Heels hurt, why it hurts to attack, how to treat pain in the heels

Probably, some of you experienced soreness in the heel when walking. By the way, this is a very common symptom of a certain range of illnesses or consequences of injuries. In women, this ailment is more common than in men. Walking on a high heel significantly contributes to its negative contribution to the appearance of heel pain.

Our heel thanks to a special anatomical structure with the presence of a dense layer of fat can withstand heavy loads. But because of the spongy structure of the calcaneus, the mass of nerves and blood vessels passing through it, it is extremely vulnerable and sensitive to trauma or diseases. Elementary damage to many nerve endings leads to constant pain during walking, difficulty, and sometimes to complete inability to step on the heel.

How is the heel arranged?

In the features of the structure of the heel, its main function is laid. The heel acts as a shock absorber when supported by a foot. It accounts for the bulk of the load during walking or standing on the legs. The heel consists of muscles, ligaments, tendons, calcaneus, a thick fat layer, a network of blood vessels and a variety of nerve fibers.

The sponge calcaneus is the largest of 26 bones of the skeleton of the foot. Located at the bottom of the back of the metatarsus. Has a flattened lateral and slightly elongated body, a well palpated calcaneal tubercle and two articular surfaces. Employees for articulation with a cuboid bone in the front, with a ram from the top. In addition, there is a protrusion, which is the support of the talus bone. It binds the bones of the lower leg and the heel.

Pain in the heel when walking: causes

Pain in support of the heel can occur for a variety of reasons, conventionally divided into several groups:

1. factors not associated with any diseases;
2. diseases with direct damage to foot structures;
3. diseases affecting the osteoarticular apparatus; injury.

Causes not related to diseases

№ п / п	Disease	Comments
1	Prolonged overstrain of foot structures	Promotes the emergence of "heel pain syndrome". Overstrain of muscles can result in wearing shoes with an unsuitable shoe, lifting, insole, and frequent changes of high heels to unusually low. Strain can be strained because of flat feet.
2	Atrophy of the subcutaneous fat pad in the heel	It occurs as a result of a sharp weight loss or an increase in everyday motor activity, coupled with physical overload.
3	Constant stay on the feet for a whole day	By the end of the day, the legs are tired, and a person can feel soreness in the heels while walking.
4	Stable obesity or harsh weight gain	For a short time, it increases the load on the feet.

Diseases of foot structures, manifested by pain in the heels

№ п / п	Disease	Comments
1	Plantar,orplantar fasciitis	The most common cause of pain in the area of ​​the heel. Pathology is widely known as "calcaneal spur". This foot disease, characterized by inflammation of the plantar aponeurosis - a dense sheet of connective tissue that connects the bases of proximal phalanges of the fingers to the anterior medial surface of the calcaneus. Stretching, aseptic inflammation, microflora of the plantar fascia arise due to increased stress on it, weakness of the ligamentous apparatus, hypertension of the gastrocnemius muscles, etc. The process affects mucous bags, soft tissues and perioste, accompanied by the deposition of calcium salts in the area of ​​inflammation. As a result, a pathological bone growth is formed, leading to chronic pain in the heel when walking (calkanodinia).
2	Achilles tendon tendonitis	Inflammation of the calcaneal tendon, accompanied by degenerative changes.
3	Disease of the North, orapophysitis of calcaneus	Often diagnosed in children with a disease, accompanied by painful tension and / or stretching of the tendons and muscles, resulting in pain in the foot after a long run, playing sports or because of the rapid growth of the skeleton.
4	Haglund-Shinz disease	Disease caused by aseptic necrosis (necrosis) of the bone surface at the site of the greatest mechanical effect.
5	Bursitis	Inflammation of the synovial cavity with abundant production and accumulation of inflammatory exudates therein.
6	Achillodinia	The onset of the inflammatory process in the calcaneal tendon.
7	Thrassal canal syndrome	It is characterized by compression of the branches of the posterior tibial nerve.
8	Morton's Neuralgia, orcompression neuropathy of plantar nerves	Compression compression of the common nerves of the sole innervating the toes. The result is an acute burning pain that spreads over the entire surface of the sole.
9	Sensory neuropathy of a hereditary nature- varietypolyneuropathy	In autosomal dominant type of pathology, distal legs are hypotrophic with dissociated sensitivity disorders, leading to severe pain in the feet.
10	Valgus deformation of the foot	The pathology, characterized by the X-shaped curvature of the axis of the feet, as a result of this they flatten, "falling" inward, and the heels turn outward.

Common diseases leading to damage to the bones and joints of the feet

№ п / п	Disease	Comments
1	Erythromelalgia	A rare vascular disease caused by paroxysmal expansion of capillaries and small arteries, disturbing peripheral vasomotor reflexes. The zone of lesion can serve as a stop, while burning pain occasionally arises from exposure to heat.
2	Malignant neoplasm in the bones of the feet	The growth of the tumor leads to compression of the nerve endings and vessels, causing chronic pain.
3	Metastatic disease	Metastases of cancer with blood flow are recorded in the lower extremity, in particular the foot.
4	Rheumatoid arthritis	Systemic inflammatory-degenerative disease, affecting small joints of the whole body, including the foot.
5	Bechterew's disease	A serious systemic disease of a chronic nature, affecting the advantage of large joints and articulations of the vertebrae. Sometimes, due to ossification of the ligaments and disks of the joints of the spine, the patient experiences pain in the heels.
6	Osteomyelitis	Bacterial infection affecting the bone, bone and bone marrow. In the osteomyelitis of the calcaneus, deformation and sclerosis of bone structures is observed.
7	Tuberculosis of bone	With melting of the bone or its necrosis.
8	Gout	Serious metabolic disease. The deposition of uric acid crystals in joints leads to pronounced deformations of the bones, and in the kidneys to inflammation and the formation of stones.
9	Various infectious diseases	Some intestinal infections, for example, iersiniosis or salmonellosis, as well as urogenital, whether gonorrhea or chlamydia. Flowing in a latent form, they often lead to the emergence of reactive arthritis, which affects along with other joints and the articulation of the calcaneus.
10	Cracks on the heels	They are the result of diabetic foot, mycosis or dermatitis.

In the appearance of heel pain can be to blame for beinginjury:

1. Rupture or stretching of the tendon.
2. Fracture or fracture of calcaneus.
3. Heel bruise.

What is the nature of the pain when walking in the heel?

Depending on the etiological factor, the heels can hurt differently. By nature, the pain is stinging, cutting, dull, shooting, aching.

It is important to distinguish its features, this will help doctors to establish the exact cause and to prescribe adequate treatment. Pain can be both the initial manifestation of foot disease, and one of the symptoms of a common disease.

Burning painhappens whenerythromelalgiaandpolyneuropathy. ATfirst casehot weather or even a dream under a warm blanket leads to a pathological expansion of capillaries and vessels in the limbs, as a result of which a person suffers from a debilitating burning sensation not only in the heel, but in the entire foot.

Sleep and mood are disturbed, discomfort appears when walking. The skin in the area of ​​the heel acquires a red color with a cyanotic hue. There is a unique desire - to cool feet, having lowered them in cold water.

Inthe second, for example,metatarsal neuralgia, the compression of the plantar nerves results in the appearance of sharp, burning pains that spread all over the foot. Inflammation or trauma to the tendon also manifests acute burning pain in the affected area.

Pain in the heel affectedfasciitis, it happens when walkingAfter sleeporrecreation, especiallyin the morning. It is so strong and unbearable that a man must avoid stepping on his heel.

At rest, the pain subsides or dulls, but with the slightest load on the heel resumes. The return of pain during walking is explained by repeated microfractures of the inflamed and edematous aponeurosis, which grow together during the absence of motor activity of a person.

Whenheel spurpatients complain aboutblunt aching pain in the middle of the heel, increasing with walking. At everyone the pain can be different: periodic when you step on a heel, or a constant nojushchej, alternating acute at walking. Often a person feels a "nail in the heel." The most difficult is for obese people. They are due to obesity, the load on their feet is several times higher than in people who have a normal weight.

Tendonitis of Achilles tendon, rupture of ligaments, plantar fasciitis, bruises of heeloften diagnosed in athletes involved in running or those who are forced to dramatically increase the systematic burden on their legs.

Sharp unbearable painin the heel areawith inability to supportIt appears atcalcaneus fracture. Traumatologists know that the period of bone fusion and recovery period is very long. Even after removal of gypsum the patient for a long time can not fully step on the injured heel.

Lesion of foot joints, accompanied by painfulness of different intensity, occurs whenRheumatoid arthritis, ankylosing spondylitis, some systemic autoimmune diseasesorinfectious diseases. Diabetesleads to disruption of the trophism of the tissues of the feet, manifested by painful cracks and ulcers on the heels.

How to diagnose pathologies that result in heel pain

For pain in the heel, you should consult a rheumatologist or an orthopedic trauma specialist. It may be necessary to consult other "narrow" specialists - oncologist, infectious disease specialist, surgeon or neurologist.

Scheme of diagnostic measures is determined after a physical examination of the patient. The collection of anamnesis and complaints with the elucidation of the presence of chronic or recently transferred diseases, visual objective examination with palpation of the painful area allow the doctor at this stage to make a preliminary diagnosis and to assign the necessary examinations, the results of which will serve as the basis for confirming or excluding the alleged pathology.

Clinical and laboratory diagnostics

№ п / п	Method of research	Comments
1	"Biochemistry" and a clinical blood test	Allow to detect the presence of inflammation, for example, with arthritis. An increase in the level of uric acid indicates gout.
2	Blood test for oncomarkers	Assign if you suspect a malignant tumor.
3	Revmoprobes	With the definition of rheumatoid factor, circulating immune complexes, albumins, C-reactive protein, detection of antibodies to O-streptolysin. Necessary to confirm rheumatic and autoimmune diseases.
4	Bacterioscopic examination of exudate	Taken after the puncture of the joint bag. These methods allow us to identify the inflammatory lesion of the bursa.
5	Microbiological examination of scraping from the urethra	In order to determine the causative agent of infection of the genital area.
6	Bacteriological analysis of articular fluid	To clarify the nature of the inflammation, the type of pathogen and determine its sensitivity to antibiotics.
7	Blood test for sugar	It is necessary to determine the level of glucose in diabetes, so that, by stabilizing the index, reduce the negative impact of sugar on the vessels of the legs.

Instrumental diagnostics

№ п / п	Method of research	Comments
1	Radiography	The leading diagnostic method for painful sensations in the heel. It allows to reveal breaches of bone tissue integrity and other specific structural changes.
2	Puncture bone biopsy	It is indicated if there is a suspicion of a tuberculous lesion of the bone system.
3	Puncture of the synovial bag	Conducted if suspected of bursitis.
4	Ultrasound, magnetic resonance imaging or CT	Assign in controversial cases or for the detection of a malignant tumor.
5	Electroneuromyography	Registration of bioelectric potentials of muscles against the background of excitation of muscle fibers.

Watch a video about plantar fasciitis - "Spurs" on the heels

Pain in the heel: treatment, what to do

Pain in the calcaneus region is a symptom of some pathological condition or underlying disease. Proceeding from this, the method of treatment is chosen. But for the beginning the patient should adhere to the general recommendations:

1. more rest and exclude everyday long walks or staying on legs;
2. to abandon shoes with an inconvenient shoe with or without a high heel;
3. reduce weight with obesity;
4. use instep arresters or wear orthopedic shoes;
5. to practice therapeutic gymnastics for feet.

With pain in the heel, not related to trauma, get rid of the illness mainly with the help of conservative therapy. If the pain is a consequence of the underlying disease, the emphasis is on treating it, and depending on the disease, the therapy has its own nuances:

1. with urogenital infection prescribe antibiotics for eradication of microorganisms;
2. In rheumatoid arthritis, non-steroidal anti-inflammatory drugs and corticosteroids are used;
3. Bone tuberculosis is treated with antibiotics and synthetic antituberculosis drugs.

Treatment of fasciitis of the sole:

1. the course of taking one of the non-steroidal anti-inflammatory drugs (diclofenac, nimesulide or another);
2. when non-narcotic analgesics are ineffective, extra-articular drug blockade is done;
3. teiping;
4. Physiotherapy, for example, electrophoresis;
5. compresses on the heel with a solution of dimexide, novocaine, acetylsalicylic acid;
6. applications from a mixture of tinctures of saber, badger fat and mummies;
7. gymnastics;
8. foot massage.

In certain pathologies accompanied by constant pain in the sole of the foot, it is often usedorthoses (brace) ortires. In fractures of the calcaneus, a gypsum lingeta is applied for immobilization on the leg from the knee to the fingers for a period of 3 to 8 weeks.

Of physiotherapy procedures exceptelectrophoresiseffectiveshock wave therapy, magneto-andlaser therapy, ultrasound, phonophoresis, UHF. Also helpsmanual therapy, massage.

Surgical treatment is indicated in severe variants of pathologies that are not eliminated by medication. The operation is performed with ruptures of the tendons, in some cases to remove the calcaneal spur, etc.

Prevention to prevent pain in the heel area

1. Refusal of shoes with high heels or with a flat sole. The heel should be wide and stable, not more than 5 cm high. Fashionable to date ballet flats have a negative effect on the structure of the feet, leading to overstrain of muscles and tendons.
2. Timely treatment of major diseases, such as diabetes or osteomyelitis.
3. Fighting obesity, since every extra kilogram increases the burden on your legs.
4. Use of orthopedic insoles.
5. Regular foot care.
6. Maximum avoidance of foot injury.

Reviews and comments

Olga: "I also had heels because of cracks. To deal with them, I began to apply Hilfix, about which I read below. In fact, the remedy is quite good and effective. The agent acts as a protective film, which appears when applied and therefore the cracks heal much faster. At me already cracks have begun to live and heels of smooth steel ».

Maria: "My heel began to hurt, looked, and then the skin cracked, it turns out. And it's not clear what kind of doctor to go to, and there's no time for me, to be honest. I went to the pharmacy myself to buy something, I was very Hilfiks advised that the Swiss and it helps well. I put his day two or three on the crack and was very pleased that she so quickly healed, the composition is probably some cool. "

Andrei: "I am 66 years old. A month ago I felt discomfort in the right heel - the feeling of an alien body - when wearing street shoes. With wider shoes and slippers with no home, this feeling is almost nonexistent. When walking barefoot, discomfort - compared with the left heel sense of the calcaneus is more noticeable. Actually, there is no pain. X-ray results: a small posterior spur, there is nothing more noticeable. You can live with this discomfort. Question. What should I do? Will it be worse next? How fast?".

Anatoly: "Try a compress on the heels of medical bile, I got rid of the pain on the second day."

Source: Editorial fromhttp://bezboleznej.ru/bol-v-pyatkah