Why does the joint in the heel hurt? What to do if the heel hurts when walking and it hurts to step on it how to treat? Treatment with improvised means and objects

Heel pain when walking and after sleeping is very common. In most cases, this symptom is associated with plantar fasciitis or heel spur, but other causes are possible.

According to some estimates, about 10% of people complain of heel pain at least once in their life. Most often, heels hurt in athletes-runners, as well as in people between the ages of 40 and 60 years. In most cases, only one heel hurts; both feet are affected in about a third of people. Heel pain is usually most severe in the morning or during the first steps after sleeping. If you disperse, the unpleasant sensations subside, but they arise again after a long walk or heavy exertion. Some people develop lameness or strange gait as they try to spare a sore leg.

The most common cause of heel pain is damage and thickening of the bundle of connective tissue that supports the arch of the foot, the plantar fascia. It connects the heel bone to the bones of the foot and also acts as a shock absorber. Due to injury or gradual wear and tear, micro-tears can appear in the structure of the plantar fascia. Because of this, it thickens and hurts. The scientific name for this phenomenon is plantar fasciitis. The surrounding tissue and the heel bone can also become inflamed. On the heel, a bone spike often grows - a heel spur, which injures the surrounding tissues when walking and causes pain.

For the treatment of pain in the heel, physiotherapy, physiotherapy exercises, various fixing devices and bandaging of the foot, as well as medications are used. In rare cases, they resort to surgery. In about 80% of people, the disease goes away within a year.

To prevent foot problems or rather to get rid of heel pain, it is necessary to wear comfortable shoes with small heels that protect the arches of the foot. Weight control is essential, as being overweight puts additional stress on the heels.

Why does heel hurt?

The most common cause of heel pain (about 80% of cases) is plantar fasciitis. This is an injury and thickening of the calcaneal fascia, a thick bundle of fibers that connects the calcaneus to the rest of the foot. Damage to the heel fascia can occur in the following ways:

• as a result of injury, for example, while running or dancing - such damage is more common in young and physically active people;
• in the course of gradual wear of the tissues of the plantar fascia - typical for people over 40 years old.

The risk of gradual wear and, as a result, damage to the plantar fascia increases in people who are overweight or obese, in those who spend most of the day on their feet, as well as in flat-soled shoes like flip-flops or flip-flops.

With plantar fasciitis, heel pain after sleep is more common. After a while, it becomes easier, but by the middle of the day, with long walking, the pain in the heel increases again.

Less Common Causes of Heel Pain

Heel spur- This is an overgrowth of bone tissue in the form of a spike on the heel. A heel spur is often associated with plantar fasciitis as a consequence, but it can develop on its own without causing heel pain.

Fatigue (stress) fracture occurs as a result of long-term excessive loads on the calcaneus when walking, running, jumping, etc. It is more common in people who go in for sports. Less common in osteoporosis - when the heel bone loses strength and even walking or light jogging can lead to the destruction of its structure. A stress fracture is accompanied by aching pain that worsens with pressure on the heel. There may be a slight swelling at the fracture site.

Fat pad atrophy- Thinning of the layer of adipose tissue under the heel bone under the influence of excessive pressure on it. The layer of fat between the bones of the foot and the skin plays an important role as a shock absorber when walking, softening impacts on the ground. The risk of developing fat pad atrophy is increased in women who walk in high heels for a long time, as well as in the elderly. In rare cases, atrophy of the fat layer on the foot develops after injections of corticosteroids into the joints, as well as after fractures. Orthopedic insoles help deal with this cause of heel pain.

Bursitis is inflammation of one or more bursae (small sacs of fluid, usually located around joints and between tendons and bones). There are three bursae near the heel, each of which can become inflamed under the influence of heavy loads on the foot or infections.

Tarsal (tarsal) canal syndrome- tunnel syndrome associated with compression of the tibial nerve in the connective tissue canal near the inner ankle of the foot. The cause of the narrowing of the canal can be damage after dislocations, fractures, or the formation of a cyst in it. Tarsal canal syndrome is characterized by impaired sensitivity (from pain to numbness) in the foot and fingers, including at night, weakness in the muscles of the foot. Feeling the inner ankle of the leg and the area around it increases the pain and discomfort in the foot. Sometimes heel pain occurs.

Aseptic necrosis of the calcaneus may cause heel pain in children. Most often, necrosis develops as a result of stretching and contraction of the muscles and tendons under the knees and ankles due to the rapid growth of the child. When stretched, the calf muscle pulls on the calcaneal (Achilles) tendon. This stretches the growing area of ​​bone at the back of the heel (growth plate), causing pain. This pain is aggravated by playing football or doing gymnastics. Pain often occurs on the side of the heel, but can also be felt underneath. As a rule, aseptic necrosis of the calcaneus is well treated with exercises to stretch the hamstrings and calf muscles and tendons, as well as, if necessary, wearing special pads under the heel.

Diagnosing heel pain

To diagnose diseases of the heel, you need to refer to. In most cases, it will be this specialist who will deal with your further treatment. If it is difficult to get an appointment with this specialist, you can start with a visit. It may be necessary to consult other doctors during the examination: - to exclude systemic diseases of the joints, - to exclude diseases of the nerves of the foot.

There are some additional signs that you and your doctor can suspect as a cause of heel pain. So, numbness or tingling in the leg rather indicates nerve damage. This may be the tarsal canal syndrome described above or a manifestation of general damage to the peripheral nerves, which happens, for example, in diabetes mellitus. If the foot is hot and swollen, it can cause soft tissue or heel infections. In these cases, the help of a surgeon will be required. Limited mobility and pain in the joints of the foot indicate the likely development of arthritis - inflammation of the joint.

To clarify the diagnosis, the doctor may prescribe the following examinations:

• blood tests;
• radiography - the use of a small dose of radiation to detect pathologies in the bones;
• magnetic resonance imaging (MRI) or ultrasound (ultrasound) methods for more detailed scanning of soft tissues.

How are sore heels treated?

Typically, heel pain is treated comprehensively, such as stretching exercises and pain relievers. This can be a lengthy process, sometimes up to a year. If after this time the pain persists, surgery is recommended as a last resort. This happens only in 0.5% of cases.

The success of your heel pain treatment depends a lot on the lifestyle you lead. Regardless of the reason, you will need to wear the “right” shoes, make time for exercise, and get some rest. Most of the manipulations for the treatment of heel pain can be performed independently, without the participation of a doctor.

If possible, spare the sore heel - try not to walk long distances or stand for a long time. In this case, you should regularly perform special exercises to stretch the feet and calves.

Physiotherapy exercises for heels

Stretching exercises for the calf muscles and plantar fascia can help relieve pain and increase flexibility in a sore foot. As a rule, the exercises are recommended to be performed with both legs, even if only one of them hurts.

Stretching with a towel. Keep a long towel near the bed. In the morning, before you get up, throw a towel over your foot and use it to pull your toes towards you, keeping your knee straight. Repeat three times with each leg.

Stretching against the wall. Place your hands on the wall at shoulder level with one foot in front of the other. The front foot should be approximately 30 cm from the wall. Keeping your back straight, bend your front leg at the knee, leaning against the wall until you feel the tension in the calf muscles of the other leg. Relax. Repeat 10 times with one leg, then the same amount with the other. Do this exercise twice a day.

Stretching the stairs. Stand on the step, facing the stairs, lean on the railing. Legs should be slightly apart, heels should be hanging from the step. Lower your heels until you feel a stretch in your calf muscles. Stay in this position for about 40 seconds, then return to the starting position. Repeat six times, at least twice a day.

Stretching on the chair. Sit in a chair, bend your knees at right angles. Turn your feet so that your heels touch and your toes are turned in opposite directions. Raise your toes on your sore foot, pressing your heel firmly against the floor. You should feel the tension in your calf muscles and the Achilles tendon (the bundle of fibers that connects the calcaneus to the calf muscles). Stay in this position for a few seconds, then relax. Repeat 10 times, 5-6 sets per day.

Dynamic stretching. While seated, run with the arch of your foot (the concave part of the sole) over a round object, such as a rolling pin, tennis ball, or bank. Some people find that using a cold jar can also help relieve pain. Move your foot in all directions over the object for several minutes. Repeat twice a day.

Pain relievers for heel pain

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be used to relieve pain. Applying a cold compress to a sore heel for 5-10 minutes can also sometimes help relieve pain and inflammation. However, ice cannot be applied directly to the skin; it must be wrapped in a towel. You can use a bag of frozen vegetables instead of ice.

Orthopedic insoles

Orthopedic insoles are inserted into the shoe to keep the foot in the correct position and to cushion the impact of the heel when walking. Ready-made insoles can be purchased at sporting goods stores, major drug stores and orthopedic stores. Sometimes your doctor can advise you on custom insoles that will fit your feet perfectly. They are made to order. However, there is currently no reason to believe that bespoke insoles are more effective than standard insoles.

Bandaging or taping the feet for heel pain

To reduce the stress on the plantar fascia and the pain in the heel associated with its inflammation, you can bandage the leg with an elastic bandage. The orthopedist will show you the bandaging technique. Instead of a bandage, you can use an adhesive plaster or a special sports tape - tape. Applying a patch or tape to the foot is called taping. The patch creates additional support for the foot, mimicking the supporting role of the fascia. You can find the foot taping technique for heel pain on the Internet or check with your doctor.

Some orthopedic surgeons recommend the use of special night braces or braces to stretch the ligaments of the foot while sleeping. Most people sleep with their toes pointing downward, which causes the plantar fascia to contract. Pain after waking up is associated with its sharp stretching and microtraumas.

The foot brace is designed with the toes and feet pointing upward during sleep. This helps to stretch the Achilles tendon and plantar fascia, allowing the torn ligament fibers to grow back together in the correct position and accelerate healing. As a rule, such orthoses or braces can only be purchased in specialized stores or on the Internet.

Corticosteroid shots

If the above methods do not help relieve the pain, your doctor may prescribe corticosteroid shots. These are powerful anti-inflammatory drugs that must be used with caution, as they have severe side effects if overdose, such as weight gain and high blood pressure (hypertension). Therefore, it is not recommended to give more than three injections of corticosteroids per year to any part of the body. Your doctor may give you a local pain reliever before giving the injection of corticosteroids.

Surgery for heel pain

If none of the treatments have worked and you are still in pain after a year, you may be referred for surgery. It is sometimes recommended for professional athletes and other athletes if heel pain is negatively affecting their careers.

Plantar fascia excision surgery- The most widely used type of surgery for heel pain. The surgeon cuts the fascia to separate it from the heel bone and relieve tension in it. This should eliminate inflammation and relieve pain. The operation can be performed in two ways:

• open - when a section of the heel fascia is cut through an incision in the heel;
• endoscopic, or minimal intervention operation - when a small incision is made through which microsurgical instruments are inserted under the skin.

The recovery period after endoscopic surgery is shorter, so you can walk normally much earlier (almost immediately), while recovery from open surgery takes 2 to 3 weeks. The disadvantage of minimally invasive surgery is that it is performed only by a trained surgical team and with the help of special equipment, so the waiting time for such an operation can be longer. Endoscopic surgery also carries an increased risk of damage to nearby nerves, which can cause symptoms such as numbness, tingling, and partial loss of motion in the foot.

Like any surgery, plantar fascia excision can have complications such as infection, nerve damage, and worsening of symptoms after surgery (although this is rare). Discuss the pros and cons of both types of surgery with your doctor.

Shockwave therapy for heel spur

This is a relatively new method of non-invasive treatment, that is, it does not involve surgical intervention. Shockwave therapy is especially effective when heel pain is associated with a heel spur. The method consists in directing high-energy sound impulses to the heel using a special apparatus. This can be painful, so your doctor may inject a local pain reliever into your foot.

Shockwave therapy is believed to work bi-directionally, namely:

• has an analgesic effect;
• stimulates and speeds up the healing process.

However, there is no hard evidence for this. Some studies have shown that shock wave therapy is more effective than surgery and other methods of treating heel pain, while others have shown that this procedure is not different in effectiveness from placebo (pseudo-treatment).

Preventing heel pain

It is not always possible to avoid pain in the heel, but certain measures can be taken so that such problems do not arise in the future. Being overweight is known to put additional stress on the feet, especially on the heels, increasing the risk of injury. If you are overweight, losing weight and maintaining a normal body weight by combining regular exercise with a healthy, balanced diet will benefit your legs. (BMI) to see if your weight is appropriate for your height and body type.

The choice of the “right” footwear is of great importance for the prevention of heel diseases. Wearing high-heeled shoes to a party is unlikely to hurt you, but wearing them all week at work can hurt your feet, especially if you have to walk or stand a lot. It is best to choose lace-up shoes with low or medium heels that support and protect the arches and heels. Do not wear flat shoes.

Do not walk barefoot on asphalt or hard ground. Heel pain often occurs when a person starts to walk barefoot on vacation after walking in shoes all year. In this case, the legs are not used to the extra pressure, which causes heel pain.

If you are active, such as jogging or any other sport, change your shoes regularly. Most experts recommend changing your athletic shoes after you have run about 800 km. Be sure to stretch after exercising and incorporate regular strength and flexibility exercises into your workouts.

Which doctor should I contact if my heel hurts?

In most cases, heel pain requires a doctor's consultation. With the help of the NaPopravku service, you can quickly find one that will take care of your diagnosis and treatment. If it is difficult to get to a specialist of this profile, contact for help.

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Copyright notice: “Department of Health original content 2019”

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only supplements it. The articles have been prepared for informational purposes only and are recommendatory in nature.

Update: December 2018

A condition in which heels hurt can occur due to many reasons, which requires detailed examination and treatment by various specialists (traumatologist, surgeon, rheumatologist, oncologist, infectious disease specialist and even a phthisiatrician). Below are the main diseases in which pain can occur in this anatomical region.

Causes of pain in the heel area that are not related to any disease

• Wearing a high heel for a long time leads to overstrain of the tissues of the foot;
• With an increase in physical activity;
• Rapid increase in body weight.

In a separate group, it is necessary to take out such a common disease as dry corn (see). It not only causes a lot of inconvenience, but also causes severe pain when walking over time.

Inflammatory diseases

Plantar fasciitis ()

It is characterized by pain of inflammatory genesis, in the projection of the heels, due to stretching or prolonged damage by the growth of the plantar fascia of the calcaneus. This pathology occurs as a result of prolonged standing on the legs, trauma to the bones of the foot or flat feet. The course of this disease forms a pathological circle, that is, the inflamed fascia is involved in the formation of a bone growth (osteophyte) on the heel, and the latter, constantly traumatizing it, does not allow this process to subside. Due to this, the heels of such patients hurt constantly and without remission phases. The pain syndrome subsides only after what has been done, and then for a short while. Heel pain is especially pronounced immediately after sleep, as well as after walking or running.

Achillitis (inflammation of the Achilles tendon)

The inflammatory process in this anatomical formation occurs due to constant stress on the calf muscles (climbing uphill, jumping), wearing uncomfortable squeezing shoes and walking in high heels. The disease is characterized by pain in the projection of the tendon, and along its entire length. In addition, pain above the heels of moderate intensity and swelling of the tendon itself without fail. In the absence of treatment and reduced immunity, purulent inflammation of the Achilles tendon may occur, then the pain over the heel becomes more intense, to the point that a person cannot step even a step. In addition, the inflammation can reach such a level that tendon rupture can occur. This condition is a medical emergency.

Osteochondropathy of the calcaneus tubercle

The essence of this pathology is that, for unknown reasons, sterile necrosis of those areas of the cancellous substance of the calcaneus begins to develop, on which the greatest load is applied. A characteristic symptom is pain in the heel at the slightest load. Walking with such an illness brings the patient severe pain, which is almost never removed. Patients move only with crutches or a cane, stepping on only the front of the foot. The skin over the heel is edematous almost all the time and with symptoms of malnutrition (atrophy). Over time, atrophy of the leg muscles occurs.

Calcaneus bursitis

This pathological condition is manifested by the classic symptoms of inflammation, namely: swelling, pain, dysfunction, increased local temperature, redness.

Loading periostitis

This disease is characterized by inflammation of the periosteum due to excessive stress. Often this pathology occurs in athletes and weightlifters. Pain in the heel and inflammation of the periosteal substance stop several weeks after the end of the load.

Oncological diseases

Calcaneus sarcoma

It is characterized by the fact that the pain syndrome is initially less pronounced and is easily relieved with the help of analgesics, but after some time it becomes more intense. Along the way, symptoms of cancer intoxication appear (weight loss, exhaustion, anemia). With the progression of tumor growth, pathological fractures of the calcaneus can be observed.

Diseases of the peripheral nervous system

Neuropathy of the tibial nerve, namely its median branches

It manifests itself as a violation of the flexion function of the foot and trophic disorders in the skin above the heel. A feature of this pathology is that pain in the heel area is replaced by complete numbness. Long-term neuropathy leads to the appearance of trophic ulcers in the heel.

Traumatic origin

Calcaneus fracture

Occurs with a strong impact in the projection of the heel. It is characterized by the fact that the victim cannot focus on the heel, much less take steps. Movements in the ankle are sharply limited due to the resulting hematoma and severe pain syndrome.

Injury

Depending on the degree of injury, the clinical picture is similar to a fracture of the calcaneus and the integrity of the heel can be diagnosed only with the help of X-ray. Even after a few weeks, heel pain occurs when walking.

Epiphysitis

It is the separation of cartilage between two points of ossification. This condition only occurs in children between the ages of 7 and 16 with a heel injury or increased physical exertion. It should be noted that often there is pain in the heel after sleep, that is, without any physical exertion.

Diseases caused by infection

Bone tuberculosis

This infectious disease also affects the heel bone, which leads not only to severe pain syndrome, but also caseous necrosis of bone tissue inside the heel. In the absence of adequate treatment, a fistula is formed, which tends to periodic remission and repeated inflammation with the release of purulent contents from the bone (see).

Osteomyelitis

Pathology caused by metabolic disorders or systemic diseases

Arthritis that occurs with psoriasis

The clinical manifestations are very similar to rheumatoid arthritis, but due to the external manifestations on the skin, it is possible to distinguish them. One of the first symptoms will be the sudden appearance of pain in the heels at rest, sometimes there is an increase in the joint due to the accumulation of pathological fluid in it. Patients, as a rule, do not associate pain with the underlying disease, as a result of which the wrong treatment tactics are chosen.

Gout

- This pathological condition is characterized by the deposition of urates, that is, uric acid salts. Already at the onset of the disease, acute pain occurs in the area of ​​the joints, in this case in the heels, big toes, redness and swelling of the skin above them. These symptoms often occur at night. During palpation, there is an increase in the temperature of local tissues and their soreness. Without), such symptoms last for several days or weeks, depending on the stage of the disease. More often, in addition to pain in the area of ​​the heels, pain in the area of ​​the joint of the big toe, as well as the ankle, knee joint, and others join. The fingers and the Achilles tendon may be involved in inflammation.

Ankylosing spondylitis

Refers to inflammatory and degenerative diseases of the spine and joints. The bottom line is that the body produces antibodies to its own ligaments and joints. As a result of such processes, ossification of the ligamentous-articular apparatus of the spine begins, the vertebrae grow together, the flexibility and mobility of the spinal column completely disappears. One of the first manifestations of this disease is severe pain in the heels, as a result of which the patient cannot stand on the floor.

Rheumatoid arthritis

This disease is rightfully considered one of the most severe of its kind, which is confirmed by the rapid onset and the presence of persistent complications of almost all joints of the human skeleton. At the beginning, pains of moderate intensity, swelling and decreased mobility in the joints appear. It should be noted that pain in the heels is a rare symptom in this disease, but if they begin, then this indicates the involvement of all joints of the foot in the process. Pain syndrome occurs both at rest and at the slightest stress on the leg.

Diagnosing heel pain

• Patient complaints and clinical examination
• Complete blood count to check for anemia or leukocytosis
• X-ray of the ankle and foot bones on both sides
• Chest and abdominal x-ray
• Spiral computed tomography
• Bone scintigraphy (bone scan, mainly used to detect metastases, necrosis, or fistulas)
• Densitometry (study of bone density)
• Ankle ultrasound

How to treat heel pain

It is important to understand that heel pain should be treated immediately after a preliminary diagnosis. Until that time, all measures should be aimed only at relieving pain, since the latter significantly impairs the quality of life.

In order to reduce pain, the following measures should be used:

• Daily steaming of feet in warm water followed by rubbing (diprilif, fastum gel and others);
• According to indications and pain syndrome of moderate intensity, drugs of this series can be used orally and injected intramuscularly, but provided that there are no diseases of the stomach and duodenum. These drugs include: dicloberl, movalis, nimesil, fanigan, dexalgin and ketanov;
• Also, with severe pain, a blockade is performed (diprospan with lidocaine 2% injected at the point of greatest pain), this method is most justified in case of heel spur or arthritis;
• Trophic disorders in the heel area are treated with drugs that improve blood rheology and increase blood circulation (tivortin,);
• In the presence of dry corn, treatment consists of the use of special plasters that corrode it or the use of a lactic acid solution in the Kolomak preparation;
• Various types of surgical interventions (removal of part of the bone, sequestration or spur);
• For all types of pain in the heel area, the use of foot massage, exercise therapy exercises (walking on toes, on the edge of the foot) and wearing orthopedic insoles are indicated;
• An important therapeutic and prophylactic measure for almost all pathologies that cause pain in the heels is to reduce body weight and wear comfortable shoes.

Heel pain can occur with the following conditions:

• Haglund deformation;
• tarsal tunnel syndrome;
• fissure of the calcaneus;
• heel spur;
• Achilles tendon strain
• bruised heel;
• gout;
• diabetic angiopathy;
• epiphysitis of the calcaneus;
• bursitis;
• reactive arthritis;
• calcaneus tuberculosis;
• osteomyelitis of the calcaneus.

Haglund deformation

Tarsal Tunnel Syndrome

Heel bone fracture

Heel spur

Achilles tendon stretch

A sprain of the Achilles tendon is the easiest type of injury. A more serious injury to the Achilles tendon is its partial or complete rupture, in which a person cannot move ( like walking, running) with the help of the injured leg and feels severe pain in the heel and in the area where the Achilles tendon is located. In such cases, the support function of the lower limb is completely preserved, since this tendon is not involved in maintaining the static position of the leg.

Ankle sprain

Bruised heel

Gout

One of these main symptoms is monoarthritis ( inflammation of one joint) or polyarthritis ( inflammation of several joints). Gout can affect various joints ( ankle, elbow, hip, knee, etc.), however, most often in the pathological process, the joints of the foot are involved ( intermetatarsal, metatarsophalangeal, tarsometatarsal joints). Inflammation of the intermetatarsal joints ( calcaneal-cuboid, subtalar, ram-calcaneon-navicular etc.) with gout leads to pain in the heel.

The causes of this disease can be congenital defects in enzymes responsible for the utilization of uric acid in the body ( for example, a defect in hypoxanthine guanine phosphoribosyl transferase or adenine phosphoribosyl pyrophosphate synthetase), kidney pathology ( chronic renal failure, kidney cancer, polycystic disease, etc.), blood ( paraproteinemia, leukemia, polycythemia, etc.), eating a lot of meat, alcohol, physical inactivity ( sedentary lifestyle) and etc.

Diabetic angiopathy

Such ulcers are localized more often on the foot, toes, heel, ankle zones. With this pathology, there is also a decrease in local immunity, due to which leg ulcers are constantly infected and heal for a very long time, therefore diabetic angiopathy is often complicated by osteomyelitis ( purulent inflammation of the bones) and gangrene ( tissue necrosis) feet. Such complications are constantly observed in patients, since with diabetic angiopathy, nerve endings are damaged ( diabetic polyneuropathy), which is accompanied by a violation of the sensitivity of the tissues of the leg.

Calcaneus epiphysitis

The first ossification point appears in the body of the calcaneus at 5-6 months. Ossification ( ossification) bone in the area of ​​this point begins at the moment when the child is born into the world. At about 8 - 9 years old, the child develops a second ossification point in the apophysis ( bone process, near its end) of the calcaneus, from which the tubercle of the calcaneus is formed. After its appearance, both points gradually begin to grow together. Their complete fusion ends the moment the child turns 16 - 18 years old.

Calcaneus epiphysitis ( Sever's disease) Is a pathology in which the area of ​​the calcaneus is inflamed as a result of the partial separation of the apophysis ( the bone process, from which the calcaneal tubercle will subsequently arise) from her body, due to the incomplete process of fusion and ossification. This pathology is observed mainly in children 9-14 years old ( since the first and second ossification points are completely fused by the age of 16 - 18).

Various factors contribute to the development of this disease ( excessive physical exertion, permanent injuries, anomalies in the development of the foot, deficiency of calcium, vitamin D), which cause damage to the cartilage tissue in the calcaneus and partial rupture of its connective tissue fibers, which disrupts the normal fusion of both points of ossification and ossification ( ossification) of the entire bone as a whole. Pain in the heel with epiphysitis of the calcaneus is projected onto its lateral sides and occurs as a result of inflammatory processes inside the calcaneus.

Osteochondropathy of the calcaneus tubercle

Such loads cause mechanical damage to the vessels of the calcaneal region, as a result of which they narrow, and microcirculation is disturbed in them. The lack of blood supply to the tissues of the calcaneus provokes the development of dystrophic and necrotic changes in it, because of which it becomes inflamed. Haglund-Schinz disease is characterized by the appearance of diffuse pain in the heel area ( in the area of ​​the calcaneal tuber), which increase with physical exertion and extension of the foot. Particularly severe pain is usually projected at the junction of the Achilles tendon with the tubercle of the calcaneus. They can be easily identified by palpation ( feeling with your fingers).

Bursitis

Reactive arthritis

One of the main features of urogenital reactive arthritis is the occurrence of pain in the heel region. Their appearance is associated with the defeat of various types of connective tissue structures located in the heel zone. Most often, with such arthritis, enthesitis of the Achilles tendon ( inflammation of the site of attachment of the tendon to the heel bone), tendonitis ( inflammation) Achilles tendon, plantar aponeurosis enthesitis ( inflammation of the site of attachment of the plantar aponeurosis to the calcaneus). The localization of pain always depends on which structure is affected and inflamed. So, for example, with enthesitis or tendinitis of the Achilles tendon, pain is felt on the back of the heel; with enthesitis of the plantar aponeurosis, the patient experiences pain in the area of ​​the lower side of the heel.

Calcaneus tuberculosis

Calcaneus osteomyelitis

Diagnosing the causes of heel pain

Haglund deformation

Palpation of the back of the heel with this disease can reveal pathological bone growth, edema of adjacent tissues and severe local pain. To confirm the presence of Haglund's deformity in the patient, he needs to do an X-ray examination of the heel region. Sometimes, such a patient may also be prescribed an ultrasound examination ( Ultrasound), which is necessary for visualization and assessment of the condition of the Achilles tendon and retrocalcaneal bursa ( bursa, located between the Achilles tendon and the calcaneus).

Tarsal Tunnel Syndrome

An important diagnostic sign of tarsal tunnel syndrome is Tinel's symptom ( the appearance of pain and numbness in the innervation zones of the tibial nerve when tapping fingers in the tarsal canal). Palpation of the back surface of the entire leg can often reveal local soreness. Electroneuromyography is done to confirm that the patient has a tibial nerve injury. In order to identify the cause of tarsal tunnel syndrome, patients are prescribed radiation research methods ( radiography, computed tomography, magnetic resonance imaging).

Heel bone fracture

Heel spur

When feeling ( palpation) of the calcaneal region, an increase in pain can be detected in the area of ​​localization of the calcaneal tuberosity - the place of attachment of the plantar fascia to it. In addition to clinical examinations, such patients may also be prescribed an X-ray examination of the heel in two mutually perpendicular projections. This study helps not only to establish the exact localization of inflammation and the presence of osteophytes ( heel spurs) in the area of ​​the calcaneal tuberosity, but also to exclude other possible pathologies ( for example, tumors of the calcaneus, osteomyelitis, fracture of the calcaneus, etc.).

Achilles tendon stretch

To diagnose a stretching of the Achilles tendon, it is very important to clarify the patient's events and circumstances in which painful sensations in the heel appeared, since, in most cases, such an injury occurs during physical exertion, mechanical injuries of the leg, falling from a height, poor warm-up before training etc. Therefore, anamnestic data serve as a very important criterion for the diagnosis of Achilles tendon sprain. In addition to clarifying his complaints from the patient and collecting anamnesis, he should also be prescribed an ultrasound scan, computed tomography, and magnetic resonance imaging. Using these methods, it is possible to quickly identify damage to the Achilles tendon and exclude other possible pathologies ( ). X-ray examination in such cases is not effective, since on radiographs ( X-ray images) a sprain usually cannot be recognized.

Ankle sprain

Bruised heel

Gout

Diabetic angiopathy

If a patient is diagnosed with diabetes mellitus, then he is assigned consultations with doctors of the appropriate profile, who can establish and confirm the presence of this or that complication. For example, an ophthalmologist may diagnose diabetic retinopathy ( retinal damage due to diabetes), a general practitioner can detect diabetic nephropathy in a patient ( kidney damage associated with diabetes), the surgeon usually diagnoses diabetic angiopathy of the lower extremities.

With diabetic angiopathy of the lower extremities on the leg ( or legs) in the patient, most often in the area of ​​the foot, ulcers are visible against the background of dry, atrophied skin that has a pale or cyanotic color. The skin is often cracked and flaky. Pain in the heel area always has a different intensity, which is not related to the area and depth of ulcerative defects. This is due to the presence of diabetic polyneuropathy ( nerve damage), in which there is a noticeable decrease in skin sensitivity. Sometimes these patients have intermittent claudication ( that is, when walking, they cannot step on their feet normally due to pain syndrome). To assess the peripheral blood supply ( which is significantly disturbed in this pathology), various methods are used ( ultrasound examination, radiopaque angiography, magnetic resonance angiography, etc.).

Calcaneus epiphysitis

Osteochondropathy of the calcaneus tubercle

Bursitis

With posterior calcaneal bursitis ( inflammation of the superficial bursa of the Achilles tendon) the swelling is more distinct ( in the form of a knot) and is located on the posterior surface of the Achilles tendon. This type of bursitis occurs in people who periodically wear tight shoes with a hard back ( trailing edge). Radiation methods of research ( ultrasound examination, radiography, computed tomography). These studies can reveal with high accuracy the signs of bursitis - an increase in the size of the synovial bag, hypertrophy ( thickening) its shell, the appearance of pathological contents inside it.

Reactive arthritis

The results of some laboratory tests are also important diagnostic signs of reactive arthritis. Patients with suspicion of this disease undergo immunological typing ( study) for the presence of the HLA-B27 antigen ( a molecule on the surface of white blood cells that predisposes a patient to reactive arthritis), serological tests and PCR ( polymerase chain reaction) for the presence of antigens in his blood ( particles) harmful microbes ( which have caused urogenital infections in the past), as well as microbiological examination of smears from the urethra, cervical canal, conjunctiva of the eyes ( for the detection of chlamydia).

Calcaneus tuberculosis

Calcaneus osteomyelitis

How to treat when heel hurts?

Haglund deformation

Tarsal Tunnel Syndrome

Heel bone fracture

In the first 7 to 10 days, the patient needs to walk with crutches, while leaning on a cast leg is not allowed. After this period, you can begin full-fledged walking, gradually increasing the load on the damaged heel area. The patient's full working capacity is restored after 3 to 4 months. Such a long period of rehabilitation is explained by the fact that the heel bone serves as the main supporting structure when a person walks. When standing upright, the entire weight of the human body presses on this bone, therefore it is very important that the patient withstands the entire period of immobilization of the leg to completely heal the fracture and prevent various complications ( for example, displacement of bone fragments, an increase in the size of a crack, etc.).

Heel spur

Achilles tendon stretch

If the patient has severe back heel pain, in addition to cold compresses, he needs to take anti-inflammatory nonsteroidal drugs ( ibuprofen, baralgin, diclofenac, etc.). It should be remembered that severe pain in the back of the heel can also appear with other pathologies ( for example, with rupture of the Achilles tendon, fracture of the heel bone, etc.), therefore, before self-medication for stretching the Achilles tendon, it is recommended that you first consult with your doctor. Also, with this stretching, physiotherapy procedures ( cryotherapy, electrophoresis, ultra-high-frequency therapy, ultra-high-frequency therapy, low-frequency magnetotherapy, massage, remedial gymnastics, etc.), which noticeably reduce the rehabilitation period, which takes quite significant periods of time in such patients ( on average, from 2 weeks to 2 - 3 months).

Ankle sprain

Bruised heel

Gout

Diabetic angiopathy

Calcaneus epiphysitis

In very rare cases ( for example, when the pain in the heel is unbearable) the doctor may prescribe nonsteroidal anti-inflammatory drugs to the patient. These agents reduce inflammation in the tissues and relieve heel pain. However, these funds should not be abused, since the disease is not so serious and dangerous. Painful sensations in the heel during treatment will not go away immediately, sometimes they can last more than one week ( sometimes up to 1 - 3 months). It all depends on the speed of fusion between the partially separated sections of the heel bone. When a deficiency of calcium or vitamin D is detected in a child, appropriate medications are prescribed to him. In difficult clinical situations ( which is quite rare) such patients can put on a plaster cast on the leg to completely immobilize the injured limb.

Osteochondropathy of the calcaneus tubercle

Bursitis

Reactive arthritis

Calcaneus tuberculosis

Calcaneus osteomyelitis

Why do heels hurt in the morning?

Why does the back heel hurt?

Why does the inner side of the heel hurt?

Which doctor should I contact if my heels hurt?

If such pains are simultaneously associated with pain in other joints, it is better to go for a consultation with a rheumatologist, since damage to several joints at once most likely indicates that the patient has an autoimmune or metabolic disease ( for example, reactive arthritis, gout, systemic lupus erythematosus, rheumatoid arthritis, etc.). If, with pain in the heels, ulcers appear on the skin of the heel area and the patient has the main symptoms of diabetes mellitus ( increased desire to consume food and water, weight loss, frequent toilet use), then he should definitely go to an endocrinologist.

What ointment can you use when your heel hurts?

For other diseases ( e.g. bruised heel, sprained Achilles tendon, sprained ankle ligaments, heel spur, Haglund deformity, bursitis) Ointments help the heel zone quite well, therefore they are prescribed to the patient in most cases. In addition, local remedies do not have such a toxic effect on the body as tablets do. Local remedies act much faster, as a result of which they are preferred for injuries of the heel zone and in the presence of a superficial inflammatory process in the patient.

For heel pain, nonsteroidal anti-inflammatory drugs ( NSAIDs), pain relievers and local irritants. NSAIDs ( diclofenac, indomethacin, ketoprofen, etc.) reduce pain, swelling and redness at the site of injury. It is recommended to start applying an ointment based on non-steroidal anti-inflammatory drugs immediately after injury. Also on the first day, you can use an ointment that includes an anesthetic ( anesthetic), for example, menovazine. A few days later, after the swelling at the site of injury subsides, the patient should be applied to the painful area with local irritating ointment ( finalgon, viprosal, gevkamen, nikoflex, etc.). It should be remembered that locally irritating ointments cannot be used in the first days after injury, as they contribute to increased puffiness.

Why does the heel hurt and it hurts to step?

Why does the side heel hurt?

Why does the sole of the heel hurt?

What folk remedies can be used when heels hurt?

Folk remedies can usually be used for mechanical injuries of the foot - heel bruises, sprains of the ankle or Achilles tendon, bursitis. Sometimes they help with plantar fasciitis ( heel spur). It should be remembered that before self-medication, you must first consult with your doctor.

Folk remedies that can be used for heel pain are as follows:

• Tincture of white acacia flowers. This tincture is used for a heel spur. For its preparation, they take the flowers of white acacia and mix them with vodka in a ratio of 1/3. You need to lubricate the sole of the foot with tincture of white acacia flowers several times a day.
• Tincture of marsh cinquefoil. Take and mix the roots of marsh cinquefoil with vodka in a ratio of 1/3. After that, this mixture must be insisted for a day. This tincture is recommended to be consumed 2 tablespoons 3 times a day. Marsh cinquefoil tincture is usually indicated for patients with plantar fasciitis.
• Potato compress. Potato compresses are often applied to the injured heel, ankle or Achilles tendon sprains, and various types of bursitis. To make such a compress, you need to take a few raw potatoes and grind them on a grater. After that, a gauze compress should be made from the resulting gruel, which should be applied to the injury site several times a day.
• Plantain leaf compress. Take one tablespoon of dry, mashed plantain leaves and mix them with finely chopped onion ( 1 small onion). After that, an equal amount of honey should be added to this mixture. All this must then be placed in a boiling water bath and well placed. The resulting aqueous solution then needs to be infused and filtered. Compresses can be made from it, which are applied to sore spots on the heel, which have arisen with a bruised heel, sprained ankle ligaments or Achilles tendon.
• Infusion of horsetail. To prepare it, you need to place 50-60 grams of dry horsetail herb in 500 ml of boiling water. The resulting mixture should be infused for 30 - 60 minutes. After that, the tincture must be filtered and made into a gauze compress, which should then be applied to the sore heel 2 - 3 times a day.

What causes a child's heel to hurt?

Many people try to avoid painful sensations, believing that they are the worst enemies of the body. In fact, pain indicates the presence of an inflammatory process. The heel hurts inside at the initial stage of joint destruction or in the presence of a serious illness. This problem needs to be addressed immediately.

The heel has a cushioning function. She has increased sensitivity. This is due to the fact that it contains a large number of nerve fibers and blood vessels. Even with a minor injury or violation, a person can experience severe pain.

For people who spend a lot of time on their feet, this problem becomes a real test. Discomfort is especially intense in the morning after a person woke up.

The first step in solving the problem is to find the cause of the pain. After that, you just need to start treatment. It can be both drugs and traditional methods.

Causes of occurrence

Pain inside the heel: what is it and why can it occur? The reasons are different. In some cases, the patient can independently determine why this is happening, in others, a doctor's consultation is necessary.

Chronic inflammatory processes

The inflammatory process in the tendons can occur due to metabolic disturbances in gout, diabetes mellitus or arthritis and other diseases.

Diseases that can lead to heel pain:

• Haglund deformation.
• Spur.
• Diabetic foot.
• Heel injury.
• Bursitis.
• Tuberculosis.
• Osteomelitis.

Haglund deformation

In this case, the disease appears in the heel. It can be detected by a doctor during examination. It is located slightly above the Achilles tendon and during movement there is constant friction and damage to the fibers. It can be painful to come only at an advanced stage of the disease.

The main reason for the appearance of this deformation has not yet been established. In most cases, it occurs in the fair sex who wear heels for a long time.

Heel spur

With this disease, a non-infectious lesion of the heel occurs. The cause of the inflammatory process can be a heavy load, excess weight, as well as changes in the foot. Gradually, osteophytes develop into a heel spur.

They can only be diagnosed with an X-ray. In fact, the cause of pain in the heel is not the spur itself, but the inflammatory process inside.

Gout

It occurs due to a violation of metabolic processes within the body or kidney disease. With gout, uric acid does not leave the body in a timely manner, forming small crystals. And they, in turn, join the places where the cartilage is located. The most "favorite" place for gout is the feet. In this case, even the patient's walking changes.

Diabetic angiopathy

In the presence of diabetes mellitus, a large number of blood vessels are damaged. In medicine, there is such a diagnosis "diabetic foot". This disease occurs due to a violation of the production of insulin by the pancreas. The blood becomes thick, clogs the blood vessels. The kidneys, eyes and feet are at particular risk. There is a violation of nerve fibers and blood vessels. Due to a violation of blood flow, a violation of trophism occurs, and trophic ulcers appear. They can appear most often on the foot.

Infectious diseases

Reactive arthritis. The inflammatory process in the joints occurs a short time after the transferred infectious disease. This pathological condition is associated with autoimmune disorders. In most cases, it can be just a urogenital infection. It is characterized by an inflammatory process in different joints of the lower extremities.

Tuberculosis. This disease occurs due to infection with Koch's bacillus. It can affect not only the lungs, eyes, but also bones. This form of tuberculosis is most often found in children with weakened immunity.

Why do pains appear in one heel?

Sometimes pain occurs in neither two heels, namely in one. Why is this happening? In most cases, this is due to uncomfortable shoes or the structure of the foot.

Pain in the morning. If intense pain occurs immediately after waking up, then the fascia of the sole may be the cause. This is a thick band of muscle that occurs near the heel. Under intense stress, fiber tear can occur. In parallel, symptoms such as intense pain and impaired ability to move normally appear. Puffiness is also observed.

Calcaneus pain. They can occur due to the presence of a deformed foot, warts, corns, and flat feet. Painful sensations can be both short-term and long-term.

Pain in the left or right leg can occur due to an injury to the foot.

Pain in young children

Pain can be not only in an adult, but very often even in a child. The main cause of this disorder may be Schinz's disease. In girls, this disease occurs at the age of 8 years, and in boys - at 10 years old. A characteristic feature of this disease is painful sensations that appear on the back of the heel.

Sometimes pain can occur with severe flat feet. Additionally, scoliotic posture appears.

Diagnostics

If you have these unpleasant sensations, pains or swelling, you should consult a doctor. He will prescribe the necessary measures for diagnosis. A lot depends on the symptoms.

• General or biochemical blood test. It is done in order to determine the cause of the pain.
• Microbiological examination.
• Ultrasound examination.
• Magnetic resonance imaging.

Heel treatment

Why does the heel hurt deeply inside and what should be done? It all depends on the reason for the appearance. The most important thing to do is to eliminate painful sensations. For this, Butadion, Fastum-gel are suitable. If these drugs do not give a lasting effect, then a blockade should be done.

The cause is a pinched sciatic nerve. To eliminate this problem, stretching of the spine is necessary. It is advisable to contact a chiropractor. He may recommend sleeping soon on a hard surface.
If the reason lies in flat feet, then you need to choose the right shoes. If it is formed on one leg, then pain can only be on this side.

• For rheumatoid arthritis, it is recommended to take the following drugs: Ketoprofen, Ibuprofen.
• A folk remedy helps to eliminate inflammation.
• Ointments for external use. For example, "Ketorolgel", "Butadion".

Prophylaxis

It is much easier to do prevention than to cure a disease that has already manifested itself. Pain in the heel and on the side: what can it be and why does it appear? There are methods that can prevent the disease.

• For prevention, you need to do exercises at home.
• For the first time, days with pain must be given complete rest.
• Healthy food. Control your weight.
• Reduce salt intake. It is capable of retaining fluid and impairing the functioning of the kidneys. And this, in turn, is the reason for the appearance of a malfunction in metabolic processes.

But if pains appear, then it is necessary not only to do prevention, but also to treat this disease.

The cushioning function of the calcaneus can be severely impaired due to a variety of causal factors. At first, few people give this any serious importance. But after a couple of weeks, pain in the heel when walking makes you see a doctor. Sometimes the cause of this pathology is very serious. Almost every person suffers from this anomaly - in his life, everyone at least once had to feel this unpleasant pain. Someone stepped on a stone, while someone else's pain while walking is the result of dangerous pathologies.

Where does the pain come from?

Heel pain when walking occurs in a wide variety of segments of the population, at any age, regardless of lifestyle and occupation. In this case, the nature of pain in different circumstances can be sharp, cutting, pulling, stabbing, stable, periodic.

The course of the disease, too, depending on the causative factors, is acute and chronic. The consequences for any nature of pain are always unfavorable - they are manifested by difficulties in walking, constant soreness of the legs, and rapid fatigue.

What tissues can hurt in the heel?

In this part of the lower limb, a variety of components, tissues, blood vessels and nerves are concentrated. Therefore, soreness can manifest itself in each of them. Let us consider which structural elements of the heel can experience the consequences of pathogenic causes and signal this with pain.

1. Heel bone... This part of the foot is most often sore. They are usually caused by injury, walking on a hard surface, and may also be the result of uncomfortable shoes. At the same time, in the calcaneus, pain arises against the background of infectious bacterial or viral pathologies;
2. Fascia and tendons... A whole bundle of ankle ligaments is more likely to be subjected to sprains and dislocations. It is these reasons that cause soreness in the heel area. In this case, the pain affects the fascia of the articulation and ligaments;
3. Skin and underlying tissue... These parts of the lower limb can give off pain in the heel as a result of the inflammatory process. In addition, pathologies such as diabetic angiopathy, heel spur, stretching can provoke pathologies of the subcutaneous tissue and the skin itself;
4. Achilles tendon... This element of the foot is often the cause of pain in the back of the heel. The Achilles tendon can suffer from mechanical stress or inflammation;
5. Synovial bags... There are two of them in the heel area. Most often, soreness in this area occurs due to inflammation or the development of bursitis;
6. Intermetatarsal joints... There are several of them in the heel area. They are affected by pain associated with gout or due to inflammation. Mechanical factors, hypothermia or injury may also affect;
7. Blood vessels and nerve endings... These elements of the foot suffer from various causes, from injuries to serious infectious diseases.

The most common cause of heel pain when walking is uncomfortable shoes. This factor is especially true for women who prefer high-heeled shoes. Constant tension causes rapid leg fatigue. At the same time, a load is created on the blood vessels, as a result of which the circulation of blood flow in the lower extremities worsens.

A lot of nerve receptors, veins and capillaries are concentrated in the heels. And even the slightest excess pressure on them provokes pathological changes in the walls of blood vessels, causes pinching of the nerve roots, creates a load on the tendons and nerves. As a result, soreness develops in the heel.

At the same time, other etiological factors of the appearance of pain in the heel when walking are possible.

In orthopedic practice, they are usually divided into two categories:

• Causes of pain, as a secondary phenomenon, against the background of infectious and non-infectious diseases;
• Causes of pain that are not associated with other diseases.

The classification of both groups sometimes includes for several reasons at once. For example, heel pain can occur with gout and worsen from dislocation or bruising.

Causes not associated with other diseases:

• Shoe problems. For women, these are high heels, for men, inappropriate size;
• Increased pressure on the feet with active physical movement;
• A sharp increase in body weight;
• Atrophy of individual elements of the heel;
• Bruised or sprained.

• Sexual infections;
• Gout;
• Achillite;
• Anomalies of the support system, in particular - anatomical and physiological pathologies of the spine, as a result of which an additional load on the legs is created;
• Heel spur.

Causes

In addition, the etiological causes of pain in the heels when walking are divided according to the type of origin:

• Inflammatory reasons;
• Factors of oncological origin;
• Traumatic reasons;
• Pathology of the peripheral nervous system;
• Infectious diseases;
• Systemic abnormalities with abnormal metabolic processes.

For a better understanding of the causal factors, it is worth considering them separately.

Inflammatory etiology

Problems of an inflammatory nature include diseases occurring in the heel area, the formation of an inflammatory focus.

These include diseases such as:

• Heel spur... With this disease, sensations in the heel appear closer to the morning or even during sleep. Painful aching, prolonged, can intensify when walking;
• Achillite- a disease caused by excessive loads on the calves of the legs, often manifests itself in athletes when jumping, running or vigorous training;
• Osteochondropathy- pathology, accompanied by necrosis of some areas in the tissues of the foot. Soreness in this pathology is strong, often not amenable to the action of anelgesics. In chronic development, disability caused by complete atrophy of ligaments and muscle tissue is not excluded;
• Loading periostitis- the name itself indicates that such an anomaly occurs with increased loads. Such a manifestation is found among representatives of manual labor, weightlifters and everyone who is associated with lifting weights;
• Bursitis- the pain spreads in one part of the heel and is accompanied by all signs of an inflammatory process.

Cancer causes

The cause of oncological origin is a progressive neoplasm of bone tissue - sarcoma. This disease is accompanied by symptoms of cancer poisoning, including exhaustion, anemia. In addition to the pain in the heel itself, fractures can occur due to the appearance of fragility of the tissue.

Neuropathology

Neurological factors include neuropathy of the median part of the tibial nerve. Signs of this cause are numbness immediately after the pain has passed. At the same time, with neuropathy, trophic pathologies develop, lameness appears.

Traumatism

Factors of a traumatic nature are represented by three options:

• Calcaneus fracture... It is accompanied by intense soreness, severe swelling and the inability to step on the affected heel;
• Injury... Symptoms of a bruise are identical to those of a fracture, with the difference that in this case, the person can lean slightly on the heel;
• Epiphysitis... A rare condition in which cartilaginous tissue breaks apart. The pain is moderate, most often it begins even before physical exertion. Increased with walking or increased physical activity.

Infectious causes

Tuberculosis of bone tissue, affecting the area of ​​the foot, in particular - the heel. This is a dangerous infectious anomaly in which the pain in the heel is of a pronounced acute nature, with it it is almost impossible to step on the foot. At the same time, necrosis of bone tissue develops, which is accompanied by an inflammatory process that affects both soft tissues and tendons.

Osteomyelitis. This reason is characterized by an abundant discharge of purulent contents inside the tubular bone. At the same time, necrosis progresses. The soreness is pronounced, gradually pus with blood is released under the skin in the heel. Blood vessels are affected - they expand and burst, as a result of which hematomas form on the heel.

Systemic diseases

• Rheumatoid arthritis;
• Ankylosing spondylitis;
• Psoriatic arthritis;
• Gout.

Symptoms in these episodes are identical - the pain is moderate or severe, and swelling and redness of the skin may appear in the heel area. Lameness may develop due to periodic pain. A crunching sound is heard when walking.

Diagnostic methods

To confirm one reason or another, which is important for determining the course of treatment, a clinical examination of the heel is carried out, after which instrumental and instrumental diagnostic methods are prescribed:

• X-ray;
• Spiral tomography;
• Osteoscintigraphy;
• Densitometry.

In addition, laboratory blood tests and oncological markers are carried out.

Therapy methods

Medications are prescribed by your doctor to relieve inflammation and soreness:

• Dexalgin;
• Diclofenac;
• Ibuprofen;
• Movalis;
• Fastum gel;
• Fanigan;
• Nimesil.

With intense pain, heel blockade with lidocaine is performed together with diprospan.

Actovegin and Tivortin are shown to eliminate trophic anomalies and restore blood flow.

At the same time, physiotherapy is carried out - UFO, phonophoresis, paraffin applications.

In critical circumstances complicated by a primary disease, the likelihood of surgery is not excluded.

Prophylaxis

To prevent such consequences and costly treatment, absolute attention should be paid in advance to the pain in the heel that occurs when walking. At the first sign, consult a traumatologist or orthopedist. Only after an accurate diagnosis has been made, it is possible to start treating the pains themselves, and in case of complications, the reasons that caused them.