Update: December 2018
A condition in which heels hurt may occur due to
many reasons that require detailed examination and treatment
various specialists (traumatologist, surgeon, rheumatologist, oncologist,
infectious diseases specialist and even a TB specialist). Ниже приведены основные diseases, при
which may cause pain in this anatomical region.
Causes of pain in the heel area not related to any
- Wearing a high heel for a long time leads to
overstrain of foot tissue;
- With an increase in motor activity;
- Rapid increase in body weight.
In a separate group, you must make and such a common
disease like dry callus (see how to get rid of dry calluses).
It not only causes a lot of inconvenience, but also causes over time
severe pain when walking.
Plantar fasciitis (heel spur)
It is characterized by pain of inflammatory genesis, in the projection of heels,
due to stretching or long-term build-up damage
plantar fascia calcaneus. This pathology occurs
due to prolonged standing on the legs, injury to the bones of the foot or
flatfoot. Течение этой diseases образует патологический круг, то
there is an inflamed fascia involved in the formation of bone growth
(osteophyte) on the heel, and the latter constantly traumatizing it does not give
subside this process. Thanks to this heel in such patients
hurt constantly and without phases of remission. Pain syndrome subsides only
after the treatment of the heel spur was undertaken, and then only for a short while. Special
pronounced pain in the heel immediately after sleep, as well as after walking or
Achillitis (inflammation of the Achilles tendon)
The inflammatory process in this anatomical formation
occurs due to constant loads on the calf muscles
(climbing a mountain, jumping), wearing an uncomfortable squeeze shoe and
walking on high heels. The disease is characterized by pain
in the projection of the tendon, and throughout it. In addition, in
necessarily pain above the heels of the middle
intensity and swelling of the tendon itself. Without
treatment and reduced immunity may cause purulent inflammation
Achilles tendon, then the pain over the heel becomes more
intense, to the extent that a person cannot step and step.
In addition to this, inflammation can reach such a level that
tendon rupture may occur. This condition requires
emergency medical care.
Osteochondropathy heel bone
The essence of this pathology is that for unknown reasons
sterile necrosis begins to develop in those spongy sites
Heel bone substances with the greatest load.
A characteristic symptom is pain that occurs in the heel with
slightest load. Ходьба при такой diseases приносит больному
severe pain, which is almost no effect. Sick
move only with crutches or walking sticks, advancing at
This is only on the forefoot. The skin over the heel is almost all
time is swollen and with symptoms of malnutrition (atrophy). With time
there is an atrophy of the muscles of the leg.
Bursitis in the calcaneus
This pathological condition manifests itself as classic.
symptoms of inflammation, namely: swelling, pain, dysfunction,
increase in local temperature, redness.
This disease is characterized by inflammation of the periosteum.
due to excessive loads. Often this pathology occurs in
athletes and weightlifters. Heel pain and inflammation
periosteum stops a few weeks after
Sarcoma of the calcaneus
It is characterized by the fact that pain syndrome is at first less pronounced and
easily removed using analgesics, but after the expiration
some time becomes more intense. Along the way, appear
symptoms of cancer intoxication (weight loss, exhaustion, anemia). With
progression of tumor growth can be observed pathological
fractures of the calcaneus.
Peripheral nervous system diseases
Neuropathy of the tibial nerve, namely its median
Manifested violation of flexion of the foot and trophic
abnormalities in the skin above the heel. Specialстью этой патологии является
the fact that the pain in the heel is replaced by complete numbness. Long
existing neuropathy leads to trophic ulcers in
Heel bone fracture
It occurs with a strong blow in the projection of the heel. Characterized by
the fact that the victim can not focus on the heel and the more
take steps. Ankle movements are severely limited due to
formed hematoma and pronounced pain syndrome.
Depending on the degree of injury, the clinical picture is similar to
fracture of the calcaneus and diagnose the integrity of the heel can
only using X-ray. Even a few weeks later
there is pain in the heel when walking.
It is a separation of cartilage between in two
ossification points. This condition only happens in children.
period from 7 to 16 years with heel injury or increased physical
load. It should be noted that heel pain often occurs.
after sleep, that is, without any physical exertion.
Diseases caused by infection
Tuberculosis of the skeletal system
This infectious disease also affects the calcaneus, which
leads not only to severe pain, but also caseous
necrosis of the bone tissue inside the heel. In the absence of adequate
treatment is formed fistula, which has a tendency to periodic
remission and re-inflammation with discharge of purulent contents
from the bone (see how tuberculosis is transmitted).
This condition is characterized by the fact that inside
bone necrosis caused by purulent fusion of tissue occurs,
due to the multiplication of microorganisms. The disease is characterized as
common (body temperature up to 39 degrees, general weakness, decrease
body weight) and local symptoms (fistula in the calcaneus,
excreting a significant amount of pus out). The heel is swollen, but
venous vessels above it are greatly expanded due to compression
pasty fabrics. More on symptoms and treatment.
Pathology caused by metabolic or systemic
The clinical manifestations are very similar to rheumatoid arthritis, but
due to external manifestations on the skin can distinguish them. One of
The first symptoms will be the sudden onset of heel pain in
state of rest, sometimes there is an increase in the joint due to
accumulation of pathological fluid in it. Patients are generally not
associate pain with the underlying disease, as a result chosen
irregular treatment tactics.
Gout — это патологическое состояние характеризуется
the deposition of urates, that is, uric acid salts. Already at the beginning
the disease occurs acute pain in the joints, in this
case in heels, big toes, redness and swelling of the skin over
them. Often these symptoms occur at night. During palpation
there is an increase in temperature of local tissues and their
soreness Without the treatment of gout (including folk
methods), such symptoms last several days or weeks, in
зависимости от стадии diseases. More often than pain in the heels
joining and pain in the joint of the big toe, and
also ankle, knee and hip. In inflammatory
The process may involve the fingers and the Achilles tendon.
Refers to inflammatory-degenerative diseases.
spine and joints. Суть diseases Бехтерева заключается в том,
that the body produces antibodies to its own ligaments and
joints. Due to such processes, ossification begins
spinal-ligamentous apparatus, vertebrae fuse
among themselves, flexibility and mobility are completely lost
spinal column. One of первых проявлений этого заболевания
is severe pain in the heels, so that the patient can not
stand on the floor.
This disease is considered to be one of the most severe in its
kind, as evidenced by the rapid onset and persistent
complications of almost all joints of the human skeleton. At the beginning
pains of moderate intensity, swelling and decrease appear
mobility in joints. It should be noted that heel pain
are a rare symptom for this disease, but if they
started, it indicates that all
foot joints. Pain syndrome occurs at rest,
and at the slightest load on the leg.
Diagnosis of pain in the heel area
- Patient complaints and clinical examination
- Complete blood count for the detection of anemia or leukocytosis
- Blood chemistry
- Oncological markers
- X-ray of the ankle and foot bones on both sides
- Radiography of the chest and abdomen
- Spiral computed tomography
- Osteoscintigraphy (bone scan, mainly used
to detect metastases, necrosis or fistula)
- Densitometry (study of bone density)
- Ultrasound of the ankle
How to treat heel pain
It is important to understand that heel pain should be treated immediately.
after making a preliminary diagnosis. Until that time, all
activities should be aimed only at pain relief,
as the latter significantly impairs the quality of life.
In order to reduce pain, you must use
- Daily steaming of the feet in warm water followed by
rubbing nonsteroidal anti-inflammatory ointments (diclofenac 1 and
5%, diprilif, fastum gel and others);
- According to indications and pain syndrome of medium intensity
drugs of this series can be used inside and injected
intramuscularly, but in the absence of diseases of the stomach and
duodenal ulcer. These drugs include: dicloberl,
ibuprofen, movalis, nimesil, fanigan, dexalgin and ketans;
- Also in severe pain perform blockade (diprospan with
lidocaine 2% entered at the point of greatest pain), this method
most justified with heel spur or arthritis;
- Trophic disorders in the heel area are treated with
drugs that improve blood rheology and increase blood circulation
- In the presence of dry corn, the treatment consists of applying
special patches corroding it or using a solution
lactic acid in the preparation kolomak;
- Various types of surgery (removal of part of the bone,
sequestration or spurs);
- For all types of pain in the heel area, massage is indicated.
feet, exercise therapy (walking on the toes, on the edge of the foot) and
wearing orthopedic insoles;
- An important therapeutic and preventive measure for almost all
abnormal heel pain is weight loss
body and wearing comfortable shoes.