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Reactive arthritis of the heel

22 Sep 18

Symptoms, causes and treatments for heel arthritis

Modern medicine identifies approximately 100 different joint diseases, which are accompanied by pathological processes in them. One of the most common joint diseases is arthritis. It can affect any joint: hip, elbow, knee, subtalar, talocaleonavicular, etc. In the latter case, arthritis of the heel is diagnosed.

Heel arthritis: the essence of the problem and symptoms

Regardless of location, arthritis is an inflammatory process that occurs in the joint. The joints of the lower extremities, particularly the feet, are commonly affected by rheumatoid arthritis. Heel arthritis is a lesion of the subtalar and talocaleonavicular joints of the foot and the ligaments connecting the heel to the phalanges of the toes.

The subtalar joint is located in the posterior part of the talus and calcaneus. It has the shape of a spiral or cylinder. The axis of rotation is in the sagittal plane. The joint is surrounded by a thin capsule with ligaments. In the anterior section between the calcaneus and talus bones there is a ball-shaped talocaleonavicular joint. It is formed as a result of the connection of the head of the talus, calcaneus and navicular bones.

Both of these joints are an inextricable joint: their movements are functionally interconnected and have a common axis of rotation, which passes through the calcaneal tubercle and the head of the talus. It is around this axis that supination and pronation of the entire foot occurs. These joints are strengthened by the interosseous talocalcaneal ligament.

In addition, not only the heel bone and its joints are damaged, but also the tissue that connects this bone with the phalanges of the fingers. In this case, the inflammatory process affects the entire foot.

Heel arthritis is nothing more than an inflammatory process that occurs in one or both joints.

Symptoms of heel arthritis

The inflammatory process causes very discomfort in the sick person. At the beginning of the development of the disease, a person simply experiences unpleasant sensations, but as the disease progresses, these symptoms become painful. Over time, if no attempts are made to heal, the pain becomes very strong, aching, and constant. In this case, painful symptoms first appear only after prolonged physical activity, which largely affects the foot and heel, in particular.

Then, as the disease progresses, pain symptoms occur with minor exertion and even at rest, in the morning. A person subconsciously tries to protect the heel from stress: transfers weight to the front of the foot, tries not to step on the heel, etc. If at this stage the patient does not take any therapeutic measures, then arthritis of the heel often develops into other chronic diseases that cause much more problems and suffering. For example, such a disease is a heel spur, in which the pain is simply unbearable, and the person would be glad to, but cannot even step on the heel. Many people who suffer from spurs are forced to get around with the help of crutches.

All this indicates that heel arthritis must be treated as soon as a person notices the first symptoms of the disease: quickly onset fatigue, aching pain in the heel, even minor ones.

Heel arthritis: causes of the disease

The reasons for the development of the disease are the same as for any other type of arthritis. The most common of them are the following:

  • Excessive stress on the joints in the heel area.
  • This is usually a problem for overweight people and professional athletes, since the load on the feet is many times greater than the permissible norm established by nature. In addition, inflammation can also begin in an amateur athlete if he begins active training on “cold” muscles and joints.

    • Joint injuries.
    • Injury to the joints in the heel area can also lead to an inflammatory process in the future, that is, heel arthritis.

      • Features of biomechanics of the lower extremities, deformation.
      • For example, in cases of deformation of the legs (and feet in particular), arthritis may develop. And not only the heel, but also in the area of ​​the knee joint. This occurs due to the uneven distribution of load on the feet when moving.

        • Wrong lifestyle.
        • Poor diet and smoking have a detrimental effect on joints. Junk food contributes to weight gain, which is an additional risk factor for arthritis. Smoking negatively affects the joint fluid and its “lubricating” property. An inactive lifestyle can also contribute to the development of the disease. Here you need to be able to find the optimal balance between excessive stress during sports and the lack thereof: everything is good in moderation.

          Long-term studies have identified categories of people who are at increased risk:

          • Women, especially those who prefer high heels.
          • Women themselves are more prone to this disease than men. If a woman regularly wears high-heeled shoes without giving her feet rest, then she risks many times more. High-heeled shoes should not be worn for more than 4 hours at a time if you do not want to have problems with joints and veins in the future.

            • People who work in certain fields of activity.
            • Joint disease can be of an occupational nature, when for a long time the same joint (or group of joints) has been subjected to constant excessive impact: pressure, compression, etc.

              Treatment Methods for Heel Arthritis

              At the first signs of arthritis or after a final diagnosis, you should completely rely on your doctor. You should not self-medicate. The doctor selects a course of treatment strictly individually for each patient. Only in this case can you count on a positive result. Modern medicine has a wide range of techniques that help people recover from illness or significantly alleviate their condition. Activities must be carried out comprehensively.

              • Drug therapy.
              • Drugs are prescribed primarily to reduce pain symptoms. For this purpose, the doctor may prescribe ointments or gels that are rubbed directly into the affected area. If the disease has not progressed too far, the effect can be achieved within 2 weeks. In more severe cases (for example, if arthritis has caused a complication in the form of a heel spur), injections are prescribed that are made directly into the heel. This method is very painful, but also effective: after just 2 injections, relief comes.

                • Physiotherapy.
                • Physiotherapy is very popular and effective in the treatment of joint diseases. Thus, patients are usually prescribed electrophoresis, magnetic resonance, laser or shock wave therapy. A single procedure may be prescribed or several procedures may be combined at the same time.

                  • Physiotherapy.
                  • All exercises from the gymnastics complex are aimed at improving and normalizing blood circulation in the affected joint. In addition to physical therapy, swimming and various exercises on the water give very good results.

                    • Massotherapy.
                    • A special massage is aimed at improving blood circulation in the sore limb and gradually developing the affected joint. Only an experienced specialist should perform a massage so as not to aggravate the situation and cause even greater inflammation of the joint.

                      Diet for patients diagnosed with heel arthritis

                      Proper nutrition is extremely important for joint health. There is a special diet designed for people with arthritis and other joint diseases. It is a must for those who want to cure the disease as best as possible. The diet is aimed at:

                      • Normalization of weight.
                      • Strengthening the musculoskeletal system.
                      • Healthy joints.
                      • Elimination of pain symptoms.
                      • Deficiency of certain microelements and vitamins may well lead to arthritis. Therefore, it is very important to establish a balance of substances and vitamins necessary for healthy joints. These include:

                        • Protein.
                        • It is a building material for joints. It is its deficiency that leads to various disorders associated with joint fluid and pain. The largest amount of protein is found in dairy products (lean cottage cheese, milk, natural yogurt), fish and poultry. Omega-3 fatty acids are especially necessary for people diagnosed with rheumatoid arthritis.

                          • Vitamin C.
                          • This vitamin is extremely important as it is involved in the production of collagen. In turn, collagen is the basis of all building substances in joints. Therefore, the diet of a patient with arthritis should be rich in foods high in vitamin C: tomatoes, strawberries, sauerkraut and cauliflower, lemons, oranges, spinach - this is a list of foods that are richest in this vitamin.

                            • Calcium.
                            • Without calcium, a strong skeletal system is impossible. The following foods are rich in calcium: apricots, apples, strawberries, grapes, blackberries, peaches, currants, gooseberries, pineapples, oranges, carrots, cucumbers, beets, onions, radishes, cherries, honey, all green vegetables, legumes and wheat grains, celery, milk, bran, cheese, eggs.

                              A balanced diet will not only improve the health of the body as a whole, but can actually quickly relieve joint pain and increase the therapeutic effect of the measures prescribed by the doctor for the treatment of arthritis.

                              Symptoms and treatment of heel arthritis.

                              Since ancient times, when a person rose to his feet from all fours, he was forced to pay for walking upright. Since the load on the lower extremities is great, various pathological conditions often arise in the legs. One such disease that is quite common is heel arthritis.

                              The foot is an excellent shock absorber, allowing you to move, jump and run painlessly and easily. The largest bone of the foot is the calcaneus; it is connected to neighboring bones by small joints, the mobility of which, together with the structural features of the tendons and muscles, holds the arch of the foot and provides shock-absorbing properties. It is these joints that are most often affected by arthritis.

                              The incidence of heel arthritis is no more than 0.1%, however, among the entire group of arthritis, this is the most common disease. The disease affects the working population aged twenty to forty years.

                              Inflammation of the heel and adjacent tissues occurs under the influence of various factors: hereditary, immunological, infectious, metabolic disorders. Accordingly, among heel arthritis we can distinguish:

                            • reactive arthritis;
                            • metabolic (gouty);
                            • psoriatic arthritis;
                            • rheumatoid arthritis (usually seropositive);
                            • ankylosing spondylitis (ankylosing spondylitis).
                            • That is, the heel can be affected by any type of arthritis. Most often (in seventy percent of cases) reactive arthritis occurs - aseptic inflammation of the heel, affecting not only the joint, but also surrounding tissues. It is usually associated with previous infections caused by chlamydia and E. coli.

                              Predisposing factors leading to arthritis may be:

                              • excess weight;
                              • heavy physical activity;
                              • previous infectious diseases of the genitourinary system and gastrointestinal tract;
                              • injuries of the heel bone and tendons;
                              • poor diet, drinking alcohol and smoking.

                              The onset of the disease may be gradual. After suffering from an acute respiratory viral infection or intestinal infection, pain in the heel appears two weeks or a month later. Sometimes the infection can be asymptomatic and it is impossible to trace a clear relationship.

                              The patient is bothered by severe pain, sometimes not only during exercise, but also at rest. The general body temperature may increase, minor catarrhal symptoms and conjunctivitis may occur. The lesion is often symmetrical, swelling is detected, and there may be skin hyperemia. It hurts to step on the foot, so the patient spares the foot, trying to lean on the toe, limping. The patient complains of a stabbing pain, a “nail” sensation that does not go away even at rest or at night. Sleep is disturbed.

                              Based on the severity of symptoms, there are four stages of heel arthritis:

                              Changes in the joints may be accompanied by various extra-articular symptoms. In the case of reactive arthritis, these are lesions of the eyes and urogenital area (conjunctivitis, cystitis, urethritis). In the case of autoimmune conditions, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis - skin lesions characteristic of these diseases, myocarditis, pleurisy, nephritis.

                              Diagnosing heel arthritis is not so difficult; it is more important to determine the cause leading to damage to the joint. The tactics of further treatment depend on this. Making a diagnosis begins with interviewing the patient, identifying complaints, and examination.

                              The most important examination for heel arthritis is X-ray diagnostics. It allows you to identify characteristic changes in the bone and adjacent muscles and fascia, the degree of deformation and the stage of the disease. The X-ray image clearly shows the loss of bone tissue, the formation of additional growths accompanying arthritis of the heel and traumatic tendons. Magnetic resonance and computed tomography are considered effective diagnostic methods. MRI allows us to detect pathology not only of the joint, but also of the surrounding soft tissues: tendon ruptures, tumors, injuries, etc.

                              All patients must undergo a laboratory examination: a general blood test reveals signs of the inflammatory process (leukocytosis, increased ESR, neutrophil shift, possible anemia), a general urine test determines the presence of pathology of the urinary system (leukocyturia, protein in the urine, salts, microhematuria). Immunological studies (PCR diagnostics) make it possible to obtain data on the presence or absence of antibodies to infectious agents (chlamydia, mycoplasmas, etc.), rheumatoid factor, and immune complexes. For analysis, not only blood serum is used, but also synovial fluid.

                              Biochemistry will help determine C-reactive protein, Antistreptolysin-O, sialic acids, seromucoid, the amount of uric acid, etc.

                              Ultrasound scanning, electrocardiography, microbiological tests to identify the pathogen (cultures from the eyes, genitals, urethra, etc.) are used as additional instrumental diagnostic methods for heel arthritis.

                              Helping a patient with heel arthritis involves more than just providing medication support. Therapy should be comprehensive, aimed at eliminating the cause, alleviating symptoms and restoring function.

                              In the case of reactive arthritis, the first group of medications are antibiotics. They are selected taking into account the identified pathogen and its sensitivity. The most commonly used are macrolides (erythromycin, azithromycin), fluoroquinolones (levofloxacin) and tetracyclines. If ineffective, cephalosporins of at least third generation (ceftriaxone) may become the drugs of choice. If heel arthritis is caused by an autoimmune process, then basic treatment with cytostatics and immunosuppressants is indicated.

                              Symptomatic treatment is aimed at relieving pain, reducing inflammation, stopping extra-articular manifestations, and removing general intoxication. The drugs used for these purposes can be used for any type of arthritis. These are non-steroidal anti-inflammatory drugs (NSAIDs), analgesics and glucocorticosteroids. They can be used not only internally or as injections, but also topically as ointments, gels, and compresses. If NSAIDs are ineffective, hormonal drugs (Diprospan, Kenalog) can be injected into the joint. This is especially indicated in the third and fourth stages of the inflammatory process, when drug treatment is aimed at maintaining the condition and reducing pain. Vitamins and chondroprotectors (arthra, inoltra, chondroxide) that restore cartilage tissue are indicated in the first two stages, when joint destruction has not yet occurred and the process is reversible. In the future, with significant deformations, taking these medications does not make sense. Alternative therapies play an important role in the treatment of heel arthritis. This includes massage, physical therapy, physiotherapy, and orthopedic aids.

                              In the acute period, the legs need to be provided with rest and the load removed. Exercises and physical therapy should begin in the attenuation phase, when the main symptoms have already been relieved. Therapeutic physical education is selected individually, begins with gentle exercises, with a gradual increase in load. Manual therapy and various types of massage are indicated. The physiotherapy provided includes: electrophoresis with drugs, diadynamic currents, amplipulse, ozokerite and paraffin applications. Laser is considered an effective treatment method.

                              Orthopedic insoles, heel pads, and special pads reduce the load on the heel, help reduce pain, help bring the foot into the correct position and support the arch. In critical situations, complete immobilization of the limb is used by applying a plaster splint.

                              Surgical intervention is used only in extreme, advanced cases when contractures have developed. Usually used very rarely.

                              Equally important in the complex of therapeutic measures is proper nutrition. And although it is necessary to fight excess weight, you should never go hungry. The diet must be complete and contain sufficient amounts of vitamins and minerals. Alcoholic and carbonated drinks, products containing preservatives, dyes and artificial flavors should be avoided. Marinades, pickles and smoked foods are prohibited. Food should be boiled, steamed, stewed or baked. It is not recommended to eat fatty meats, sausages, margarine, tomatoes, and eggplants.

                              The patient should receive a sufficient amount of calcium-rich foods - kefir, cottage cheese, Varenets, mild cheeses. Eating fish and plenty of vegetables is also beneficial. To restore cartilage tissue, dishes containing natural chondroprotectors are well suited: jellied meat, aspic, jelly, etc. It is necessary to limit sugar, chocolate and other sweets. Replace them with fruits and freshly squeezed fruit juices.

                              Treatment with folk remedies

                              1. Pour lilac flowers with alcohol in equal proportions. Leave in a dark place for at least a week. Use the tincture for rubbing or compresses.
                              2. Mix a teaspoon of salt with a tablespoon of honey, add 50 ml. Yoda. Lubricate the heel at night.
                              3. Bring one hundred grams of honey to a liquid state in a water bath, add five grams of mumiyo. Use as a lubricant or compress. Use if you are not allergic to bee products.

                              It is impossible to completely protect yourself from heel arthritis, because the load on each person’s feet is great. However, following some rules will keep your feet healthy for a long time. First of all, it is maintaining a healthy lifestyle, giving up alcohol and smoking.

                              An important role in prevention is played by maintaining personal hygiene, sanitizing chronic foci of infection, wearing the right shoes, regular exercise and self-massage of the feet.

                              Remember that it is easier to prevent the onset of a disease than to cure it.

                              Table of types of heel arthritis - symptoms and treatment

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                              Arthritis is an inflammatory disease of the joints. Damage to the joints of the lower extremities often occurs as a result of rheumatoid arthritis. Depending on the symptoms of heel arthritis, treatment is selected by a qualified doctor after a comprehensive diagnosis of the patient.

                              Heel arthritis affects the subtalar joints - the articulations of the lower surface of the talus and heel bones.

                              Among the provoking factors that can trigger the development of the disease are excess body weight, a sedentary lifestyle, poor diet, exposure to poor environmental conditions, and abuse of bad habits. Europeans and Americans are more susceptible to developing this disease.

                              Arthritis can be infectious, traumatic, dystrophic. Cases of reactive arthritis have also been reported. If one joint is affected, this indicates the occurrence of monoarthritis; if several are affected, the doctor diagnoses the development of polyarthritis. There are acute and chronic course of the disease:

                            • In acute cases, inflammatory processes develop sharply, are accompanied by intense pain, and body temperature rises.
                            • Chronic processes are accompanied by a slow course with gradual progression.
                            • There is often a transformation from the acute to the chronic form.

                              According to statistics, more than 10% of people who play sports professionally are susceptible to heel arthritis. Symptoms appear depending on the stage of development of the pathological process:

                            • At the first stage of the disease, pain is completely absent; sometimes there are complaints of discomfort after waking up, as well as during walking. Rent reveals that the heel bone has thinned slightly. Timely initiation of therapy allows the inflammatory process to be completely eliminated.
                            • The cartilage pad gradually decreases, and complaints of pain impulses arise. The process of deformation of the heel joint begins, and the progression of destructive processes is observed. Transformation of arthritis into a chronic form, treatment helps to increase the duration of remission.
                            • Alarming symptoms in the form of intense pain, motor activity is difficult. There is swelling of the feet and legs. X-ray results demonstrate significant degenerative changes in the joint tissues. Treatment helps eliminate symptoms and prevent the transformation of arthritis into stage 4.
                            • Patients lose the ability to move independently, the affected joints swell, and symptoms in the form of intense pain constantly bother them. The articular tissues of the heel degenerate, and irreversible deformation of the heel bones occurs. Conservative treatment methods are ineffective and help to temporarily eliminate the symptoms of arthritis.
                            • Treatment is selected taking into account the stage of development of arthritis, emerging symptoms, and the presence of additional disorders.

                              3 exercises for heel pain

                              Signs of heel arthritis manifest themselves in the form of complaints of pain and impaired motor activity.

                            • The leading symptom of arthritis is the development of arthralgia - joint pain with a stable, wave-like character, with a tendency to intensify at night and in the morning.
                            • The pain can be mild or severe, significantly limiting physical activity.
                            • The development of fever and chills is observed with an infectious type of disease.
                            • Local symptoms: affected joints become hot to the touch, swollen, and mobility is limited.
                            • Psoriatic arthritis affects the toes and heels, which also causes symptoms: pain, limited mobility.
                            • Patients may complain of a feeling of weakness and the development of malaise, which is associated with overwork.
                            • Feeling gradually worsens, and daily activity and functioning decrease.
                            • In severe cases, the limb is completely immobilized.
                            • There are other symptoms: the skin at the site of the inflammatory process may change, and the development of exostoses - benign bone outgrowths - is observed.

                              To make an accurate diagnosis, a face-to-face examination, an oral interview with the patient, and laboratory and instrumental research methods are used. For example:

                            • X-ray.
                            • Rapid test for rheumatoid factor.
                            • Magnetic resonance imaging.
                            • Arthrography.
                            • Ultrasonography.
                            • Radionuclide scintigraphy.
                            • Arthroscopy.
                            • The joint fluid is also examined.

                            Be sure to consult a rheumatologist in order to exclude or confirm the rheumatic nature of the disease.

                            Heel arthritis is treated depending on the cause that triggered its development, as well as the degree of the disease. Self-medication is unacceptable, as it can worsen the clinical picture of the disease and provoke complications. An integrated approach includes elements of pharmacotherapy, physiotherapy, and lifestyle correction. Be sure to use massage and physical therapy in order to prevent contracture and functional disorders.

                            Subacute and chronic course of the disease requires the use of medications with analgesic and anti-inflammatory effects. Patients are recommended drugs from the NSAID group: Meloxicam, Nimid, Denebol, as well as hormonal drugs with pronounced anti-inflammatory properties based on prednisolone and methylprednisolone. The doctor determines the dose and duration of treatment individually.

                            Elements of physiotherapy can provide analgesic and anti-inflammatory effects, help prevent the development of fibrotic changes and dysfunction of joints. Doctors recommend that patients undergo phonophoresis with corticosteroids, electrophoresis with painkillers, and light therapy with ultraviolet lamps.

                            During the recovery period, mud therapy, balneotherapy, and resort treatment are recommended.

                            Nutrition during and after illness

                            The diet should be balanced and varied. Reduce or completely eliminate the consumption of meat and animal fat. Significantly limit sugar and salt, exclude smoked meats, marinades, carbonated drinks, canned goods. Fruits, vegetables, herbs, and grains are introduced.

                            In order to compensate for the lack of essential vitamins and microelements, doctors may recommend taking vitamin complexes.

                            Folk remedies are used as an auxiliary element in order to reduce symptoms and slow down the progression of arthritis. Compresses with buttercup flowers, potato tincture, apple cider vinegar, and decoctions of bay leaves are used. Patients with gastrointestinal dysfunction are advised to refrain from taking vinegar internally.

                            To relieve pain using folk remedies, the use of juices is recommended: carrot, beet, cucumber, spinach, salad.

                            In order to reduce symptoms in the form of pain, drink juice from apples, grapefruits, turnips, and honey.

                            To prevent the disease it is recommended:

                          • Give preference to proper nutrition.
                          • Bring your weight back to normal.
                          • Do not create excessive loads.
                          • In case of traumatic diseases, it is necessary to contact a surgeon or traumatologist. Traumatic arthritis may not appear for many months or even years, while the pathological process progresses.
                          • Affected joints benefit from warmth.
                          • It is also recommended to give preference to moderate physical activity, physical therapy, and massages.

                            Patients with arthritis should be under constant medical supervision.

                            In the vast majority of patients, the cause of arthritis development is infectious processes. In other cases, the impact may be caused by age-related changes, allergic reactions, immune disorders, and psychological imbalance. Arthritis often develops due to natural wear and tear of joint tissues. Among the main reasons are the impact of:

                          • A number of diseases: tuberculosis, gout, gonorrhea.
                          • Alcoholic drinks.
                          • Toxic substances.
                          • Congenital joint injuries.
                          • Hereditary predisposition.
                          • Hormonal disorders (women during menopause form a risk group).
                          • Excess body weight, creating excess stress.
                          • Traumatic lesions that provoke chronic inflammatory processes in the joints.
                          • When exposed to infectious diseases provoked by bacteria, viruses, fungi, the body's natural defenses are triggered. A malfunction occurs, the cells of the immune system eliminate not only pathogenic microorganisms, but also joint tissues.
                          • Taking into account the causes of the pathological process, various types of arthritis are distinguished:

                            — Primary arthritis is diagnosed when an infectious pathogen enters the body through open wounds.

                            - Secondary arthritis develops under the influence of gonorrhea, tuberculosis, dysentery, chlamydial, viral, gonococcal infections.

                            — The following symptoms are observed: development of a feeling of pain, gradual destruction of bone tissue.

                            — Accompanied by chronic inflammation of the joints and corresponding symptoms.

                            — Exacerbation is accompanied by partial or complete loss of ability to work.

                            — The risk group consists of middle-aged and elderly people.

                            - Also found under the name Still's disease.

                            — The risk group consists of people under 17 years of age.

                            — The disease is chronic and constantly progressive.

                            — In severe cases of the disease, internal organs are affected, which can cause disability.

                            — Uric acid gradually crystallizes and provokes the development of an inflammatory reaction.

                            — There is a gradual destruction of cartilage tissue, which provokes symptoms in the form of intense pain and impaired mobility.

                            Arthritis of the heel, calcaneal joint

                            Arthritis (an inflammatory process in the tissues of the joint) can affect almost all the bones in the human skeleton. One of the places where it is localized is the heel. The type of arthritis that affects this joint is called reactive arthritis or rheumatoid arthritis. It develops gradually and has 4 degrees, differing in symptoms and effects on the condition of the heel bone and joint tissue. Treatment depends on the phase of the disease.

                            In grade 1, reactive calcaneal arthritis occurs almost unnoticed. The onset of the inflammatory process does not cause severe pain or external manifestations. Minor pain is possible after long walking and during sleep. If an X-ray examination is performed in stage 1 of the disease, a slight thinning of the bone will be visible. Treatment at this stage will bring maximum effect, but timely contact with a specialist when the symptoms do not cause serious concern is quite a rare case.

                            In degree 2, active changes in the heel joint begin with a decrease in the cartilage pad and severe pain, worsening at night. An active inflammatory process in the heel bone causes swelling and redness of the joint area. An x-ray of the heel in stage 2 arthritis will reveal a clear change and deformation of the affected bone. The symptoms cause serious discomfort and in most cases force you to seek qualified medical help. Treatment carried out at this stage is no longer able to cure the disease, but can help slow down the development of the disease and reduce pain.

                            In grade 3, rheumatoid calcaneal arthritis causes almost complete deformation of the joint, accompanied by severe pain and limited motor function. The area at the junction of the foot and lower leg bone swells and swells. Pressure on the heels is accompanied by sharp pain. Walking independently without the use of aids becomes almost impossible. In grade 3, the x-ray fully shows joint tension and severe degenerative changes. Symptoms and consequences make it possible to assign a disability. Treatment comes down to pain relief, reducing exacerbations and delaying the transition to the last stage as much as possible.

                            In grade 4, reactive calcaneal arthritis leads to complete loss of the ability to move independently. Irreversible changes in bone and joint tissue cause permanent pain, swelling and deformity. If the disease is localized in both heels, a wheelchair is the only way to move for the rest of your life. Treatment can alleviate the patient’s condition, but it is no longer possible to restore lost functions. In grade 4, the x-ray shows the degeneration of joint tissue and irreversible bone deformation.

                            Excess weight leads to arthritis

                            Reactive (rheumatoid) arthritis of the heel joint can be caused by several factors:

                          • Genetics. Congenital joint deformities with age can provoke the occurrence of arthritis in any part of the skeleton.
                          • Accompanying illnesses. Arthritis in the heels can be the result of an infection or previous injury to the ankle. Coxarthrosis, which causes a decrease in bone strength, can also trigger reactive arthritis of the heel area.
                          • Metabolic imbalance. The increased content of purines, which promotes the deposition of uric acid salts (urates) in the bones, makes it difficult to fully supply blood and nourish the joint for self-healing. The inflammatory process and tissue changes begin, gradually increasing with the transition of arthritis from 1st to 2nd, 3rd and 4th degrees of disease development.
                          • Smoking, alcohol abuse, unhealthy diet. When several factors coincide, the development of grade 1 arthritis in the heels can be provoked. Subsequently, they contribute to the accelerated progression of the disease from 1 to 2, 3 and 4 degrees in a short period of time. All symptoms will be exaggerated, and treatment will have less positive effect.
                          • Physical overload. Professional activities or strength sports that cause regular overstrain of all ankle joints with maximum load on the heels.
                          • Excess weight. Excess weight causes inconvenience to almost all organs and systems, but it is in the heels that the maximum impact is concentrated due to the peculiarities of the human structure. It is this reason that can multiply all the negative consequences of arthritis of the heel joint, even in the initial 1st degree. It accelerates the irreversibility of joint deformation in stages 2, 3 and 4 of the disease. Bringing weight back to normal is a necessary condition for treatment to produce results.
                          • Nervous overstrain. A large number of nerve endings pass through the heel, which makes it susceptible to the negative effects of stressful situations and can cause inflammation of the joint.
                          • Pain in the heel joint is a clear sign of arthrosis

                            Rheumatoid (reactive) arthritis localized in the heels has certain symptoms that intensify with the transition from 1 to 2, 3 and 4 degrees of damage.

                          • In grade 1, minor pain begins when walking and overexertion. There are no external signs of deformation. There may be slight swelling in the area where the heel meets the ankle.
                          • In grade 2, the pain increases sharply, not stopping at night. There is redness of the skin in the heel area, swelling and swelling of the joint. The deformity begins to change the appearance of the joint. The size of the heel bone increases. Motor activity becomes difficult.
                          • In grade 3, the deformity actively progresses with increased pain and swelling. The bones practically turn out, the ability to move independently is lost.
                          • In grade 4, changes in the heels become irreversible, causing severe constant pain and swelling of the heel area. Possible fusion of the heel bone. If the disease cannot be stopped at stages 1, 2 or at least 3, disability is inevitable. A constant inflammatory process negatively affects the general condition of the body.
                          • If you experience heel pain that does not go away over time, you should consult a doctor for an accurate diagnosis. It makes no sense to self-medicate - this can lead to a worsening of the condition. Heel arthritis responds well to treatment in grade 1, but with the progression of the disease and increasing bone deformation (grades 2, 3, 4), the chances of recovery rapidly decrease. Therefore, timely diagnosis of symptoms and treatment of arthritis is so important before changes in the joint become final. The doctor prescribes a comprehensive examination, including several methods.

                            Diagnosis of arthritis of the heel joint

                            • X-ray. An image of the heel bone in several projections can reveal changes even in the initial 1st degree. During the treatment, x-rays are performed regularly in any degree of arthritis development: in 1, 2 and 3 - to monitor the treatment process; in 4 – to confirm the irreversibility of changes and determine the disability group.
                            • Blood analysis. A strong inflammatory process, characteristic of any arthritis, including the heel joint, causes leukocytosis. Its presence confirms the development of the disease.
                            • Puncture. In some cases, to completely eliminate the error, a sample of synovial fluid is taken. This test confirms or refutes the presence of changes in the composition of joint tissue and the intensity of inflammation.
                            • Treatment of arthritis in the heel area is carried out according to the method of treating all diseases of this group and depends on individual indicators and the degree of development of the disease. The treatment complex includes several methods of influence to achieve the best result:

                              Drug treatment

                              Anti-inflammatory and painkillers are prescribed. In case of exacerbation, antibiotics may be used. Additional intake of chondroprotectors to restore joint tissue makes sense only in the initial stages of the disease (1 and 2). Complexes of vitamins and microelements are prescribed to maintain immunity and alleviate the general condition. The use of external agents, in the form of ointments and rubs, helps reduce inflammation, swelling and reduce pain.

                              A Balanced Diet Boosts Arthritis Treatment

                              The diet helps restore metabolism and improve the condition of affected joints. Eliminating purine-rich foods and building a menu that takes into account the body’s needs helps alleviate the condition and helps curb the negative manifestations of arthritis. General recommendations for catering have been developed.

                            • Exclusion of alcohol, strong and carbonated drinks.
                            • Refusal to eat fatty foods, especially fried ones.
                            • Exclusion of preservatives, smoked products, semi-finished products.
                            • Preference to lean unrefined oils.
                            • Consuming plenty of fresh vegetables, fruits and freshly squeezed juices.
                            • Drinking large amounts of liquid: infusions, decoctions, juices.
                            • Outside the acute stage, procedures are used to help relieve the inflammatory process, reduce pain and improve the motor functions of the heel joint.

                            • Mud therapy. Regular baths with therapeutic mud.
                            • Electrophoresis. Exposure to electric current to deliver drugs directly to the affected area.
                            • Laser procedures. They influence the inflammatory process, improving the condition of the joint.
                            • Massage. Regular kneading improves blood circulation and increases the supply of necessary substances to depleted joint tissues.
                            • Gymnastics. Strength-based exercises help restore mobility and maintain motor ability.
                            • The most important thing in the treatment of heel arthritis is timely seeking qualified help and compliance with medical prescriptions. Our body deserves careful, careful treatment.

                              Symptoms of heel arthritis

                              Arthritis is the most common joint disease. It can occur anywhere: from the heels to the shoulders. The disease is an inflammatory process that occurs at the junction of bones. With arthritis of the heel, there is an impact on the subtalar and talocalcaneal-navicular joints, the function of which is to connect the heel with the phalanges of the fingers.

                              Features of the course of the disease

                              When arthritis of the heel appears, it goes through several stages, which have characteristic symptoms and methods of treatment.

                              It goes away without obvious signs of the disease, since there is no pain and no deformities appear on the heel. Determining the presence of heel arthritis at this stage of the disease is only possible with the help of an x-ray scan. Only a qualified imaging specialist will be able to notice a slight thinning of the bone in the foot area.

                              Arthritis of the heel begins to manifest itself more: a person experiences severe pain, the bone in the foot area becomes even thinner. Externally, the mentioned disease is expressed by redness and swelling, the heel bone increases in size. An X-ray examination will easily confirm the presence of arthritis of the heel and the beginning of the process of its deformation. At this stage, heel arthritis can no longer be cured, but the treatment provided will help reduce the rate of progression of the disease.

                              Heel arthritis at the third stage has obvious external signs of the disease, namely a strong change in the joint on the heels, causing difficult movement and unbearable pain. In this case, the heel becomes very red and swells even more. An x-ray shows severe deformation of the foot. Treatment at this stage is aimed at reducing signs of the disease, pain relief and preventing further development of the disease.

                              The last stage of heel arthritis is characterized by the inability of a person to move independently. The pain and swelling of the heel increases, the deformity becomes more noticeable, and sometimes fusion of the heel bone is possible. Treatment in this case involves reducing pain and swelling. In most cases, independent movement of a person at this stage is impossible.

                              Heel arthritis does not appear in the body on its own. The following factors contribute to its manifestation and development:

                            • the presence of hereditary changes in the joints, which over time causes disease of the connective tissues and bones in the body;
                            • the formation of other foci of inflammation in the body;
                            • the presence of joint disease in the heel, for example, coxarthrosis, injury;
                            • poor metabolism, causing salt deposition in the bones;
                            • bad habits;
                            • lack of foods containing vitamins in the diet;
                            • playing sports that place a lot of stress on the heels;
                            • excess weight, since excess weight puts pressure on the foot and causes changes in the joints;
                            • sudden stressful situation or prolonged exposure to a nervous atmosphere;
                            • wearing high heels for a long time.
                            • Although heel arthritis cannot be cured in later stages, treatment will reduce symptoms, prevent the development of the disease, and also improve the appearance of a deformed heel. In some cases, treatment may restore the ability to move independently. To achieve maximum effect, it is advisable to carry out complex treatment with medications, physical therapy and diet.

                              Treatment with pharmaceutical medications consists of taking a complex of drugs to relieve inflammation and reduce pain. Additionally, patients with heel arthritis are recommended to consume vitamins, minerals and other trace elements. External symptoms of the disease are best relieved with ointments, which additionally have the function of reducing pain. In special cases, when the body is very inflamed and cannot cope on its own, the doctor may prescribe a course of antibiotics.

                              Physiotherapy courses play a special role in the treatment of heel arthritis, including:

                            • massage, which should be carried out by a specialist so as not to aggravate the patient’s situation and not cause more harm (the effect of massage improves blood circulation, promotes the absorption of minerals and trace elements);
                            • gymnastics to help normalize blood circulation in the heel joint;
                            • electrophoresis is used only in cases of individual tolerance, since this method is based on the use of electric current for targeted delivery of medications;
                            • laser, shock wave, magnetic resonance procedures;
                            • mud treatment involves foot baths with the addition of clay or mud.
                            • Diet for heel arthritis is considered one of the most effective ways to combat pathology. A sick person needs to saturate the body with vitamins and microelements, since it is often their lack that contributes to the development of joint diseases. To do this, you need to enrich your diet with protein foods (milk, cottage cheese, fish, poultry), Omega-3 (fish, flax, walnuts, greens), vitamin C (tomatoes, bell peppers, black currants, kiwi), calcium (apples , carrots, cucumbers, legumes).

                              If you have heel arthritis, it is strictly forbidden to drink alcohol, carbonated water, fatty and canned foods, and processed foods. It is recommended to include juices, infusions, and decoctions in your diet.

                              Heel arthritis can also be treated at home with folk remedies. To do this, the heel is affected in the following ways:

                              Its action is based on taking cold and hot baths for 5 minutes each in three repetitions.

                              Ointment for pain relief

                              To prepare it at home, take 100 ml of vinegar, 100 g of soft butter and 1 chicken egg with shell. All ingredients are mixed and infused in a cool place for 20 days. The finished product is applied to the sore spot three times a day after taking a foot bath.

                              Tincture with analgin

                              To treat heel arthritis, a similar tincture is prepared as follows: take 5 analgin tablets and 5 ml of iodine per 100 ml of alcohol. The product should be infused in a dark place for two weeks, after which the heel should be wiped 5 times a day.

                              In order to make such an ointment, you need to take 100 g of propolis per 100 ml of olive oil and heat it in a water bath for half an hour. When the propolis is completely dissolved, the mixture should be allowed to cool. It is advisable to rub the heel with propolis ointment three times a day until it dries completely. If possible, you can leave the ointment on the sore spot overnight, after wrapping it.

                              Why does heel arthritis occur, what are the symptoms and treatment for inflammation of the heel bone?

                              Arthritis can occur in almost any joint. The disease is accompanied by inflammation of the synovial membrane and other tissues, and later by destruction of the surface of the bones and their deformation. The article will discuss the localization of arthritis in the heel area.

                              Causes and types of inflammation of the heel bone

                              Heel inflammation occurs for various reasons, and its main types are as follows:

                            • Reactive – provoked by the activity of infections. This pathology develops as a result of the action of various infectious agents that affect the genitourinary or digestive tracts (for example, gonorrhea, chlamydia, salmonella, etc.).
                            • Gouty – accompanies metabolic disorders in the body. An increased level of uric acid in the blood causes its crystals (urates) to settle on the surface of the articular cartilage and other components of the joints, causing reactive inflammation.
                            • Autoimmune – associated with disorders of the immune system, which provoke inflammatory processes in connective tissues and joints. Examples are rheumatoid and psoriatic arthritis, ankylosing spondylitis.
                            • Another disease that can lead to arthritis is diabetes. With this pathology, many blood vessels suffer, tissues experience hypoxia, and lack nutrients.

                              Predispose to the development of inflammation of the heel bone:

                            • intense physical activity;
                            • genetic predisposition;
                            • injuries to the heel area or tendons;
                            • frequent hypothermia;
                            • the presence in the body of a source of chronic infection (bacterial, viral or fungal);
                            • chronic intoxication (smoking, alcohol and drug abuse);
                            • poor nutrition.
                            • Localization of inflammation

                              There are various tissues in the heel area that can be affected by inflammation:

                            • The calcaneus itself (crack, fracture, reactive arthritis, infections, epiphysitis).
                            • Skin with subcutaneous fatty tissue (bruises, diabetes mellitus, transfer of inflammation from ligaments and tendons).
                            • Synovial bursae (bursitis).
                            • Ligaments (bruises, heel spurs).
                            • Achilles tendon (achilles).
                            • Nerves and blood vessels (bruises, tuberculosis and other infections, osteomyelitis, diabetes mellitus).
                            • Intertarsal joints (gout).
                            • Symptoms of heel arthritis by stage

                              Heel arthritis does not actively manifest itself at first. Minor pain may occur after standing or walking for a long time, as well as at night.

                              Symptom! In the second stage of the disease, the articular cartilage becomes thinner and the pain becomes intense, mostly at night.

                              The soft tissues in the heel area swell and turn red. It is in this phase of the disease that most patients consult a doctor.

                              At the third stage of arthritis, visible deformation of the affected area is observed. The patient suffers from severe pain. Swelling from the area of ​​the heel joint rises higher - to the ankle. Already at this stage the patient moves with the help of a cane or crutches.

                              The fourth stage is clinically difficult to distinguish from the third; it is established and differs from stage III by radiological signs.

                              The doctor finds out in detail how long ago the disease appeared, what preceded it, and how it progressed. Next, inspection and palpation, assessment of active and passive movements are carried out.

                              As additional methods, the doctor can use:

                              Attention! Let me remind you that if you have any problem, you can seek advice from our specialists.

                              • laboratory diagnostics (clinical and biochemical tests of blood and urine, rheumatoid factor, etc.);
                              • Ultrasound examination;
                              • computed tomography;
                              • magnetic resonance imaging;
                              • radiography.
                              • X-ray of the affected area remains one of the simplest and most inexpensive diagnostic methods.

                                1. At the first stage, changes in the heel area in the pictures are minimal - there is minor bone damage and thinning of the cartilage.
                                2. The second stage is manifested by initial deformations of the heel bone, osteoporosis. The joint space of the calcaneal joint is narrowed, and erosions of bone tissue may be observed.
                                3. In the third stage, deformations are clearly visible on X-ray photographs; the bone tissue is affected by many abnormalities.
                                4. The fourth stage, in addition to pronounced deformations in the joint and inflammatory changes in the surrounding tissues, is also characterized by loss of movement in the joint - the development of ankylosis.
                                5. Treatment methods for heel arthritis

                                  Treatment is more effective the earlier it is started. The processes are completely reversible only at the first stage of the disease. Therapy at later stages of arthritis can stop or slow down the progression of the disease, but may not always lead to a complete recovery.

                                  Medicines: tablets and injections

                                  If the cause of the disease is reactive arthritis, then all efforts are devoted to eliminating its main cause - infection. For this purpose, antibiotics are used (macrolides, fluoroquinolones or other drugs, depending on the pathogen).

                                  In case of an autoimmune process, immunosuppressive therapy and other basic drugs (Methotrexate, Sulfasalazine, Auranofin and others) are prescribed.

                                  Symptomatic treatment includes non-steroidal anti-inflammatory drugs (Diclofenac, Ketorolac), glucocorticosteroids (Kenalog), including in the form of injections.

                                  Attention! Hormones, NSAIDs and any basic medications should be prescribed only by your doctor, since self-medication can lead to the development of severe side effects.

                                  In addition, the doctor prescribes vitamins and chondroprotectors (Arthra, Chondroxide, Dona, Structum), which are designed to improve the condition of cartilage and prevent joint destruction.

                                  Local remedies: ointments, gels

                                  For local application to the heel area, gels and ointments based on NSAIDs (Voltaren, Olfen, Ketoprofen, Diclofenac) and injections of glucocorticosteroids into the joint are used, which help relieve swelling and reduce pain.

                                  Darsonvalization of the heel for arthritis and other physiotherapy procedures

                                  This procedure improves local blood circulation, stimulates the body's defenses, reduces swelling and pain, and kills bacteria. This is the effect on tissue of a high-frequency pulsed current or magnetic field. This method is considered outdated due to the creation of new procedures, but it helps well with arthritis.

                                6. electrophoresis;
                                7. diadynamic currents;
                                8. radon, mineral baths;
                                9. mud and clay applications;
                                10. paraffin therapy.
                                11. At home, for the purpose of physiotherapy, you can warm up the joint (in the absence of suppuration!) with bags of sand or salt, paraffin and ozokerite.

                                  Treatment with folk remedies

                                  Traditional medicine methods complement traditional medicine. The Internet is replete with all sorts of recipes that can be used for heel arthritis. For example, iodine mixed with honey and salt is used for this purpose. It is believed to relieve the symptoms of arthritis if applied to the sore heel at night.

                                  Useful for pain relief:

                                12. herbal tinctures - golden mustache, comfrey, St. John's wort, cinquefoil;
                                13. camphor alcohol and oil;
                                14. Dimexide with Novocaine;
                                15. black radish juice;
                                16. ointment with propolis;
                                17. compresses with salt solution;
                                18. vinegar lotions.
                                19. However, you should not get carried away with traditional recipes. If you want to use any of them, be sure to consult your doctor.

                                  Massage and gymnastics to strengthen the ankle and heel

                                  In the acute phase of arthritis in the heel, you need to eliminate any stress on the joint and give it rest. When the inflammation subsides, you can begin massage and therapeutic exercises.

                                  A gentle massage of the affected joint area improves blood circulation and promotes healing. It can be carried out in a clinic, massage room or independently. For massage, rubbing and stroking techniques are used.

                                  Important! The directly affected joint can only be lightly stroked. Other techniques (rubbing, kneading) are applied to the rest of the foot. The massage is carried out until the skin turns slightly pink.

                                  The load during gymnastics is increased gradually. Exercises are selected by the doctor individually.

                                  Dr. Evdokimenko talks about heel pain.

                                  Why does your heel hurt: other reasons besides arthritis

                                  In addition to heel arthritis, pain in the heel area can be caused by:

                                20. heel bone crack;
                                21. bruised heel;
                                22. tarsal tunnel syndrome;
                                23. bursitis;
                                24. sprain or damage to the Achilles tendon or ankle ligaments;
                                25. osteomyelitis;
                                26. Haglund's deformity (bone growth).
                                27. Heel arthritis is a pathology that requires seeking medical help at the first signs of the disease. Only in this case is it possible to stop and reverse the process, which will keep the joints healthy and mobile for many years to come.

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