Aching pain in the heel causes. Heel pain: causes and treatment methods. Help of medicinal plants

Great amount people are faced with such a problem as painful sensations in the heel when walking.

This is one of the symptoms characteristic of many diseases, or a consequence of an injury. Female representatives are more often susceptible to such diseases because they wear high heels, further increasing the load on their feet and heels.

Features of the heel structure

Together with the foot, the heel is considered a shock absorber. It consists of bone and a layer of fat, thanks to which it can withstand heavy loads when walking and running. Heel tissues reduce pressure during movement, protecting the spinal column from injury.

The heel bone is the largest of the twenty-six bones of the foot. It consists of vessels, blood, nerve endings, tendons. Heels are often susceptible various injuries, provoking pain syndrome.

Causes of heel pain when walking

If a person complains that the heel hurts, it hurts to step, the cause of this phenomenon may be pathologies that affect the structure of the foot, bones and joints, or injuries. Among the factors that provoke pain, which are not related to diseases, there are:

• the foot structure is too stressed for a long time, as a result of which “heel pain syndrome” appears. This phenomenon is provoked by wearing uncomfortable shoes with a high instep, low-quality insoles or abrupt change high heel to low. Foot tension is often a consequence of flat feet.
• Depletion of the fat layer under the skin of the heel. This can lead to too much quick loss weight, increasing the amount of physical activity and movements.
• Regularly being on your feet all day. This provokes excessive stress on the feet, after which, when a person walks, heel pain appears.
• Active weight gain.

Fasciitis

This is an inflammatory process involving the fascia (the connective membrane responsible for distributing loads on the foot). Inflammation can be triggered by the following factors:

If the causes of heel pain lie precisely in the presence of fasciitis, you can see the following characteristic symptoms:

• Painful sensations are more pronounced in the morning.
• The heel area becomes red, inflamed, and hot.

Treatment of the disease is carried out comprehensively, using medications and foot braces.

Heel spur

This is another pathology that makes it painful to step on your heels. A heel spur is a growth that forms as a result of the appearance of calcium salts on the heel, which begin to protrude beyond its limits, preventing comfortable movement. Often the disease is provoked by fasciitis present in a person. Distinctive features heel spurs from other diseases are:

• pain during physical activity, provoked by the pressure of the growth on the soft tissue.
• The appearance of a swelling that becomes very hard.
• The existing growth is red and hot to the touch.

Treatment of the disease should begin immediately to avoid active growth of the spur, leading to the fact that the foot stops moving. To diagnose the disease, specialists send the patient for an X-ray or ultrasound. When the diagnosis is confirmed, the patient puts a special bandage on the foot to protect it from any pressure.

Tendenitis

Some people cannot determine the reason why their heel hurts and it hurts to step on it. This phenomenon can cause a stretch of the Achilles tendon, called tendonitis. The problem is a consequence of excessive loads on the foot, as well as damage to the heel area.

Tendenitis can be identified by the following characteristic features:

• pain in the heel area is localized on the side of the sole or above it. They become sharp when a person walks or rises on his toes. The most severe pain is felt in the morning, several hours after waking up.
• The pathology site is red, swollen, and hot to the touch.
• It is difficult to move the foot and walk.

When treating tendonitis, you need to provide complete rest to your legs. To do this they are wrapped elastic bandage.

Cold is applied to the heel to reduce acute attacks pain.

Arthritis and arthrosis

Heel pain when walking may be due to arthritis or arthrosis. Arthritis is an inflammatory process in the joints, which is provoked by infectious diseases, weakness immune system. In contrast, arthrosis is changes in the joints that appear with age.

Both diseases manifest themselves similarly:

• painful sensations in the heels, which appear mainly in the evening. Discomfort may also occur in another area of ​​the foot and may not subside even at night.
• Motor activity becomes limited.
• The joint increases in diameter and becomes deformed.
• The site of the disease becomes very swollen.

To cure diseases, they take medications that eliminate the inflammatory process and painkillers. Launched stages diseases may require puncture of the joint affected by inflammation.

Erythromelalgia

It may be painful for a person to walk if they suffer from erythromelalgia, which is caused by dilation of blood vessels. There are such characteristic symptoms of the disease:

• a person has profuse sweating;
• the pathological area becomes reddened;
• the patient suffers from hyperemia;
• a person feels a burning pain if he steps on his entire foot while walking.

Osteoporosis

To understand why your heels hurt when walking, you need to pay attention to the symptoms that are present. If pain is caused by osteoporosis, which reduces the density of the bone process, not only the heel, but the entire foot may hurt. The patient often has a curvature of the spinal column, so he hunches over. The causes of the disease are considered:

• poor nutrition;
• Availability bad habits;
• menopause that occurs too early in a woman;
• After giving birth, a young mother breastfeeds for a long time.

Treatment of the disease primarily involves taking medications that will help replenish the body’s lack of vitamins and microelements.

Bursitis

This is a disease that provokes an inflammatory process in bursa. It appears unexpectedly, and a person experiences pain in the heels when walking. Symptoms characteristic of bursitis are:

• swelling of the lump calcaneus;
• redness;
• the place where the inflammatory process occurs is hot to the touch;
• touching the heel, a person experiences severe discomfort and pain.

Bursitis therapy involves taking antibacterial drugs, complete rest of the legs, necessary physiotherapy.

Heel Spitz

The disease is otherwise called suspended wart. This is a dense, rounded formation that makes it painful to step on your heels and causes itching and burning of the affected area. Treatment of the disease is carried out by removing the pathology medicines or instrumentally.

Damage and injury

Heels hold up heaviest loads, so her injuries are very common. The following types of injuries are distinguished:

• heel bone crack;
• Sever's disease;
• bruised heel.

Calcaneal fracture

This phenomenon often occurs if a person lands on his heels from a height. The heel bone splits into pieces - this is main reason pain in the heels when walking. The affected area becomes swollen and bruising appears. The injured leg moves with difficulty or is completely immobilized.

Calcaneal epiphysitis or Sever's disease

Those who play sports professionally often wonder why their heels hurt after a long walk. Painful sensations also bother them during physical exertion and when lifting on tiptoes. The damaged area is swollen, the calf muscles are limited in movement. When treating Sever's disease, the patient is recommended to wear a special heel pad that accelerates the regeneration of the damaged area.

Video

Plantar fasciitis

Treatment for heel pain

It is very important to know what to do if your heel hurts and it hurts to step on it. Treatment is determined after the underlying cause of the pain is diagnosed. Until the diagnosis is carried out, you must follow these recommendations:

• provide your feet with rest, walk less;
• stop wearing uncomfortable shoes, avoid high heels or flat soles;
• in the presence of overweight body, try to normalize its indicators;
• do therapeutic exercises for feet

If the pain is not caused by a foot injury, the attending physician carries out conservative treatment. If you have diseases that make it painful to stand on your heel, therapy has the following features:

• if there is a urogenital infection, it is recommended to take antibacterial agents capable of overcoming pathogenic microorganisms;
• a person suffering rheumatoid arthritis, prescribe non-steroidal anti-inflammatory drugs, corticosteroids;
• to eliminate pain caused by bone tuberculosis, it is recommended antibacterial therapy, the use of anti-tuberculosis drugs of a synthetic nature.

For foot injuries that cause pain in the heels, orthoses and splints are often used. If a fracture of the heel bone is diagnosed, a splint is applied from the knees to the toes to immobilize the lower limb.

When treating heel pain, doctors recommend various physiotherapeutic procedures and massage. Surgical intervention is carried out extremely rarely if the disease cannot be eliminated with the help of conservative therapy. The operation is performed when a tendon ruptures or it is necessary to remove a heel spur.

Heel pain. “Feeling like a nail was driven in with every step”! - this is how patients describe heel pain and believe that it occurs only because of a heel spur. What is a spur? The plantar fascia starts from the median protrusion of the calcaneus and attaches to the heads metatarsal bones. A heel spur occurs on the anterior surface of the calcaneal tubercle at the site of attachment plantar aponeurosis.

When walking, the moment the heel comes off, tension occurs in the fascia. When wearing uncomfortable shoes, flat feet, or sports overload, this tension can become excessive and lead to chronic inflammation places of attachment of the fascia to the calcaneus. When the foot is overloaded, there is a slow stretching of the plantar aponeurosis, separation from the place of attachment to the heel and gradual calcification of the place of attachment.

This process is slow and takes years. Subsequently, calcium salts are deposited in this place, and a horizontal “spike” up to 2 cm long (heel spur) is visible in the picture. Thus, a heel spur is an outcome, not a cause of the disease. When the heel begins to hurt due to inflammation of the tendon, the bone “spike” is not yet visible on the x-ray. The presence or absence of a heel spur does not in any way affect the diagnosis and treatment of heel pain. Many people have heel spurs on x-rays and have never had heel pain. When this osteophyte matures completely, it does not hurt.

So, heel pain should never be blamed on the “notorious” heel spur. What then could it be cause of heel pain ? And many other serious diseases debut or manifest as heel pain. Put accurate diagnosis and appoint competent treatment Only a specialist can. If you have heel pain, the main thing is not to miss serious illness which can lead to surgery and disability.

Risk factors for heel pain include: overweight, high-heeled shoes, flat feet, chronic overload foot, sports injuries, heel bruise when jumping from a height. In this article we will not consider traumatic causes heel pain. Fractures, dislocations, bruises, and sprains require treatment by a traumatologist.

Heel pain: symptoms. Heel pain causes significant suffering with every step. Clinical picture largely depends on the disease that caused the heel pain. Heel pain can be aching, dull, sharp, burning, or shooting. More often, heel pain occurs when walking. Sometimes pain occurs even at rest, at night, disrupting sleep. The nature of heel pain, as well as the cause that caused it, can be different.

Diseases that cause heel pain.

Plantar fasciitis or heel spur " The main symptom of the disease is sharp pain under the heel, especially pronounced during the first steps after sleep or long rest. The pain can be so severe that during the first minutes patients move with support on the edge of the foot or toes, avoiding stepping on the heel. After a few steps, heel pain noticeably decreases. On palpation, the middle of the heel on the plantar side is sharply painful. If such a painful point is absent, then the diagnosis is doubtful.

Achilles bursitis (inflammation of the Achilles tendon and its bursa). The Achilles (calcaneal) tendon attaches the gastrocnemius and soleus muscles to the heel tubercle. The cause of heel pain is long-term chronic overexertion or acute situational overload. calf muscle, taking anabolic steroids or frequent blockades with corticosteroids. Achilles bursitis occurs mainly in athletes, ballet dancers and dancers, and is often accompanied by tears or ruptures of the tendon.

The pain is localized above the heel and along the back of the leg, accompanied by lameness and the inability to stand on the toes. Clinically, there is tenderness, swelling and redness on both sides of the Achilles tendon. The calf muscles are tense and painful. Pain in the heel and calf intensifies in the morning; when standing up, the patient has difficulty leaning on the sore leg.

Bursitis of the posterior Achilles tendon bursa often develops as a result of excess friction and pressure from the uncomfortable heel of the shoe. But maybe early symptom rheumatoid arthritis. Such bursitis is clearly visible above the heel bone, like a round, painless subcutaneous formation.

Bechterew's disease, reactive arthritis may debut with “spontaneous” heel pain in young people even before the onset of typical clinical manifestations underlying disease.

Reactive arthritis due to infections (chlamydia, ureaplasmosis) has characteristic features: pain in the heels bothers not only when walking, but also at rest, worsens at night. In addition to heel pain, other joints and eyes become inflamed, and urethritis (Reiter's disease) appears.

Radiculopathy S 1 spine occurs when a herniated L5-S1 disc prolapses. When the S1 root is compressed, pain spreads along the back of the leg below the knee to the heel. The Achilles reflex disappears, sensitivity in the heel area is impaired.

Osteochondropathy in the zone of ossification of the calcaneal tubercle occurs in adolescents 12-15 years old. A delay in the remodeling of this area during growth causes severe heel pain. The disease is treated conservatively, the effect is weak. In most cases, heel pain goes away on its own once the child stops growing. In adults this pathology does not occur.
Very rarely, heel pain occurs with tumors, osteomyelitis, and tuberculosis.

In what case should you immediately consult a doctor?

• when there is very severe pain in the heel;
• the intensity of heel pain increases over time;
• with redness and swelling of the heel area;
• with an increase in body temperature.

Diagnosis for heel pain.
General blood analysis(leukocytes, ESR) confirms inflammatory processes in the body. The higher the leukocytes and ESR (erythrocyte sedimentation rate), the more inflammation. An increase in ESR in combination with night pain indicates a rheumatic disease.

Blood test for rheumatic tests. In rheumatic diseases, the level of CRP is sharply increased. Negative rheumatic tests exclude rheumatic causes of heel pain. Positive rheumatoid factor confirms the association of heel pain with rheumatoid arthritis.

Blood test for antibodies to chlamydia and ureaplasma, scraping from the urethra allows you to exclude reactive arthritis in case of heel pain.

X-ray displays bone changes in the heel area, excludes traumatic causes of heel pain, tumors, osteomyelitis, bone tuberculosis.

MRI of the heel area helps to detect the earliest changes in cartilage, tendons, and ligaments. MRI of the lumbosacral spine confirms the presence of disc herniation due to radiculopathy.

Treatment for heel pain depends on the reason. Various diseases require different approach to treatment. To reduce heel pain there is also general rules:

• limit the time you spend on your feet;
• ensure rest of the lower limb for 2-3 weeks;
• give up high heels;
• reduce weight in case of obesity;
• use arch supports, insoles or orthopedic shoes;
• study physical therapy for feet

For achillobursitis, compresses with dimexide or medical bile, or ointments with NSAIDs can be used for external use. You should be careful with warming ointments and compresses. In case of injuries or swelling, warming procedures are contraindicated. In this situation, it is better to apply an ice pack wrapped in a towel to the sore spot for 10-15 minutes.

Physiotherapy and mud therapy are indicated. In case of tendon rupture, it is necessary surgical treatment. For heel spurs, ointments, compresses, laser therapy, acupuncture and physiotherapy have no effect. Shock wave therapy relieves pain well.

In case of inflammation, remove quickly sharp pain in the heel, therapeutic blockades with corticosteroids directly to the source of pain. But they must be carried out by competent doctors strictly according to indications, no more than 3 procedures at one point. Frequent administration of corticosteroids promotes tendon avulsion, so it is dangerous to abuse this method!

For rheumatoid arthritis, treatment should be prescribed by a rheumatologist. Shown constant reception specific basic drugs, non-steroidal or steroidal anti-inflammatory drugs. For radiculopathy, treatment is carried out by a competent neurologist.

For urogenital infections, antibiotics are prescribed under the supervision of a dermatovenerologist. For tumors, tuberculosis, osteomyelitis it is required specific treatment from specialized specialists.

In my hands, the best treatment for heel pain is interstitial electrical stimulation. Just 2-3 VTES procedures relieve the patient of heel pain for several years, or even for life.

Legs are our everything! They carry us through life, taking on everything that we put on our shoulders. However, they also have a section that takes most of the load. While this area is healthy, people usually don’t think about it, but as soon as pain appears, life becomes dramatically more complicated. Today we will talk about why heel pain occurs when walking. The causes of this pathology are different, and the consequences, to put it mildly, are unpleasant. We hope the information presented to your attention will help maintain healthy feet.

Heel from an anatomical point of view

The foot bears the weight of the body and allows for upright walking. The heel is a kind of shock absorber. It is based on the largest bone of the foot - the heel, which is surrounded by a large layer of fatty tissue. All this makes it maximally adapted to heavy loads. When moving, it softens the force of impact, thereby protecting the spine from injury. This is why injuries to the heel bone can lead to various violations spine and, as a result, the spinal cord. Unfortunately, such cases occur quite often, because despite the apparent solidity, the heel bone is quite fragile. This is due to the fact that it has a spongy structure, with nerves and blood vessels passing through it. All this creates certain preconditions for its damage. As a result, a person feels pain in the heel when walking. The reasons for this can be very different. Let's look at the most common ones. So…

Causes not related to diseases

Oddly enough, one of the most common causes of heel pain is uncomfortable shoes. Of course, beauty, as we know, requires sacrifice, but narrow shoes that squeeze the foot, as well as high heels, are a direct cause of pain in the heel of the left foot, and the right one too. By shifting the load when walking onto the foot and thereby disrupting the order established over millions of years of evolution, uncomfortable shoes can greatly affect the health of the feet in general and the heels in particular. Fortunately, this problem is easily solved. What needs to be done to stop heel pain when walking? Treatment in this case will consist of revising your wardrobe and giving up those pairs of shoes that cause the most negative sensations. Orthopedic insoles that help support the foot correct position, can also improve the situation.

Another common cause not related to pathological processes in the body is injury. Spicy, burning pain in the heel can be caused by damage to other bones that make up the foot or the ankle joint. The logical solution in this case would be a visit to a traumatologist.

Pathological changes in the heels

In addition to physiological ones, there are a number of factors that can cause heel pain when walking. The causes of discomfort should often be sought in disruption of the body’s activity and various pathologies. Such symptoms may accompany the following diseases:

• plantar fasciitis;
• heel spur;
• inflammation of the tendons of the foot - tendinitis;
• arthritis of various origins - rheumatoid, psoriatic, reactive infectious etiology;
• osteoporosis;
• gout;
• erythromegaly;
• diabetes.

Of course, not all of these diseases are widespread, so let’s talk in more detail about the most common pathologies.

Plantar fasciitis

Among all pathologies associated directly with the foot, plantar fasciitis occupies a leading place. Its development occurs due to degenerative inflammatory processes in the fascia of the sole of the foot. It is a durable plate connective tissue, with the help of which the calcaneus is combined with the metatarsals. The plantar fascia performs a supporting function, forming the arch of the foot. In addition, its task is shock absorption when running and walking. Under significant loads, micro-tears and cracks form in the fascia, which cause inflammation. Most often this is due to wearing shoes with too low heels or no heels at all, overweight, work on your feet. As a result, pain appears in the heel of the left foot if the process affects the left fascia and, accordingly, in the right one if the right one is damaged.

Treatment in this case will consist of limiting the load, using orthopedic shoes, as well as special orthoses that fix the foot at a right angle at night. If the measures taken do not produce results and do not relieve heel pain when walking, treatment consists of the use of anti-inflammatory and painkillers. You can also achieve significant relief by doing an ice massage.

Heel pain: spurs

A heel spur is a direct continuation of plantar fasciitis. IN damaged tissues plantar fascia located at the heel bone, calcium salts are deposited over time and a bone outgrowth is formed. The main symptom of this disease is pain in the heels in the morning, when walking up stairs and during prolonged exercise. Spur is a rather serious disease, and its treatment requires integrated approach. First of all, the patient needs to be provided with functional rest for several weeks. Hormone therapy is carried out: corticosteroid drugs are injected into the heel area. In addition, physiotherapy has proven itself well - shock wave and laser therapy, massage. If conservative treatment is ineffective, surgical intervention is resorted to.

Achilles tendonitis

This disease is a degeneration and inflammation of the tendon connecting the calf muscles and the heel bone. The cause of the pathology is most often excessive load and tight, uncomfortable shoes. If the inflammatory process continues long time, a tendon rupture is possible. Tendonitis manifests itself as pain along the tendon, which intensifies when you try to stand on your toes. The pain syndrome is most severe in the morning. When examining the limb, you may notice swelling and redness in the ankle and heel area. The mobility of the foot is sharply limited.

Treatment of teninitis requires urgent medical intervention. If a tendon ruptures, the limb must be immobilized, cold compresses applied, and the victim urgently taken to the hospital. medical institution. Surgical intervention in this case is inevitable. If a rupture does not occur, a visit to the doctor still should not be postponed. A trauma surgeon or orthopedist will prescribe anti-inflammatory therapy and draw up a rehabilitation program.

Diagnostics

In order to answer the question “how to get rid of heel pain,” you first need to correctly determine the cause of the discomfort. At the first appointment, the surgeon or orthopedist will general examination and will appoint additional examinations. An X-ray is usually sufficient to diagnose a heel spur or fasciitis. Sometimes additionally prescribed ultrasonography. An MRI is used to identify problems in the Achilles tendon.

It is much more difficult to make a diagnosis if the heel pain is associated with systemic diseases. In this case, it is necessary to involve doctors of other specialties. So, for example, if possible reason rheumatoid arthritis could cause similar pain, then without extensive biochemical blood tests and consultation with a rheumatologist, diagnose correct diagnosis it will be very difficult. The same applies to diabetes mellitus. If your blood sugar level increases, you simply need to consult an endocrinologist.

Heel pain when walking: how to treat

Of course, treatment for this problem should be prescribed by a doctor, but if the pain appears for the first time, you can try to cope with it yourself. In the first two days, it is recommended to use ice massage. To do this, rub the heel with a piece of ice several times a day for five to seven minutes (until it becomes numb). IN next days cold is alternated with heat, that is, fifteen minutes after the massage with a piece of ice, a heating pad is applied to the heel. Once a day such exposure will be enough. With pronounced pain syndrome You can use anti-inflammatory drugs (Ibuprofen or Diclofenac). However, it is better to talk to your doctor about choosing a drug.

Prevention

Of course, any discomfort, including pain in the heel when walking, the causes of which can be very different, will not make anyone happy. And if you haven’t encountered it yet, then it’s better to take certain measures to prevent it from appearing. Shoes play a huge role in this. Avoid tight shoes in very high heels. However, you should also not wear flat shoes or sandals. In addition, it is necessary to limit loads - excessive loads will not benefit your body. Excess weight is also an important factor in the development of the pathology we are considering. But the most important thing is to remember that such pain cannot be ignored. If they do not disappear within a few days, then you should consult a doctor, because the longer treatment is delayed, the greater the chance of developing complications.

Conditions for survival in modern world force many people to spend a large number of time on the move and “on your feet,” sometimes for days without being able to fully rest. This kind of workaholism puts a lot of stress on your feet, which can ultimately lead to a heel injury. Heel pain creates a lot of discomfort, but many people are used to enduring it.

Doctors do not advise performing such feats and, if possible, do not delay and consult a doctor as early as possible, because a sore heel is no joke, and the treatment of this pain must be approached responsibly and not delayed until the pain worsens.

The heel, consisting of the calcaneus and a soft layer of fat, performs a very important shock-absorbing function when walking and running. In addition, a large number of capillaries and nerve endings are concentrated in the heel. All this makes the heel a very vulnerable place, in fact an Achilles heel.

Causes of heel pain

1. Diseases of the heel bone.
2. Arthritis of the joint under the talus.
3. Heel tendon rupture.
4. Heel paratendinitis (pain noted deep in the heel tendon).
5. Posterior calcaneal bursitis (thickening of the bursa above the roughness of the heel bone, on the back of the heel).
6. Soreness of the heel (heel) pad (in this case, pain is noted in lower section heels).
7. Plantar fasciitis (pain under the front of the heel bone).

Statistics show that patients most often complain about plantar fasciitis- inflammation or tearing of the strip of fibrous connective tissue that covers the entire sole from the heel to the toes. The sources of fasciitis can be either uncomfortable shoes or a violation of the bone structure due to heavy loads, flat feet and other mechanical problems with the legs. Heel pain can also occur due to inflammation of the tendon tissue, which is accompanied by a feeling of a “needle in the heel.” Rheumatoid arthritis is another source of heel pain. In such a situation, doctors recommend wearing shoes with open heels.

Most often, people who are prone to obesity, have problems with the spine, and flat feet have problems with heels. Athletes, especially athletes, often have problems with heel pain. Fasciitis mainly affects older people, but in Lately this disease has become significantly “younger” due to poor ecology, poor-quality food, and a stressful lifestyle. All these factors disrupt the metabolism in the body and calcium metabolism, which makes bones and joints more vulnerable.

Injury to the tendon, its overload due to flat feet, as well as a bruise of the heel bone can lead to heel pain. There are also infectious prerequisites for the appearance of a “nail in the heel”: gonorrhea, chlamydia and other sexually transmitted diseases can cause heel pain even at rest and during sleep. Doctors also found that the cause pain in the area of ​​the heel bone there may be chronic joint diseases, such as ankylosing spondylitis, psoriatic arthritis, gout.

Fasciitis and its symptoms

The first symptom of fasciitis or “heel spur” is pain in the heel when walking immediately after sleep or rest. The pain feels so unbearable that victims of fasciitis try to step on their heels as little as possible. After some time, the pain may subside, or it may return at the most unexpected moment or at the moment of sudden stress on the legs. This painful effect occurs due to the fact that while a person is immobile, micro-tears in the edematous, chronically overloaded aponeurosis grow together. However, as soon as a person takes a few steps, the fascia ruptures again.

Doctors note that most often patients complain of a dull aching pain in the middle part of the heel bone. Such pain can torment all day without a break. It is especially difficult for overweight people and those who “due to duty” are forced to be “on their feet” for a long time during the day. This pain may move distally down the foot toward the metatarsal heads. There have been cases where heel pain causes pathologies in the Achilles tendon area, but this phenomenon is quite rare. Medical observations allow us to conclude that most often fasciitis occurs during prolonged everyday stress, which a person, due to habit, may not even pay attention to. Athletes are more susceptible to the disease, especially those who decide to increase the systematic load on their legs, for example, when running.

There is a theory that frequent change Sports shoes can lead to fasciitis, but in practice there are not many such cases. Fatigue injuries in athletes, such as tendinitis or paratendinitis of the Achilles tendon, also in combination with plantar fasciitis, which is usually found in athletes, make it difficult to make a more accurate diagnosis in a short time.

Neurological causes of heel pain

Mechanical damage to the heel can lead to pinching of the posterior and lateral tibial nerve, which can also turn a healthy person’s foot into an “Achilles heel.” This pain mainly occurs at rest. It can cause the development of low or hypersensitivity(hypo- or hyperesthesia) in the distal parts of the foot. This complicates the diagnostic process, since problems with nerve patency do not make it possible to establish the exact causes of the disease. Pinching of the branches of the lateral calcaneal nerve completely makes the muscles adjacent to the bones insensitive, which makes it difficult for doctors to determine the diagnosis.

The influence of systemic diseases on heel pain

The feeling of a “nail in the heel” can occur as a consequence of systemic connective tissue diseases such as Reiter’s syndrome (arthritis, urethritis and conjunctivitis), ankylosing spondylitis (ankylosing spondylitis), systemic lupus erythematosus and others. If swelling is visually visible in the heel area or joint below the ankle, you should sound the alarm and immediately go to the doctor. X-ray will not help in this case. Need deeper diagnostic methods, such as magnetic resonance imaging and when “heel” pathologies associated with systemic diseases are detected, treatment must begin with the main disease, and only if the patient does not have any improvement, it is worth starting treatment directly for heel pain.

Treatment for heel pain

At the first symptoms of fasciitis or other pathologies associated with heel pain, you should never self-medicate, otherwise you can only harm yourself. And it is not recommended to delay going to the doctor. To establish a diagnosis, you need to contact an arthrologist, rheumatologist or orthopedist. Typically, patients are first referred for X-ray diagnostics, general and biochemical analysis blood, and only after that a course of treatment is prescribed.

If we do not take into account diseases of the heel bone and rupture of the Achilles tendon, then they usually resort to conservative treatment: the patient is recommended to change shoes (so that they do not rub their feet).

Local steroid injections may help with calcaneal paratendinitis and plantar fasciitis. If conservative methods If treatments do not relieve the pain of posterior calcaneal bursitis, the bursa can be removed surgically.

Treating a sore heel is a long process. And to relieve pain, doctors advise adhering to the following tips.

1. Alternate ice massage with warming. For the first two days after the onset of acute pain, doctors advise doing an ice massage 3 to 4 times a day. Continue the procedure for 5 - 7 minutes until the heel goes numb. It is also recommended to apply ice to the sore spot for 15 minutes once a day, then take a 15-minute pause and immediately apply a hot heating pad to the sore spot. Warm up the heel for about 15 minutes.
2. Take pills. Non-steroidal anti-inflammatory drugs, for example, ibuprofen or its more effective analogue, will help reduce inflammatory processes. A doctor's consultation is required first.
3. Use instep supports and thrust bearings. In pharmacies you can buy special instep supports and heel pads that ease the body's load on the sore heel and protect it from impacts. Since there are quite a few types of thrust bearings, an orthopedic surgeon will help you in choosing the necessary “model”. Arch supports and orthopedic inserts - special orthopedic insoles - will also help relieve not only symptoms, but will also directly help treat heel pain, especially if they are associated with injuries, flat feet and others mechanical damage feet.
4. Increase the heel lift in your shoes. The essence of the advice is that you need to raise and fix the position of the heel in the shoe to reduce the load on it. A heel insert that is inserted into everyday shoes will help with this. It will increase the heel lift by 0.3 - 0.6 cm and significantly relieve pain.
5. Knead your heel with a massage. Poor elasticity of the connective tissues in the heel area can cause pain. To relieve pain, you need to regularly stretch your tendons. Sometimes doctors prescribe massages as the main treatment.
6. Do exercises for your feet. On distance arm's length Take a position near the wall, rest your palms on it, spread your arms shoulder-width apart. Take a step back with your right foot, bend left leg in the knee. Now you need to tilt towards the wall, while you need to touch right heel floor and hold your leg in this position for 10 seconds. You will immediately feel the muscles in your right calf stretch. As the exercise progresses, you can move closer to the wall, while moving right leg. The exercise is performed in 10 approaches for each leg. Please note that the load on the heel should be balanced, without excessive pressure at the moment it touches the floor. do not make sudden movements.
7. Choose the shoes you wear carefully. Comfortable and the right shoes- the key to a healthy heel. When buying shoes, first of all, keep in mind that your feet should feel comfortable. Pay attention to the line from the middle of the heel to the toe. If this line does not divide the arch of the foot into two approximately equal parts, then in such shoes the load on the heel will be much greater. In addition, shoes should have heels or high arches for greater stability. However, the heel should not exceed 0.8 -1.2 cm, and the outsole should be sufficiently elastic. Shoes should not be hard. Shoes should also not be worn out, since the shock-absorbing properties of such shoes deteriorate significantly, which can increase heel pain. As soon as you notice that the sole is worn out by more than 50%, you should go to shoe shop for something new.

When walking and stepping - a fairly common symptom of many diseases and traumatic injuries. The heel area is saturated blood vessels And nerve endings, which leads to painful sensations at the slightest deviations in tissue structure. But to understand why your heels hurt when walking, and what to do if it hurts to step on your heels, you need to find out what pathological process such feelings are associated.

Causes not related to diseases

Man leading active image life, experiences significant discomfort when it hurts to step on the heel. After all, he not only experiences unpleasant discomfort, but also loses the ability to move normally. Often such sensations appear in absolutely healthy people and the search begins for what to do if the heel hurts and it hurts to step on - the reason may be on the surface, you just need to analyze your lifestyle.

The causes of heel pain when walking are often associated with:

1. Availability excess weight. People who have suddenly gained weight or are severely obese are especially affected. An unbearable load puts pressure on the feet and pain inevitably appears after walking.
2. Pregnancy. This is one of the situations where the weight increases quite sharply and increased load falls on the legs when walking.
3. Excessive physical activity. Moreover, this can be either sports or loads associated with professional activity, and prolonged standing.
4. Wearing uncomfortable shoes. Tight and with a narrow toe, on high heels and with an uncomfortable last, shoes inevitably lead to discomfort after prolonged wear.
5. Atrophy subcutaneous tissue. Pain in the heel area may be associated with loss of shock-absorbing function due to loss of fat layer - this process develops against the background of sudden weight loss and excessive stress on the foot.

With these factors, pain usually appears after a long walk. It is enough to give your legs a rest so that the discomfort goes away.

Traumatic injuries

Pain in the heel when stepping may indicate tissue damage in the area. Typically, such symptoms are preceded by direct or indirect trauma. At the same time, the person is worried strong pain exactly at the moment of injury. Further symptoms will depend on the type of injury:

If it is painful to step on your heels due to an injury, complete immobilization of the right or left leg will be required. IN difficult situations the operation is being performed.

Inflammatory processes

If the heel hurts when walking, a person often attributes the discomfort to excessive loads, the result of excessive impacts on the surface of the shoe. But aching pain in the heels may indicate the presence of inflammatory processes in this area. In this case, specific treatment is required, and its absence can lead to the transition of the disease to the chronic stage.

Arthritis

Unbearable sharp pain in the right or left leg may indicate worsening arthritis. Usually such sensations do not come suddenly, the pain increases gradually. At the site of the lesion, local hyperemia, swelling and stiffness in the joint are observed.

Among all types, rheumatoid and reactive ones most often affect.

The rheumatoid form is considered the most dangerous. It is almost impossible to cure it. The disease belongs to the systemic autoimmune form, in which the body itself destroys tissue as if it were foreign. How to treat heel pain associated with rheumatoid arthritis is determined by the attending physician, depending on the body’s response to certain drugs and methods. First of all, the inflammatory reaction is removed, after which they can be prescribed basic drugs cyostatics, antimalarial drugs, sulfonamides, penicillamines.

No less dangerous is the reactive form of the disease, in which the pain comes suddenly and negative symptoms develops in a matter of hours. Typically this pathology has infectious origin and is often associated with the presence of a viral infection.

In addition to the use of anti-inflammatory and painkillers, the patient is prescribed antimicrobial drugs.

Treatment for heel pain due to arthritis involves providing functional rest. When acute symptoms stopped, physiotherapy and therapeutic exercises are prescribed.

Video

Video - Heel pain

Bursitis

Often patients complain that the leg in the heel area suddenly hurts, without any significant reason. If the back of the heel hurts, there may be inflammation of the joint capsule. This disease often occurs in athletes who constantly load the heel bone and foot during training. These are, first of all, football players, cyclists, and volleyball players.

Sharp pain is accompanied by:

• swelling of the back of the heel;
• redness of the inflamed area;
• pain on palpation;
• increase in skin temperature.

The pain intensifies when walking - which is natural in the presence of an inflammatory process.

Tendinitis

The causes of this pathology lie in excessive load calf muscle. Constant overexertion provokes contraction and shortening of the tendon. As a result, the tissues cannot take their natural position, which explains why the heel hurts and it hurts to step on the foot.

In this case, the pain extends not only to the heel area, but also to the calves. It is especially problematic to take the first steps after rest.

If such symptoms are left unattended, the tendon tissue degenerates, and the risk of complete separation from the heel bone increases significantly.

Can be heard from some patients if available inflammatory pathologies that, despite the pain, I get up and walk. In this way, patients try to give a minimum load in order to disperse. But this approach is fundamentally wrong. Any walks must be canceled during treatment.

The main thing is to give the leg complete rest at the first stage of treatment. Only after the inflammation has been eliminated is it possible to include massage, exercise therapy and physiotherapy.

Age-related and dystrophic changes

From patients over 40 years old, you can hear complaints that walking has become difficult, and the heel hurts unbearably when stepping on it. Most often, such signs indicate age-related changes in the structure of the tissues of the foot.

Plantar fasciitis and heel spurs

The diseases are closely related to each other. The primary is overstrain of the fascia, which occurs against the background permanent loads on the foot, deterioration of tissue elasticity. As a result, the fascia connecting the heel and toes become inflamed, which leads to unpleasant sensations. The first steps after a night's rest are especially painful. During sleep, the foot is in a position in which the plantar tendons are relaxed. After a long contraction, returning the fascia to its original position is problematic. It is at these moments that piercing pain is felt.

Over time, at the site of attachment of the tendon to the heel bone, it becomes denser due to the accumulation of calcium elements. In fact, in this place appears bone spur, which looks like a spike. In backgammon, such a spike-like formation is called a “heel spur.” Patients complain of pain directly when stepping, when the heel literally pierces like a needle.

Depending on the location and size of the calcaneal osteophyte, the patient may feel pain only in the morning or in certain shoes. As the growth increases, walking becomes problematic, as almost every step is accompanied by pain.

There are many treatment methods for heel spurs in the form of:

• unloading of the pathological zone due to orthoses and special shoes;
• physiotherapy aimed at softening bone formation;
• shock wave treatment.

But it is considered the most effective surgery, in which the growth is removed.

Osteoporosis

The presence of strong ones may signal depletion of bone density. The development of osteoporosis affects almost every bone in the body, and the heel bone is no exception. There can be many reasons for such a disease, but it is based on either leaching minerals, necessary for the synthesis of bone elements, or an imbalance in the activity of osteoblasts and osteoclasts, responsible for the destruction and production of bone cells.

Moreover, the nature of heel pain in osteoporosis can be twofold:

• loss of density of the heel bone itself causes painful symptoms and even microtraumas;
• deterioration of the spine, which leads to a redistribution of loads specifically on the foot area;
• damage to the knees or hip joints causes changes in gait and excessive pressure on the heels.

The disease is considered quite insidious, as it does not give characteristic symptoms on initial stages. When patients come to the doctor with complaints that their heels hurt when walking, it is too late to look for causes and treatment for advanced osteoporosis, since the bone structure, and the foot is deformed. Most often, drugs with calcium and vitamin D are prescribed, as well as drugs that stop the activity of osteoclasts.

In addition to the main reasons, causing pain in the heel, there are also more rare ones associated with infectious, neurogenic, oncological lesions, and diseases of the spine. Therefore, ignoring such a sign and letting the disease take its course is dangerous, and sometimes fraught not only with loss of mobility, but also with disability.