Heel pain is a very important health problem that reduces the quality of life of people. When you ask the people around you, you will see that most middle-aged people suffer from this problem at some point in their lives.
Contrary to popular belief, the heel spur (epin calcanei) is not responsible for all heel pain. The leading cause of heel pain is the strain of the plantar fascia tissue, which is called planter fasciitis and is a part of the springing mechanism when walking on the sole. As a result of the forcing of this tissue, small tears occur in the tissue. If the body cannot heal these tears, the patient’s pain begins and later on, petrification (calcification) appears in the X-ray films of this structure close to the heel bone.
Patients call this condition, which feels like a thorn prickles their feet, especially when they take their first step in the morning, but contrary to popular belief, there is no tangible thorn causing the pain. The cause of the pain is the stretching of the diseased tissue with the first compression. After taking a few steps, this tension is usually relieved and patients’ pain is relieved. However, if the person walks for too long or stands for a long time, the pain starts again and sometimes the pain continues even at night.
The conditions that are most confused with heel spurs can be listed as nerve compressions at the ankle or lower back, Achilles tendon problems, osteoporosis and stress fractures. Your doctor may start treatment or refer you to another doctor, depending on the cause of the pain.
If your ball has been hurting for more than a month and the pain is too much in the first step, it would be beneficial to go to the doctor. Although there are cases of self-pain in the public without doing anything, patients suffering from chronic pain are in the majority. It should be noted that in cases diagnosed early, treatment can be much more successful. An accurate physical examination is the most important element in diagnosis. It is not absolutely necessary to take a film in a patient who is admitted to the doctor with heel pain. In addition, diagnostic tools such as normal x-ray film, Doppler USG, EMG or MRI can be used when necessary.
After the diagnosis of heel spur (plantar fasciitis), different treatment alternatives can be applied in the early or chronic periods for treatment. 95 percent of heel pain can be treated without the need for any surgical intervention. A simple silicone heel to be used in the early period (first 1-1.5 months), plantar fascia stretching exercises, shoe changes and medications are generally improved. In cases where there is no success in the later or early period treatment, the success rate is close to 80% with a specially made insole that balances the pressures on the soles of the feet and a cortisone injection made in accordance with the technique.
If success is not achieved despite these treatments, or if your problem continues for more than 3 months, ESWT treatment, which has been applied in the world in recent years, is the last option before surgery. In fact, according to some authors, ESWT treatment should be offered as an option before cortisone injections in the heel, since it is not an invasive method.
ESWT therapy works in principle similar to kidney stone breaking machines (lithotripsy). The misconception in society is that this treatment is a thorn breaking treatment. The sound waves created by the machine are focused at one point and cause minor damage to the tissue. This stimulates the body’s healing mechanisms and allows the damaged area to heal quickly. The treatment is completed in 3 sessions performed once a week and at a pain level that will not disturb the patient. Healing continues at an increasing level within 1-2 months after the end of the treatment and the pain is expected to decrease to zero at the end of this period. Studies show that ESWT treatment provides 80 percent success.
If none of these treatments are successful and the pain affects the daily life of the patient or reduces his activity, surgical treatment methods are used. What is done in surgery is to remove the diseased tissue and it is applied as a day surgery (without hospitalization). There is a recovery period of 3-6 weeks after surgery and has a 95% recovery rate.
In the light of this information, we need to know that there are different causes of heel pain and that there are treatment methods that vary according to each cause. Heel pain should be taken seriously by the person and should not be left aside because it will go away on its own anyway. It should be kept in mind that with early diagnosis and simple treatment methods, a high rate of painlessness can be achieved.