02
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Heel Aches
02.07.2017 02:24
Overview

Painful Heel

The most common cause of heel pain is plantar fasciitis. Many patients with plantar fasciitis have a heel spur on the front and bottom of their heel, but heel spurs do not cause pain. The common name is "heel spur" because it's easier to pronounce than "plantar fasciitis" and doctors are able to point to the spur on an x-ray. Causes of heel pain include inadequate flexibility in the calf muscles, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on the feet. Arch support was rated the best treatment in our first survey of 1,800 visitors to heelspurs.com. The Plantar Fasciitis Orthotic is getting the best customer reviews and it is the most popular product. It is new for 2011. Returning customers may be seeking the Pinnacle Orthotic. The primary difference is that the PF Orthotic should be used only for current cases of plantar fasciitis or heel spurs and the Pinnacle is best for general use once the condition has subsided. Survery respondents also benefited from: rest, ice, tape, and night splints.

Causes

Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, can cause heel discomfort in some cases. Heel pain may also be the result of an inflamed bursa (bursitis), a small, irritated sack of fluid behind the heel. A neuroma (a nerve growth) involving the so-called Baxter's Nerve, (a nerve that courses under the heel bone), may also cause heel pain that mimics the pain of a heel spur. Tarsal Tunnel Syndrome, a pinched nerve beneath the inside ankle bone, too, can cause pain in the heel. Haglund's deformity ("pump bump") is a bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure against the shoe, and can be aggravated by the height or stitching of a heel counter of a particular shoe. Pain at the back of the heel is associated with inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called Achilles tendinitis. It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is strained over time, causing the fibbers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon. Bone bruises (Periostitis), are also common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot. Stress fractures of the heel bone also can occur, but these are less frequent. On very rare occasions, there can be problems within the bone structure itself that cause heel pain. Paget's disease, cysts, bone tumours, and other conditions can occur in the heel causing pain, so it is important to be examined thoroughly.

Symptoms

The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot especially after a long period of rest or inactivity. This is usually most pronounced in the morning when the foot is first placed on the floor. This symptom called first-step pain is typical of plantar fasciitis. Prolonged standing can also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the toes back toward the face can be very painful.

Diagnosis

In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history, examining your heel and foot.

Non Surgical Treatment

There are a number of treatments that can help relieve heel pain and speed up your recovery. These include resting your heel, try to avoid walking long distances and standing for long periods, regular stretching, stretching your calf muscles and plantar fascia, pain relief, using an icepack on the affected heel and taking painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs), wearing good-fitting shoes that support and cushion your foot, running shoes are particularly useful, using supportive devices such as orthoses (rigid supports that are put inside the shoe) or strapping. Around four out of five cases of heel pain resolve within a year. However, having heel pain for this length of time can often be frustrating and painful. In around one in 20 cases, the above treatments are not enough, and surgery may be recommended to release the plantar fascia.

Surgical Treatment

Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.

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Prevention

Feet Pain

A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after running. Pace yourself when you participate in athletic activities. Don?t underestimate your body's need for rest and good nutrition. If obese, lose weight.

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