Dr. Ebraheim’s educational animated video describes video describing the conditions and treatment associated with heel pain.
Heel pain is an exteremly common complaint with several common causes. It is important to make a correct diagnosis of the cause of the symptoms so that the appropriate treatment can be given.
Common causes of heel pain include:
1-Baxter nerve compression
2-Plantar fasciitis
3-Fat pad atrophy
4-Achilles tendonitis
5-Stress fracture of the calcaneus
Baxter nerve compression
•The first branch of the lateral plantar branch of the posterior tibial nerve would become entrapped in the medial heel.
•The entrapment would result in heel pain, paresthesia, abnormal sensation on the plantar aspect (bottom) of the heel, and medial heel tenderness.
•Sprinters, dancers and gymnasts have well developed abductor hallucis muscles which will compress the nerve when the athletes are frequently on their toes.
Treatment includes
•Heel stretching exercise
•NSAIDS
•Orthosis
•Surgery to decompress the nerve at the fascia between the abductor hallucis and quadratus.
Plantar fasciitis
•Irritation and swelling of the thick tissue on the bottom of the foot.
•This fascia can become inflammaed and painful making walking more difficult.
•Plantar fasciitis is most severe in the morning when patients first stand on their feet.
•Stretching exercises or walking often help in releiveing the painful tightening associated with plantar fasciitis.
•Pain symptoms will intensify with prolonged exercise or standing.
Tretamnet includes
•Anti-inflammatory medications
•Heel stretching exercises
•Shoe inserts (heel padding)
•Rarely surgery.
Fat pad atrophy
•In fat pad atrophy the fat that cushins the calcaneus is thinned.
•This condition is common in elederly people and can cause significant pain while walking.
•History of steroid injection
Treatment includes
•Anti-inflammatory medications
•Shoe inserts (custom orthotics)
Achilles tendonitis
•Chronic injury to the tendon that joins the heel to the muscles of the lower leg primarily occurring from overuse.
•Achilles tendon gives us the ability to rise up on our toes, allowing fro the act of walking and Achilles tendonitis can make walking painful and difficult.
Treatment includes
•Anti-inflammatory medications
•Physical therapy
•Massage therapy
•Ice therapy
•Immobilization
Stress fractures
•Stress fractures of the calcaneus can occur due to overuse injuries
•The patient will experience weight bearing pain
•Stress fracture injuries of the heel are typical of running sports due to repetive shock being placed on the heel.
•Side to side compression of the calcaneus is painful
Treatment includes
•Rest
•Partial to complete immobilization
•Activity modification
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