivity are detected on the plantar surface of the heel bone. Atrophy of the lower leg muscles often occurs.
Bursitis is characterized by all the classic symptoms of inflammation. Swelling, redness, and soreness appear on the back of the heel. The skin in this area becomes warm to the touch. The swelling gradually increases. With chronic inflammation, the swelling behind the heel may harden.
Achilles tendonitis is inflammation of the tendon. It can occur due to excessive stress on the Achilles tendon (overstrained calf muscles, frequent running uphill or downhill, a sharp increase in the amount of physical activity, for example, long-distance running); wearing uncomfortable shoes, frequently wearing high-heeled shoes and changing heels to flat soles every night. With tendonitis, pain occurs along the tendon, usually closer to the heel; swelling in the tendon area with a local increase in skin temperature, redness and increased sensitivity; pain when standing on your toes and jumping on your toes. Following a stressful condition, the inflamed Achilles tendon can rupture, which is often accompanied by a characteristic bursting sound. It is almost impossible to walk with a torn tendon. If you can't stand on your toes, you may have a tendon tear. This is a medical emergency.
5. Malignant tumors. As with other primary malignant bone tumors, the earliest symptom is pain in the area of the affected bone, initially passing, then constant with increasing intensity. As the disease progresses, swelling is detected in this area, becoming more and more noticeable. Depending on the tumor subtype, the soft tissue component may be hard or soft. With rapid tumor growth (as observed in children), cachexia and progressive anemia may develop. Pathological fractures are possible. Above the tumor there is sometimes a network of dilated blood vessels.
6. Neuropathy of the medial calcaneal branches of the tibial nerve. Manifestations of the disease consist of impaired plantar flexion of the foot and toes, as well as inward rotation of the foot. Sensation in the heel and sole area is impaired. With long-term damage to the tibial nerve, trophic ulcers develop in the heel area and foot deformity.
When examining patients with heel pain, complaints are important. In addition to pain in the heel, the patient may be bothered by pain in the joints of various locations, pain and the inability to fully move in the back, pain in the first toe, its redness and swelling, etc. Pay attention to the medical history (for example, previous foot injury, previous chlamydial infection, morning stiffness, etc.) and physical examination (for example, redness, swelling, dysfunction, fistulas, etc.). Together, these findings can lead to identifying the cause of your heel pain. If the diagnosis is not clear or requires confirmation, a laboratory and instrumental examination is performed.
1. Complete blood count (possible anemia, leukocytosis, increased ESR in rheumatoid arthritis, ankylosing spondylitis);
2. Biochemical blood test: increase in uric acid in gout;
3. Microbiological examination (for example, scraping from the urethra for chlamydia if reactive arthritis is suspected);
4. X-ray examination is one of the main examination methods for pain in the heel area. Specific changes characteristic of a particular pathology will be visible.
5. Testing for tumor markers in cases of suspected malignancy;
6. Serological analysis: rheumatoid factor in rheumatoid arthritis.
7. Puncture bone biopsy for suspected bone tuberculosis and osteomyelitis: material for culture is obtained by aspiration of pus from the bone or soft tissue, or a bone biopsy is performed.
The plan for further examination depends on the patient’s age and clinical manifestations. It should be especially thorough if pain in the heel area has been observed for a long time.
Since heel pain is a symptom, its treatment method depends on the cause or underlying disease.
However, to reduce pain and prevent its occurrence, regardless of the cause, you must follow some recommendations:
1. Fight against excess body weight. Excess weight increases stress on the foot muscles.
2. Wearing orthopedic insoles. Especially with flat feet.
3. Wearing comfortable shoes with a heel of no more than 5 cm. Shoes without heels are also not recommended.
4. Therapeutic exercises for legs daily.
To quickly reduce severe pain in the heel, you can apply a piece of ice to the aching area and hold the cold for 20 minutes; you can rub the heel itself and the area above it with an anti-inflammatory cream (for example, fastum-gel).
If heel pain has been bothering you for quite a long time and you cannot cope with it on your own, seek qualified help from a doctor.
Depending on whether there was an injury, doctors - a therapist, a traumatologist, an orthopedist. You may need to consult doctors of the following specialties: neurologist, surgeon, oncologist, phthisiatrician.
Pain in the heel while walking is a common symptom of various diseases or the consequences of traumatic factors, familiar to almost every person. This disease occurs more often in women than in men due to walking in high heels.
The heel, due to its anatomical structure and the presence of a dense layer of fat, is able to withstand enormous loads. But due to the spongy structure of the heel bone, the large number of nerves and blood vessels passing through it, it is very vulnerable and sensitive to injury or disease. Damage to many nerve endings leads to constant pain when walking, difficulty, and sometimes impossibility of stepping on the heel.
The heel acts as a kind of shock absorber when resting on the foot. It bears the bulk of the load while walking or standing. The heel is made up of muscles, ligaments, tendons, the heel bone, a thick layer of fat, a network of blood vessels and many nerve fibers.
The spongy calcaneus is the largest of the 26 bones of the foot skeleton. Located in the lower part of the posterior metatarsus. It has a laterally flattened and slightly elongated body, a clearly palpable calcaneal tubercle and two articular surfaces that serve for articulation with the cuboid bone in front, and with the talus above. In addition, there is a protrusion that serves as a support for the talus. It connects the bones of the lower leg and heel.
Pain when resting on the heel can occur due to many reasons, conditionally divided into several groups: factors not associated with any diseases; diseases with direct damage to the structures of the foot; diseases affecting the osteoarticular system; injuries.
Depending on the etiological factor, heels can hurt in different ways. The nature of the pain is burning, cutting, dull, shooting, aching. It is important to distinguish its features; this will help doctors determine the exact cause and prescribe adequate treatment. Pain can be either the initial manifestation of foot disease or one of the symptoms of a general disease.
Burning pain occurs with erythromelalgia and polyneuropathy. In the first case, hot weather or even sleeping under a warm blanket leads to pathological expansion of capillaries and blood vessels in the extremities, as a result of which a person suffers from a debilitating burning sensation not only in the heel, but throughout the entire foot. Sleep and mood are disturbed, and discomfort appears when walking. The skin in the heel area becomes red with a bluish tint. The only desire appears is to cool your feet by dipping them in cold water. In the second case, for example, with metatarsal neuralgia, compression of the plantar nerves results in sharp, burning pain spreading throughout the foot. Inflammation or injury to the tendon also results in acute, burning pain in the affected area.
Pain in the heel affected by fasciitis occurs when walking after sleep or rest, especially in the morning. It is so strong and unbearable that a person is forced to avoid stepping on the heel. At rest, the pain subsides or becomes dull, but at the slightest load on the heel it returns. The return of pain when walking is explained by repeated micro-tears of the inflamed and edematous aponeurosis, which grow together during the absence of a person’s motor activity.
With a heel spur, patients complain of a dull, aching pain in the middle of the heel that gets worse when walking. The pain can be different for everyone: periodic, when you step on your heel, or a constant aching, alternating with acute pain when walking. Often a person feels a “nail in the heel”. The hardest thing is for obese people. Due to obesity, the load on their legs is several times higher than that of people of normal weight.
Achilles tendinitis, ligament rupture, plantar fasciitis, and heel bruises are often diagnosed in athletes who run or those who are forced to sharply increase the systematic load on their legs.
Sharp, unbearable pain in the heel with the inability to support it appears when the heel bone is fractured. Traumatologists know that the period of bone fusion and recovery period is very long. Even after the cast is removed, the patient cannot fully step on the injured heel for a long time.
Damage to the joints of the foot, accompanied by pain of varying intensity, occurs with rheumatoid arthritis, ankylosing spondylitis, and some systemic autoimmune or infectious diseases. Diabetes mellitus leads to impaired trophic tissue of the feet, manifested by painful cracks and ulcers on the heels.
If you have heel pain, you should consult a rheumatologist or orthopedic traumatologist. You may need to consult other “narrow” specialists - an oncologist, an infectious disease specialist, a surgeon or a neurologist.
The scheme of diagnostic measures is determined after a physical examination of the patient. Collecting anamnesis and complaints to determine the presence of chronic or recently suffered diseases, a visual objective examination with palpation of the painful area allows the doctor at this stage to make a preliminary diagnosis and prescribe the necessary examinations, the results of which will serve as the basis for confirming or excluding the suspected pathology.
Pain in the heel bone area is a symptom of some pathological condition or underlying disease. Based on this, the treatment method is selected. But first, the patient must adhere to general recommendations:
When heel pain is not associated with injury, the disease is treated mainly with the help of conservative therapy. If pain is a consequence of an underlying disease, then the emphasis is on its treatment, and depending on the disease, therapy has its own nuances: for urogenital infections, antibiotics are prescribed to eradicate microorganisms; for rheumatoid arthritis, non-steroidal anti-inflammatory drugs and corticosteroids are used; Bone tuberculosis is treated with antibiotics and synthetic anti-tuberculosis drugs.
Treatment of plantar fasciitis:
For certain pathologies accompanied by constant pain in the sole of the foot, orthoses (braces) or splints are often used. For fractures of the calcaneus, a plaster splint is applied to the leg from the knee to the toes for immobilization for a period of 3 to 8 weeks.
Among the physiotherapeutic procedures, in addition to electrophoresis, shock wave therapy, magnetic and laser therapy, ultrasound, phonophoresis, and UHF are effective. Manual therapy and massage also help.
Surgical treatment is indicated for severe pathologies that cannot be eliminated by drug treatment. The operation is performed for tendon ruptures, in some cases to remove heel spurs, etc.