What are the causes of heel pain?

Heel Pain

The time of the pain, its spread, the period in which it increases during the day, and its relationship with activity should be asked. Underlying systemic diseases and chronic diseases should be questioned.

During examination, it is reviewed as a whole from the waist to the feet. The structure of the foot, the way of walking can reveal the causes of heel pain. If we examine the region in 4 parts,

sole: plantar fasciitis, calcaneal spur, fat pad atrophy, heel stress fractures, tumors nerve entrapment

Back: achilles diseases, bursitis, bony spur, tendon diseases caused by rheumatic

Inside: tarsal tunnel syndrome, nerve entrapment, diseases of the tendon of the thumb, tedninitis

Side part: peroneal tendinitis,

In every heel strike, the sole acts as a buffer. An average healthy individual walks at a speed of 82 meters per minute. At this speed, 110% of the body weight is affected (during running, this rate increases by 200%) and approximately 58-60 heel strikes occur. The fat pad on the sole of the heel is strong enough to meet these loads.

Plantar Fasciitis; The disease we call plantar fasciitis in the sole is the most common cause. In the morning, when getting out of bed, intense pain is felt. It is the inflammation that occurs at the attachment of the fascial tendon to the heel. Pain occurs especially in the heel area. These patients usually have shortened Achilles tendons. Rarely requires surgery. Nonsteroidal drugs, stretching exercises, night orthoses, injections benefit from ESWT treatment.

Wear and tear of the oil pad; Especially after the age of 40, the amount of collagen, elastic tissue and water decreases. In general, it causes thinning and softening in its structure. Severe heel pain is seen in elderly patients on hard uneven surfaces. It has a flattened heel. The calcaneus is easily palpable. There is no tenderness or pain in the plantar fascia. The pain is just under the heel, ‘in the middle’ and at the sole. It is a pain that occurs after overuse activity. It goes away with rest. Semi-rigid heel insoles can be used. Cortisone injection is very inconvenient.

Baxter nerve compression ; It may occur as a result of the compression of the branch of the tibialis posterior nerve, which extends to the side, in the inner part of the heel. There is a ”stinging” type of heel pain. There is numbness and tenderness in the inner part of the heel. Dancers, runners, athletes can pinch the nerve due to muscle development in their thumbs.

Stress fractures of the heel; especially in runners. Repeated blows on the heel can cause this. Compressing the heel causes pain. It may not be seen at first in the x-rays taken. It may be necessary to evaluate in detail in heel pain.

Tumors in the heel area:It should be considered as a differential diagnosis in chronic pain.

Tarsal tunnel syndrome: It can be seen as a result of compression of the tibial nerve branch in the sheath surrounding the ankle. Traumatic, space-occupying masses (ganglion, etc.), bone protrusions, bone protrusions, chronic inflammatory causes may cause these. It can be seen more in heel strike runners. There is pain extending to the ankle and heel. EMG is helpful in making a diagnosis.

If we define these structures generally according to the region of origin,

On the skin: calluses, painful calluses, warts

Fat Layer: thinning, inflammation and damage of the fat pad,

Nervous Tissue: Tarsal nerve syndrome, inner heel nerve entrapment and disease of nerve endings

Bursa(pouch): Achilles bursitis, posterior heel bursitis,

Tendon: tendinitis, synovitis, ailments of the tendons in the foot

Muscular membrane (fascia): plantar fasciitis, traumatic injury

Bone: calcaneus heel spur, stress fractures, os trigonum

These diseases can occur for systematic reasons. These;

Overuse (runner’s heel, Achilles tendon problems, stress fractures)

Rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis, lupus)

metabolic disease (gout diabetes etc.)

There may be reasons such as infection, tuberculosis, gonorrhea, etc.

The content has been prepared for informational purposes. The information on the site can never replace a physician’s treatment or consultation!. Based on this source, it is definitely not recommended to start drug therapy or change the current therapy!. The content of the information should never be evaluated for personal diagnosis or selection of treatment method.

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