Pain in the heel occurs frequently in people who stand or walk a great deal. This pain may be entirely absent during rest and aggravated by use. The painful area is usually found by manual pressure.
Among the various causes of heel pain injury is the foremost.
Heel pain can manifest in various ways.
There are two bursas between the heel bone and tendoachilles.They are at risk of inflammation from friction produced by ill fitting footwear.
Rubbing of the shoe against the back of the heel leads to commonly known ‘knobbly heels’in children. The inflammation results in pain ,swelling ,redness over the skin.
In acute cases treatment consists of rest from movement.
In subacute cases the bursa may be raised above the level of the shoe by the use of internal heel raise inside the shoe.
In cases where this treatment donot provides a relief your surgeon will do a surgery excising the bursa and overlying bone.
In sportsperson and athletes forcible contraction of the tendon or overstreching can lead to avulsion or rupture of few fibres of the tendinous fibres from bone. This will result immediately in painful movements and bloody effusion at the back of heel.
Rest is essential in this type of injury and the quickest relief is by applying a cast in full plantarflexion for three weeks .
Another common cause of heel pain is inflammation of the plantar fascia which takes its origin from heel bone ,the calcaneum. This causes pain and local tenderness just anterior to the calcaneal attachment of the plantar fascia. Treatment is usually conservative in form of heel wedge, steroid injection, and ankle and foot orthosis.
Plantar Fascitis is common in metabolic disorders like rheumatoid arthritis, gout, reiter syndrome.
Calcaneal spurs is a spike of bone at the anterior edge of the heel bone. This causes pain in the ball of the heel especially on long standing or walking and slight swelling. If the pain is acute the patient should be rested.
After pain has disappeared, felt or sponge rubber pads should be inserted to relieve weight bearing on painful areas. In some cases relief is afforded by radiant heat or steroid injections into the tender area.
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