What happens to the spur during treatment. Heel spur: causes and treatment methods. Pathology caused by metabolic disorders or systemic diseases

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Heel spur, or plantar fasciitis, is a chronic microtrauma of the plantar ligament that connects the heel bone to the forefoot.

In essence, a heel spur looks like a small, but nevertheless very unpleasant, pointed growth on the sole of the foot and is an osteophyte (bone growth) on the surface of the heel bone. This growth acts as a thorn and, when loaded, compresses the soft tissues of the foot. This causes characteristic excruciating pain.

Often, especially in the early stages of the disease, such a spur is difficult to detect. Sometimes this only happens during an X-ray examination. On an x-ray, this area resembles bone tissue in density and brightness. Therefore, it seems that it continues the heel bone and looks like its pointed protrusion or spike. Heel spurs can come in different sizes. Most often, its length ranges from 3 to 12 mm. The sharp end of the growth usually faces the direction of the toes and is slightly curved upward.

Causes of heel spurs

Modern medicine believes that heel spurs are formed as a result of the following reasons::

• high load on the heel area, for example, with flat feet,


• due to age-related changes,


• at a young age - as a result of significant stress on the foot during sports and too intense training,


• if you are overweight,


• as complications of injuries, rheumatism, vascular disorders or pathologies associated with damage to the nerves of the lower extremities.

flat feet

In 90% of cases, a heel spur develops against the background of flat feet. The reason for this is that with flat feet, the distribution of load on the bones of the feet changes, which causes too much tension on the tendons. The consequence of this is that they are easily injured by any sufficiently strong impact when walking - small stones or uneven soil.

The formation of heel spurs can also be a consequence of a number of chronic inflammatory joint diseases: rheumatoid arthritis, ankylosing spondylitis, etc. Pathologies of large joints of the lower extremities and spine disrupt the normal distribution of body weight when walking on the surface of the foot and the risk of developing heel spurs increases.

Quite often, heel spurs are also accompanied by inflammatory processes in the mucous bursae of the foot (achillobursitis or heel bursitis) and inflammation of the fascia - the membranes of the muscles of the foot (fasciitis).

Even at the beginning of the 20th century, this disease was quite rare and in most cases it was caused by injuries, rather than flat feet or excess weight. But in the modern world, heel spurs have become a very common disease. According to statistics, in 80% of cases women are susceptible to it, and more than half of them are residents of cities.

Diagnosis of heel spurs

Usually this diagnosis does not cause any particular difficulties when making. It is diagnosed on the basis of fairly typical complaints.:

• pain in the heel area in the morning after a night's sleep,


• heel pain after periods of rest and rest,


• pain that occurs after running or long walking,


• gradual decrease in pain as the patient walks,


• the occurrence of local pain when pressing on the area of ​​inflammation.

X-rays are usually performed to confirm the diagnosis. However, a heel spur in most cases is detected by chance during an X-ray examination of patients who do not even complain. Therefore, it is believed that the presence of such a spur does not mean a disease. This may simply be an individual feature of the structure of a particular person’s foot. And if it does not cause any discomfort and does not increase over time, then usually such a spur does not need treatment. It is also not uncommon for some patients with severe heel pain to show no spurs on an x-ray. In this case, the cause of the complaints must be sought in other areas.

Signs and symptoms of heel spurs

Painful sensations

The most common symptom of a heel spur is the appearance of a sharp, burning pain when placing weight on the heel. Patients often describe it as a feeling of “a nail in the heel.” The pain is caused by the pressure of the bone formation on the soft tissue. In this case, the intensity of pain depends little on the shape and size of the growth. Often, sharp and large heel spurs are not felt by a person, but flat and small ones turn out to be very painful. The intensity of pain is related more to the location of the growth than to its size. In addition, the closer to the nerve endings of the foot the spur is located, the stronger the pain will be.

In the future, pain may occur without load. This is due to the fact that scar tissue that forms at the site of injury over time begins to accumulate insoluble calcium compounds. These deposits cause irritation of the surrounding tissues, mucous membranes of the joint capsules, bone elements and, as a result, inflammation, which is also accompanied by a characteristic pain syndrome.

Most often the disease develops after the age of 40 years. One of the first signs of a heel spur is pain when putting weight on your heel. The first steps after getting out of bed in the morning or after long breaks in movement are especially painful - the so-called “starting pain”. During the day, when walking, the pain subsides somewhat, and in the evening, with the accumulation of fatigue and stress, it intensifies again.

Gait changes

The pain may spread over the entire surface of the foot or be present only on the inside of the heel. Therefore, the patient involuntarily tries to unload the heel area, which affects his gait. It has been statistically determined that with heel spurs, gait disturbances are observed in 93% of cases.

In this case, the transfer of the center of gravity from the heel to the outer edge and forefoot causes improper distribution of body weight and leads to the development of transverse flatfoot. In cases where heel spurs develop on both feet, it becomes especially difficult for such a person to move.

An additional factor that increases pain with a heel spur is the thinning of the subcutaneous fatty tissue on the heel, since this layer acts as a natural shock absorber when walking.

How can I tell if I have a heel spur?

If you notice pain on the feet of the foot in the heel area, this does not mean that you have a heel spur. For specification of the diagnosis it is necessary to address to the surgeon , the orthopedist and the rheumatologist . First of all, it is necessary to exclude other diseases that have similar painful manifestations in the heel region: rheumatoid arthritis, ankylosing spondylitis and Reiter's syndrome. These diseases are diagnosed with the help of biochemical blood tests - specific rheumatoid factors are found in it. The very presence and size of the bone growth is determined by X-ray examination. But the intensity of pain no longer depends on the size of the spur, but on the sensitivity of the tissues surrounding it and the proximity of the nerve endings. Therefore, to clarify the diagnostic data, it is recommended to supplement x-rays with ultrasound as well.

Heel spur in children

The ligaments of the child's foot are usually not yet strong enough to resist increased loads for a long time and effectively. Therefore, children who are overweight, play sports intensively or grow rapidly are always at high risk of developing heel spurs. In addition, until the age of 16-18 years, a child’s foot is still very plastic and quite easily susceptible to deformation. This leads to rapid and frequent development of flat feet. Also, with the intensive growth of a child, which requires an increased supply of energy and building material to the body, his joint-ligamentous and bone apparatus may suffer from a lack of nutrients. This often leads to the development of diseases of the spine and foot.

The most important thing is shoes!

It is important to select children's shoes taking into account the anatomical features characteristic of each age. For example, for the first steps, when children still have a fatty pad on the arch of the foot, it is better to buy shoes with regular, flat insoles and a heel level raised by 2 cm.

Subsequently, depending on the condition of the foot and the individual needs of the child, you need to select shoes that will perform preventive functions or use orthopedic insoles. The sole of any children's shoes for everyday wear should not be completely flat, like, for example, sneakers or ballet shoes. But the heel must also be selected with a height of no more than 3 cm. A child’s foot should be accustomed to quality shoes from early childhood. And one more piece of advice: do not use worn sandals and boots, because each child’s foot tramples the insole strictly individually.

Therapy for heel spurs in children

All such decisions related to shoes for children should be made only after an examination and with the participation of an orthopedic doctor.

If the child has already developed a heel spur, then treatment should begin as soon as possible. Due to the stiffness of gait resulting from pain in the heel and foot, the child can quickly develop scoliosis, poor posture, and inflammation of the joints of the lower extremities. The treatment program for heel spurs in children is practically no different from that in adults, but often the cure occurs much faster. This is due to the fact that the child’s body has much greater capabilities for restoring damaged tissue.

Heel spur treatment

Can a heel spur be cured?

Of course yes! Currently, there is a very wide range of ways to effectively treat heel spurs.:

• ensuring foot unloading through the use of various types of heel pads and insoles,


• physiotherapeutic complex treatment


• ultrasound therapy,



• mineral baths,


• radiotherapy,


• local administration of corticosteroids,


• if there are no effects, surgical treatment consists of surgically removing the bone growth and excision of the altered tissue.

In most cases, treatment of heel spurs is carried out conservatively and depends on the cause of the disease.

Shock wave therapy for heel spurs

Shock wave therapy is a relatively new treatment method. In our country, this procedure began to be practiced not very long ago, but the first results are already encouraging. Of course, it is not yet possible to unequivocally judge the effectiveness of this treatment method, since there is still no opportunity to study the long-term results of therapy.

Our experience suggests that when using this treatment method, the effectiveness of getting rid of heel spurs is very high. The method is based on the influence of ultrasonic wave pulses of a certain frequency. The ultrasonic shock wave effect loosens calcium deposits in the heel spur. This allows the loosened deposits to be subsequently flushed out of the body through the bloodstream. The affected ligament thus gets rid of accumulated calcium salts.

In addition, at the same time, tissue regeneration processes are activated, swelling and inflammation are reduced. With each procedure, the pain syndrome becomes less and less, as a rule, completely disappears by the end of the treatment. The affected area largely restores its natural structure and regains the ability to endure everyday stress without causing pain. In the initial stages of the disease, the heel spur is completely eliminated, and with a long duration of the process, the deposition of calcium compounds in the ligament stops and inflammation is removed.

However, shock wave therapy is not suitable for everyone. Contraindications to ultrasound treatment of heel spurs are::

• low blood pressure,


• bleeding disorders,


• heart rhythm disturbances,



• severe nervous system disorders,


• thrombophlebitis in the heel spur area,


• acute infections and intoxications,

Radiation therapy for heel spurs

The use of X-rays in the treatment of heel spurs shows very effective results. The method lies in the fact that clearly focused x-rays are directed to the heel area, carrying a reduced dose of radiation. They cause blockage of nerve endings, and the patient ceases to experience pain. The course of treatment most often consists of ten sessions, each of which has a duration of 10 minutes.

X-ray therapy in the treatment of heel spurs has the following advantages:

• complete painlessness of the procedure,


• high efficiency,


• minimum contraindications,


• exposure to radiation only on the heel spur,


• antiallergic and anti-inflammatory effect,


• possibility of outpatient treatment.

Contraindication to the use of this method is only pregnancy. When using X-ray therapy, the spur itself does not disappear, only the pain sensations emanating from it are blocked. Therefore, after a course of X-ray therapy, it is imperative to take care of unloading the foot. To do this, you need to use orthopedic shoes or orthopedic insoles, lead a healthy lifestyle and strictly control your weight.

Laser treatment for heel spurs

Currently, low-intensity laser therapy is a popular and fairly widely used method of treating this disease. Laser therapy targets the soft tissue around the spur. Focused radiation causes an increase in blood circulation in the area of ​​inflammation, which helps to reduce pain.

There is an opinion among patients that laser therapy can eliminate the heel spur itself. However, this is misleading. Penetrating into the tissues of the foot, the low-intensity laser beam has virtually no effect on the bone growth itself. Its effect appears only on soft tissues. This means that after courses of laser therapy it is also necessary to apply all methods aimed at preventing this disease.

Treatment of heel spurs with the Vitafon device

The Vitafon device has a local effect on the affected area using vibroacoustic effects. The scope of its application, according to the developers, is very wide, including its use for the treatment of heel spurs.

Vibroacoustic effects improve lymph circulation in the foot, which promotes the rapid removal of products of inflammation and cell breakdown. This reduces the pain of heel spurs.

But the effect of using this treatment method is temporary. The use of Vitafon does not destroy the spur itself, that is, it does not eliminate the cause of the pain syndrome. Therefore, it is recommended to use it only to prevent the occurrence of heel spurs or to relieve pain during more effective therapy.

Treatment of heel spurs with medical bile

Treatment of heel spurs with medical purified bile gives fairly good results. The patient can carry out such treatment at home, since bile is sold in almost any pharmacy and is available without a prescription.

The procedure involves applying a lotion overnight to the sore heel. A piece of cotton cloth or gauze is moistened with bile, placed on the heel, covered with polyethylene and secured with a tubular bandage. You need to put a sock over the finished lotion and leave it there overnight. In the morning, the lotion is removed and the heel is wiped with boric alcohol or lotion. For a good and lasting effect, it is necessary to carry out at least 20 procedures.

At the same time, it is extremely undesirable to take breaks in treatment. Such therapy has no contraindications and in a fairly large number of cases shows results after the first five to seven applications.

Methods of drug treatment for heel spurs

Today, official medicine has developed a large number of pharmacological treatment regimens for this disease. Among the drugs used to treat heel spurs:

• non-steroidal anti-inflammatory drugs, for example dimexide,


• hydrocortisone, introduced into the body using phonophoresis,


• topical gels, ointments, creams and patches for the treatment of heel spurs, which have a resolving and anti-inflammatory effect,


• A single local injection of diprospan has a lasting effect.

Physiotherapy in the treatment of heel spurs

With this disease, physiotherapeutic procedures such as therapeutic exercises, massage and exercises are widely used, which are aimed at improving lymphatic drainage and blood circulation in the foot. In addition, it applies:

• ultraviolet irradiation,


• electrophoresis with various drugs (for example, novocaine or potassium iodide),


• warm foot baths,


• UHF therapy using alternating current of low voltage, strength and high frequency.

Heel spur block

With a low efficiency of conservative treatment, a medicinal blockade of the heel spur is performed - chipping the sore spot with a syringe with a medicinal substance. The drugs used for this purpose have a pronounced local anti-inflammatory effect, which quickly suppresses the inflammatory process and reduces pain.

This procedure requires knowledge and extensive experience, so only a qualified specialist can carry it out. The choice and quantity of the drug, the accuracy and depth of administration are of great importance. If the procedure is performed correctly, the patient’s condition is alleviated for several years, but if mistakes are made, complications may develop, such as inflammation and suppuration of the calf tendon or osteoporosis. With frequent use of the method, destruction of the ligament or fascia is possible.

Surgical intervention

In especially severe cases, with unsuccessful conservative treatment and severe pain, surgical intervention is used, but it has very limited indications. Surgery and removal of a heel spur always gives a quick and lasting positive effect, but this operation is complex and painstaking work. Therefore, it is recommended to resort to surgical intervention as a last resort - if all other methods have demonstrated their ineffectiveness. Remember that in most cases, heel spurs are quite treatable without surgery.

Folk remedies: recipes, methods and methods for treating heel spurs

Despite the achievements of orthopedic medicine and pharmacology in the modern world, treatment of heel spurs with folk remedies is still very common. For the most part, these methods do not stand up to the slightest criticism from the point of view of official science, and even if they have a positive effect, it is often explained by psychological reasons.

The use of all kinds of ointments, heating pads, bandages and other local remedies, sometimes containing the most extravagant ingredients, can only be useful for a short-term reduction in pain.

What can you find in folk recipes and methods for treating heel spurs? Some suggest using rough physical force, breaking the foot on stones or, for example, the handle of a shovel during excavation work. Naturally, apart from greater trauma, this will bring nothing more.

Some recommend mixing completely unexpected substances, such as, for example, chicken bile with vodka and shampoo for washing your hair and making long-term compresses from this mixture. There is a recipe for treating heel spurs with vinegar with onion peels, crushed garden iris root, walnut gruel, etc.

Among the more or less effective methods that have an objective temporary effect, relieving pain, we can highlight the treatment of heel spurs with golden mustache balm, applying salt and iodine in the form of applying an iodine mesh.

Nutrition and diet for heel spurs

Diet and special nutrition in the treatment of this disease should be aimed at reducing inflammatory processes in the body and increasing the excretion of salts. This can be achieved by limiting the consumption of salty foods, smoked foods and salt itself. In addition, it will be useful to drink as much water as possible (not teas or juices, but water) - up to three liters per day. In addition, introduce more watermelons or fresh cucumbers into your diet.

Which doctor treats heel spurs and where?

It must be remembered that self-medication often brings only temporary relief of symptoms and does not cure the very cause of the disease. Therefore, the best solution would be to contact a specialist as soon as possible, who will reliably determine the cause of the pain, determine the diagnosis and prescribe treatment. In this case, you need to contact a surgeon or orthopedist. Treatment of heel spurs does not require the services of specialized clinics and can be carried out at any district clinics with an orthopedic department.

Consequences of heel spurs

In about a quarter of cases, a heel spur causes partial loss of mobility. In case of particularly severe pain, gentle working conditions or bed rest are prescribed. But it becomes difficult to lead a normal life when suffering from a heel spur. Particularly significant changes await those who, before the disease, were intensely involved in sports or led an active lifestyle, since it is very difficult to maintain the same rhythm of existence, provided that every step is accompanied by sharp pain.

Prevention of heel spurs

Preventive measures should be aimed primarily at preventing premature wear, aging and injuries of the osteoarticular system:

• need to fight excess weight,


• maintain an active motor mode,


• try to avoid overloading your feet,


• carry out qualified and timely treatment of diseases of the joints and spine,


• prevent the development and progression of flat feet,


• if you already have flat feet, use orthopedic insoles,


• give preference to physiological, ergonomic and comfortable shoes,


• in the presence of the most minimal symptoms of a heel spur, immediately begin a preventive course of therapy using various physiotherapeutic methods.

How to protect your body from heel spurs?

It is quite possible to prevent the appearance of heel spurs. First of all, it is necessary to take all possible measures to prevent wear of the heel bone, injury to the ligaments, prevent flat feet and inflammatory processes in the soft tissues of the foot.

Those who are overweight should take measures to reduce it - this will immediately reduce the load on the feet. It is useful to periodically do foot massage and special exercises for the legs. Frequent walking barefoot on sand and grass improves blood supply to the feet and prevents the development of their pathologies.

If you already have flat feet, it is better to treat it as early as possible, before complications arise in the form of heel spurs. The first step to treating flat feet should be the use of special shoes and orthopedic insoles. And if you are worried about pain in your feet, you should not delay contacting a specialist, because every day the situation will only get worse.

Comfortable shoes that do not injure the feet are also important in the prevention of this disease. It is best to use shoes with low (3-4 cm) heels that do not squeeze the foot. High heels increase the risk of developing heel spurs if worn continuously. But the complete absence of heels also negatively affects the condition of the foot.

Orthopedists do not recommend constantly wearing sandals that do not have a backdrop - the arch of the foot in them is under constant tension. Such shoes can be used for short-term wear, but for everyday use it is preferable to choose one that will fit firmly on the foot.

Before use, you should consult a specialist.

One of the most common causes of foot pain is a heel spur, and this disease can lead to long-term disability and even disability. Knowledge of the causes and conditions for the occurrence of heel spurs allows us to determine the most effective method of treatment. After all it is necessary to eliminate the cause of the disease, and not just treat its symptoms. Only in this case can you expect that the disease will not return after the next course of treatment.

Military Medical Academy named after. CM. Kirov, St. Petersburg;

biophysicist, full member of the Academy of Medical and Technical Sciences Fedorov V.A.

What is a heel spur?

A heel spur is an inflammation of the fascia on the plantar side of the foot. In medicine, this disease is called plantar (plantar) fasciitis.

The plantar fascia is a powerful connective tissue plate that stretches from the top of the heel bone (tubercle) across the entire sole over the muscles and is attached by four rays to the metatarsal bones of the toes. The fascia is in a taut state, like a bowstring, and supports the longitudinal arch of the foot, regulating the load on the leg when walking. It protects the moving bones and joints of the foot from injury and damage. Half of a person's body weight falls on the heel area and puts stress on the plantar fascia.

Due to excessive stress on this area, microtraumas of the fascia may occur, mainly at the site of its attachment to the heel bone. In a healthy body (especially in young people), these microdamages heal unnoticed. If the body does not have time to restore the tissue of the plantar fascia in a timely manner, it starts an inflammatory aseptic (microbial-free) process. Swelling and pain occur.

When heel pain occurs, the “spur” itself (bone growth) may not yet be there. Pain initially occurs due to the inflammatory response in the surrounding soft tissue and the process of destruction of the plantar fascia.

The cells of the plantar fascia are rich in calcium, and in case of their extensive death (mainly in the area of ​​the heel tubercle, where the greatest load is), this calcium is deposited. The inflamed area ossifies and a bone formation is formed, shaped like a spur. It is this phenomenon that came to be called a “heel spur.”

However, this name for the disease can be misleading. In his study, the American doctor DuVries noted that an extensive heel spur (bone growth) is often observed, which does not cause any pain and is discovered by chance when diagnosing other diseases. Often, ossification itself is not a disease, but rather a normal age-related tissue change for the body. A spur may be present, but not be a pathology, and vice versa, a spur may not yet be present, but the process of painful inflammation is evident.

Symptoms and signs of heel spurs

Plantar fasciitis of the foot manifests itself heel pain. Pain sensations occur more often on the plantar surface, less often on the back surface of the bone, and can radiate to the toes and leg muscles. These symptoms may intensify in the evening or with prolonged walking or standing.

Despite the pain and tension experienced in the foot, the start of treatment is often delayed, as the sensations are attributed to tired legs. However, over time, the pain in the sole intensifies after rest. There are so-called “starting pains” at the beginning of the movement after rest or in the morning when getting up, after sleep.

Heel pain can occur suddenly or develop gradually. Often, a sharp pain is felt immediately when putting pressure on the foot; it seems as if something sharp has hit the heel. If the disease becomes chronic with the formation of a heel spur, the person tries to walk on tiptoes or rely only on the outer part of the foot, but not on the heel.

If you experience foot pain, it is important to consult a doctor promptly ( orthopedist-traumatologist or surgeon). There are a number of diseases that present with similar symptoms. Self-medication can lead to serious complications, including dysfunction of the foot, the formation of contractures (immobility of joints) and lead to disability.

Your doctor will also be able to identify additional factors that may have contributed to the development of heel spurs and heel pain. In this case, first of all, treatment of the underlying disease is necessary. You can read more about these factors.

A “heel spur” occurs when the process of damage to the plantar fascia begins to prevail over the process of its restoration.

Pain with plantar fasciitis (heel spur) is a protective reaction of the body. In this way, the body “urges” the person to protect damaged tissues from further injuries to the fascia and to give time for the proliferation of new cells in the area of ​​necrosis.

The administration of painkillers (using an injection (blockade), phonophoresis, electrophoresis), the use of radiation therapy (x-ray therapy), when the nerve endings signaling pain are blocked, leads to rapid relief. As a result, the patient has the illusion of "curing from the disease." However, the price of this illusion is further damage to the fascia and progression of the disease. Once the medications or radiation therapy wears off, symptoms will return.

Like any other part of the body, the plantar fascia is made up of cells. Damage to the plantar fascia is the death of the corresponding cells. Dead cells are resorbed (utilized) naturally due to immune reactions. However, this process may not keep pace with the appearance of new dead cells as a result of constant microtrauma due to constant damaging loads (it is impossible to immediately stop walking).

Pain appears when too many dead cells accumulate, and the body launches an active recovery (inflammatory) process. Around the heel spur in the soft tissues, interstitial pressure increases. This is necessary in order to increase the influx of immune cells and ensure their faster passage through the tissues. The more cells that die, the stronger the reaction and pain will be.

In practice, when treating heel spurs, anti-inflammatory (in particular, hormonal) drugs are used, the essence of which is to “freeze” immune reactions. That is, the medicine acts in such a way that the body slows down its actions to cleanse the tissues in the heel area. As a result, the inflammatory process subsides, and the person feels relieved. However accumulation of dead cells, due to which a “heel spur” grows, remains. In this regard, a relapse is likely, since sooner or later the effect of the drug will end, the body will “wake up” and begin the inflammatory process again. This method is also dangerous because the administration of hormonal drugs often leads to necrosis (death) of the heel bone.

Thus, proper treatment should involve helping the body cleanse the tissues of the heel to prevent the formation of a spur. It is better to give preference to methods that enhance microcirculation in tissues, increase blood flow and lymph flow (for example, shock wave therapy in the clinic). The inflammatory process will eventually end if measures are taken in parallel to reduce the load on the plantar fascia.

The underlying cause of heel spurs

The plantar fascia is constantly exposed to shock when walking, running, and jumping. The degree of this load depends on the correctness of gait, the coherence of the entire musculoskeletal system, as well as on the chosen shoes. It is no coincidence that, according to statistics, heel spurs occur more often in women, since they often prefer beautiful, but “unhealthy” shoes (tight, with heels). The greater the load, the more often and more severely the fascia is damaged.

on the foot occurs, for example, in cases where one leg was injured and the person began to limp on the other leg. However, this is not a typical case of heel spur formation. Much more often the load on the foot increases with age due to the gradual deterioration of the entire, which is responsible for the correct, gentle gait.

The neuromuscular shock absorption system refers to the system that controls the functioning of skeletal muscles (primarily the legs and back). Many mechanoreceptors that control the position of the joints allow the nervous system to control the muscles so as to ensure smooth movements and reduce shock loads when walking and running tenfold. Without such shock absorption, the joints and spine would degrade within a few months. It is the neuromuscular protection that “gives our legs” when we try to jump on straight legs, makes us limp, trying to protect the sore joint from overload.

Causes of impaired neuromuscular depreciation:

1. Muscle wasting due to malnutrition of the cells. The most favorable conditions for muscle functioning are uniform physical activity. Therefore, both a sedentary lifestyle and, on the contrary, excessive sports activities have an unfavorable effect on the functioning of muscle cells.
2. Poor performance of the kidneys. We are not talking about kidney diseases, such as pyelonephritis and others. The kidneys may be healthy, but cannot cope with filtering (purifying) the blood due to its severe “pollution”. As a result, the electrolyte and water-salt balance of the blood is disrupted, which directly affects the performance of all muscles.
3. Spinal diseases– , disc herniations lead to tissue swelling, impaired blood supply and pinching of the spinal cord and nerve roots. As a result, the passage of nerve impulses along the nerve pathways is slowed down or disrupted, which leads to a mismatch in muscle function and a decrease in neuromuscular amortization.

Weakened muscles do not adequately absorb the everyday impacts of walking, running and jumping, resulting in damage to the plantar fascia as well as the spine. The functioning of the spinal cord, hidden in the spinal column, from which signals are sent to the muscles, is disrupted. Due to poor conduction of nerve impulses, muscles begin to work inconsistently, do not group properly for maximum shock absorption, and the plantar fascia and spine are damaged.

Due to pain in the heel, a person’s gait changes, he begins to limp or walk on tiptoe. The load on the muscles is distributed unevenly, and the destructive load on the spine increases.

This creates a vicious circle when muscle weakness leads to injury to the spine and plantar fascia, and problems in the spine further impair muscle function. It is very difficult for the body to break this vicious circle on its own, which is why it is so important to change your lifestyle and provide competent assistance to the muscles, kidneys, and spine.

Principles of effective heel spur treatment

Based on the above, effective treatment of heel spurs includes the following key measures:

• reduction of heel load by choosing the right and comfortable shoes, using orthopedic insoles and/or heel pads, and by performing therapeutic exercises by stretching the gastrocnemius muscle and plantar fascia. Gymnastics is very important, but, unfortunately, in most cases it is not sufficient for recovery;
• cleaning tissue from excess dead cells in the heel area by increasing blood flow and lymph flow;
• restoration of the neuromuscular shock absorption system, first of all, improvement of muscle function.

Compliance with these principles helps to avoid relapse (recurrence of the disease).

Currently, there are many medical treatments for heel spurs, varying in effectiveness, cost and availability. Unfortunately, most of them do not meet all three principles of effective treatment of heel spurs. Most methods affect only the heel area and are aimed only at reducing/eliminating heel pain, relieving swelling and destroying bone growth. In this regard, some time after treatment, relapse (recurrence of the disease) often occurs.

The exception is phonation method. (vibroacoustic therapy) is the transmission of sound (frequency range (30-20,000 Hz) into the human body using.

Currently, this is one of the effective methods for treating heel spurs for the following reasons:

1. Phonation improves blood flow and lymph flow, promotes cleaning of tissues in the heel area and natural resorption of bone growth. Thanks to sound microvibrations, immune cells pass through tissues faster and more actively. As a result, the inflammatory process proceeds more easily, with less intensity and pain, and the heel spur resolves in a shorter period of time without surgical intervention.

At the same time, cell damage is excluded during phonation: the amplitude of microvibrations is comparable to the size of cells (0.0001-0.05 mm), and the frequency is within the speech range, that is, similar to those microvibrations that arise when the vocal cords are excited during singing or speaking.

2. The method has a proven effectiveness in reducing pain. The pain usually goes away in 2-3 weeks. According to vibroacoustic therapy (phonation) it is more effective in reducing pain than ultrasound and laser therapy.

Graph of changes in pain intensity on a scaleMcGill

This graph shows that the effectiveness of phonation in reducing pain intensity is 30% higher than that of laser and ultrasound therapy.

The effectiveness of phonation is comparable to shock wave therapy (SWT), while a similar result is achieved faster - in 2-3 weeks. As many studies on shockwave therapy show, a pronounced effect (reduction in pain intensity) is observed only after 3 or more months, and before that a person is forced to walk with severe pain. In practice, phonation shows better results with more frequent use (2-3 times a day).

3. Restores the elasticity of the plantar fascia by improving nutrition in this area and accelerating regenerative processes. Strengthens the effect of therapeutic exercises aimed at stretching the calf muscle and plantar fascia.

4. Phonation can be used from birth. The therapeutic effect is based on the natural sound microvibration of the body in the audible (speech) range, in contrast to ultrasound and infrasound. Has a limited list.

5. Aimed at restoring neuromuscular shock absorption. Unlike other types of therapy, the phonation technique includes an effect not only on the area of ​​the heel spur, but also on the muscles of the lower leg and the kidneys.

• Phonics treatment of the kidney area improves the condition of all muscle resources by accelerating the removal of uric acid and improving the electrolyte composition of the blood (PH). Thanks to this, the muscle corset better copes with the function of protecting the musculoskeletal system from shock loads.
• Radiation of the lower leg area directly improves the tone of these muscles.
• Long-term and daily phonation of the problem area of ​​the spine (,) relieves swelling and, accordingly, improves the conduction of nerve impulses.

6. Prevents diseases of the joints and spine.

Additional advantages of this method:

7. Availability. Devices for phonation can be purchased, as well as with delivery throughout Russia and abroad.

There is a possibility that your attending physician may not know about this new modern treatment method (phonation) and the corresponding devices, so before going to your appointment, we suggest printing out information about contraindications and methods of treating heel spurs.

Comparative table of the main treatment methods for heel spurs

Name of the treatment method	Price	The essence of the method, its effectiveness, complications
Phonation

Heel spur (plantar fasciitis) is a disease associated with the formation of a bone growth in the heel bone, accompanied by inflammation and changes in the degenerative-dystrophic nature of the soft tissues around it. The risk group includes obese people, mostly females, over 40 years old.

1. Inadequate physical activity on the heel region. After all, increased irrational load on the area of ​​attachment of the muscles and tendons of the foot can cause an inflammatory process.
2. Excess weight, as a result of fat deposits and fluid retention in the patient’s body. This aggravating factor causes thinning of the subcutaneous tissue, which acts as a shock absorber when walking.
3. In 90% of cases, this is a consequence of flat feet.
4. Metabolic disorders as a result of delayed excretion of salts.

The occurrence of heel disease is also facilitated by such factors as, for example, osteochondrosis of the lumbar region with severe damage to the sciatic nerve or any other ailment of the musculoskeletal system.

Can a heel spur be cured?

Of course, it is quite difficult to completely cure this disease, but it is quite possible to control it. By the way, the latest statistics show that every tenth of the patients who seek medical help with diseases of the musculoskeletal system is diagnosed with this heel ailment. If a heel spur is detected, they are often one of the means to combat this disease.

Most often, patients resort to such methods of unconventional treatment as various warming foot baths, walking on stones, morning walks barefoot in the dew, rubbing the feet with all kinds of means and infusions, compresses and others. However, we should not forget that the use of traditional medicine can only reduce pain and relieve symptomatic manifestations, but in no way affect the causes and mechanisms of development of the disease.

How to remove a heel spur?

First, a diagnosis is required, which is carried out by an experienced doctor (orthopedist, surgeon, traumatologist) and consists of the following:

1. fixing the patient's complaints with the help of visual inspection and palpation of the heel region;
2. confirmation of the diagnosis by the results of radiography and, if necessary, ultrasound;
3. a complete examination with the need to take a general and biochemical blood test to detect the presence of a particular infection, disturbances in metabolic processes, in order to exclude the presence of other rheumatic diseases.

Let's take a closer look at the clinical picture of the disease:

• impulsive pain in the heel region, aggravated by walking;
• inflammation of the affected area of ​​bone tissue during physical exertion and wearing uncomfortable shoes;
• general malaise with fever;
• increased sensitivity of the feet.

Heel spur - treatment methods are effective only with an integrated approach, namely:

• elimination of the inflammatory and dystrophic process in the soft tissues of the heel region;
• improvement of metabolic processes in the body;
• activation of the blood supply to the lower extremities;
• reducing the overall load on the heel area (reducing excess weight);
• preventing the development of lumbar osteochondrosis.

Treatment of heel spurs with medication

• taking targeted antibiotics;
• the use of non-steroidal anti-inflammatory ointments, creams and gels;
• novocaine injections for certain pain thresholds.

Treatment with physiotherapeutic procedures:

• electrophoresis;
• laser therapy;
• magnetic therapy;
• mud and paraffin baths.

The use of surgical treatment is surgical removal of the heel spur. This rational method of surgical intervention is performed under local anesthesia and ends with a plaster cast for two weeks.

Shock wave therapy is a treatment using an electrical impulse through a special current generator. Under the influence of current, the structure of the tissue changes, as a result of which the growth on the heel bone disappears over time. This newest method has positive reviews and is a good alternative to the surgical method.

A heel spur is a growth of bone tissue in the form of a spike in the area of ​​the tubercle of the heel bone or near the Achilles tendon. Most often, the pathology is detected in middle-aged and elderly people, and the predisposition is higher in women.

The components of a spur are newly formed bone tissue, a characteristic feature of which is the presence of signs of chronic inflammation. The soft tissues located above the spur often have a mucous bursa formed as a result of its presence.

What is a heel spur?

Heel spur (plantar fasciitis, plantar fasciitis) is a foot disease that is manifested by inflammation of the aponeurosis that supports the longitudinal arch of the foot, and the resulting formation of a bony protrusion on the heel. Inflammation often affects the surrounding soft tissue, periosteum and mucous bursae.

A heel spur can be recognized by its strong painful sensations in the heel, especially in the morning. During the day the pain subsides, but in the evening it becomes even stronger.

The plantar fascia is a fibrous tissue, a ligament that connects the heel bone to the heads of the metatarsal bones. It supports the longitudinal arch of the foot. During walking and running, the tissues of the plantar fascia experience the greatest tension precisely at the site of its attachment to the heel tubercle.

With injuries, or a lot of weight, too intense loads, athletes experience microscopic tears. At first, they grow together on their own, but with constant negative influence, non-infectious inflammation of the fascia begins, as well as the nearby bone tissue, it grows, forming spikes.

That is, a heel spur is an overgrowth of the plantar fascia due to inflammatory and degenerative processes, injuries, etc., and the disease is called plantar fasciitis.

Characteristic sign of the disease

Everyone who has had inflammation of the plantar fascia knows that in the morning, when you try to step on the heel, there is a feeling that a nail was hammered into it - such a sharp pain. Because during the night, the tissue destroyed by inflammation begins to recover, and when you try to stand on your feet with all the weight of the body, micro-ruptures of the tissue again occur and inflammation occurs with pain.

Causes

Every year, more than 2 million people are forced to seek treatment for heel spurs, and 70-80% of them are women, more often urban residents over the age of 40 years. Doctors identify several main reasons for the appearance of spurs on the heel:

• flat feet - is the cause of the formation and growth of osteophyte in 90% of all cases;
• age-related changes - disturbances in the blood supply system of the lower extremities, reduced regenerative abilities of tissues;
• pregnancy;
• injuries, pathologies or diseases of tissues, nerves, vessels of the lower extremities -, etc.

What does a spur on the heel look like: photo

The photo shows a calcaneal spur on the heel in the initial stage, showing a normal foot with a small white speck in the center. This is a heel spur or thorn.

As the disease develops, the spike grows, increases in size and can reach a diameter of 0.5-2 cm. The length of the growth in the later stages can be more than 2 cm.

Usually, with a large spur around it, you can distinguish keratinized areas of the skin and signs of inflammation: redness or cyanosis of the heel.

Symptoms of heel spurs

In essence, a heel spur looks like a small, but nevertheless very unpleasant, pointed growth on the sole of the foot and is an osteophyte (bone growth) on the surface of the heel bone. This growth acts as a thorn and, when loaded, compresses the soft tissues of the foot.

Symptoms:

1. The most common symptom of a heel spur is the appearance of sharp, burning pain when resting on the heel. Patients often describe it as a feeling of “a nail in the heel.” The pain is caused by the pressure of the bone formation on the soft tissue. In this case, the intensity of pain depends little on the shape and size of the growth. Often, sharp and large heel spurs are not felt by a person, but flat and small ones turn out to be very painful.
2. Frequent tears in the fascia cause tissue inflammation, which are located nearby, including the bone one, and it gradually increases in size. After a certain period of time, these growths begin to resemble a beak or a thorn.
3. Inflammation and roughening of the skin on the heel. Another symptom is inflammation and hardening of the skin on the heel; a painful callus may form under the bone or salt growth. Over time, the inflammation progresses, infection is connected to it, and even suppuration can occur.
4. Most often, a spur appears on one leg, but sometimes the fascia on both heels becomes inflamed. A person with a heel spur changes his gait. He steps on the toe and outside of the foot, protecting the heel from stress. In some cases it is necessary to use canes or crutches.

If the disease is not treated when the first signs are detected, the process worsens and additional symptoms of a spur appear:

• The pain syndrome affects not only the foot and heel, but also the ankle.
• Contracture of the fingers occurs.
• The foot looks swollen. On palpation, dense formations and severe pain are felt.
• X-rays will show bone growths in the heel area - spurs

Attention! Pain in the foot area does not necessarily indicate the presence of spurs on the legs. To make a timely correct diagnosis, you must consult a doctor. After all, only a specialist can exclude diseases such as: Reiter’s disease or syndrome.

What other causes of severe heel pain could there be? This:

• various foot injuries,
• fracture of the foot bones,
• osteoma,
• sprain,
• rheumatoid diseases,
• flat feet,
• plantar warts;
• when a woman wears high-heeled shoes for a long time, and then suddenly changes them to shoes with low heels or no heels at all;
• long-term wearing of shoes with high heels and narrow toes and others.

Diagnostics

To treat a heel spur, you need to see a podiatrist. He will prescribe orthopedic products that help with walking (special insoles), medications, and, if necessary, refer the patient for treatment with the shock wave method. You can also contact an osteopath or rheumatologist. For overweight people, consultation with an endocrinologist or nutritionist will be useful.

Examination, as a rule, does not detect visible changes caused by inflammation in the area of ​​the plantar heel spur. A thick layer of soft tissue makes it impossible to palpate it, but palpation reveals pain that occurs when pressure is applied to the heel from the plantar region. A posterior heel spur sometimes manifests itself in the form of callus of the skin and the appearance of edema, localized on the side of the attachment of the Achilles tendon to the heel bone.

In most cases, the following is prescribed:

• radiography. The image clearly shows a spike-like growth, with its sharp end injuring soft tissues. Perhaps the cause of the change in bone tissue was a fracture. Radiography will confirm or rule out this assumption;
• blood test for biochemistry. Don't give up on research. Without it, it is impossible to exclude rheumatic diseases that cause pain in the heel.

Heel spur treatment

Before treating a heel spur, you need to make sure that it is a heel spur, as there is a wide range of diseases that cause heel pain. It is the orthopedic doctor or traumatologist who will be able to correctly establish the diagnosis.

Modern medicine offers several methods of treating the disease:

• medications;
• physiotherapeutic complex;
• shock wave therapy;
• ultrasound;
• laser exposure;
• surgical removal of the thorn.

Choose the right shoes, insoles and heel pads

The first thing to do when the plantar fascia is inflamed is to choose the right shoes. Without this, there is no point in starting treatment at all.

1. Shoes for plantar fasciitis should have low heels - up to 5 cm (for women) and inner insoles or heel inserts with a hole for the pain area.
2. A heel higher or lower than 5 centimeters is a factor in increasing pain with improper load on the foot and stretching the fascia.
3. The best thing is orthopedic shoes that support the arch of the foot and correct incorrect position.

Insoles and heel pads are an important component in the complex treatment of spurs. Their functions:

• play the role of a corset that fixes muscles and ligaments in the desired position;
• help reduce the load on the heel and prevent micro-tears of the fascia;
• reduce the load on the joints of the legs: knee and hip;
• fix the longitudinal and butt
• river arch of the foot, help eliminate flat feet, which provokes the appearance of spurs;
• improve blood circulation in the foot and strengthen its ligaments;
• prevent the appearance of a feeling of heaviness and fatigue in the feet.

See an orthopedist. He will study all the features of your foot, weight and degree of development of the disease and select the necessary model for you.

Medications for heel spurs

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Most often, doctors recommend taking non-steroidal painkillers to relieve pain. In addition to the analgesic effect, they reduce the permeability of blood vessels and block the development of swelling. But it should be remembered that, like any medicine, they should not be abused so as not to cause side effects.

Prescribed for local use in the form of ointments, creams, gels: butadione, ketorol, piroxicam. Medicines have a pronounced analgesic and anti-inflammatory effect: when administered enterally (tablets, capsules) and parenterally (solutions for injections).

Non-selective drugs are used: diclofenac, ibuprofen, and selective drugs (nimesulide, movalis).

• Local irritants with anti-inflammatory effects

For heel spurs, they are prescribed for pain relief, normalization of metabolism, prevention of infection, and reduction of the inflammatory reaction. Dimexide gel and medical bile are used as a compress on the heel for 12-24 hours.

• Injections

External injection therapy is used to quickly relieve pain.

1. Novocaine injections are given around the heel spur once or twice a day until the acute symptom disappears.
2. Glucocorticosteroids (Kenalog, Diprospan) are injected directly into the painful point, from one to three injections.

• Plasters

To treat heel spurs, it is possible to use patches containing herbal anti-inflammatory and analgesic components.

• The patch is applied to clean and dry skin of the heel area for 1–2 days,
• the course of treatment is also 2–3 weeks.

It should be noted that such patches are not a remedy recommended by official medicine, however, many patients recognize the positive effect of their use.

Physiotherapy and massage

Physiotherapeutic procedures alleviate the patient's condition and reduce pain: laser therapy, electrophoresis, magnetotherapy, mineral baths, and the use of high-frequency waves.

Exercise therapy

Exercise therapy acts on heel spurs by strengthening the calf muscles and foot muscles, which actually eliminates pain and increases periods of remission, while NSAIDs and hormones only suppress pain symptoms, causing damage to health.

Shock wave therapy for heel spurs

The shock wave technique eliminates inflammation and improves metabolic processes in the bone. As a result of treatment, calcium deposits are loosened, which are then washed out with the bloodstream. Bone tissue regeneration occurs more intensively. The pain becomes less pronounced after each procedure. Small spurs on the heels are completely eliminated.

Treatment is prescribed on an outpatient basis with a course of up to 8 procedures lasting 10-30 minutes.

Does not apply when:

• low blood pressure,
• pregnancy,
• bleeding disorders and thrombophlebitis,
• nervous disorders,
• acute infection and the presence of malignant tumors.

Impact with the Vitafon device

No less popular among the people is the Vitafon device, which helps accelerate lymph flow in inflamed tissues and improves the process of cell regeneration. The device is used to treat many ailments, so it can often be found in home medicine cabinets. The course of treatment usually does not exceed ten days, the duration of the procedure is from 30 to 40 minutes.

Heel spur treatment with laser

Currently, low-intensity laser therapy is a popular and fairly widely used method of treating this disease. Laser therapy targets the soft tissue around the spur. Focused radiation causes an increase in blood circulation in the area of ​​inflammation, which helps to reduce pain.

Stages:

• Laser treatment is carried out in several stages. The first 10 sessions are carried out with low frequency exposure up to 50 Hz.
• After treatment, a break is taken and at the second stage the frequency is increased to 80 Hz, and the power remains the same (80 mW). Sometimes, in severe cases of fasciitis, a third course is prescribed.

Surgical methods

Heel spur removal is prescribed in rare cases:

• When drug and physiotherapeutic treatment does not lead to results over a long period
• The growth grows steadily, hurts a lot and makes it difficult to walk

Then, using a chisel, the growth and, if necessary, all the affected tissue next to it are removed. However, conservative treatment methods are most often used.

How to treat heel spurs at home?

How to cure heel spurs at home using folk remedies? Even non-doctors understand that it is impossible to cure a spur in a day or two, except perhaps in an operating room. But long-term and persistent use of home treatment will definitely yield results!

1. Salt is an antibacterial agent known since ancient times. When treating heel spurs with salt, in addition to warming up the sore heel and improving blood circulation, the metabolism in the affected tissues is normalized and pain is eliminated. The remedy can be used in the form of compresses, for example, with iodine, or hot baths, or simply by lowering the sore foot into heated salt.
2. Take laundry soap (1 piece), dilute it in 5 liters of water, add 200 g of salt. For 7 days, at night, steam your feet in this solution, then dry your feet, put on warm socks and go to bed. The solution can be used until the end of treatment.
3. Medical bile- a remedy that has a positive effect on the outcome of treatment. Before using it, it is best to steam the heel thoroughly, then wipe it and apply a tampon soaked in purified medical bile. Secure the compress with a bandage, wrap it in polyethylene and a warm sock. The bile should be left overnight, and the foot should be washed in the morning.
4. An excellent remedy for heel spurs is dimexide. The drug must be diluted with water in a ratio of 1:3. Moisten a napkin with the diluted liquid, apply it to the area of ​​inflammation, and hold for 30 minutes. Course - 2 weeks.
5. Onion and tar are an excellent method for treating heel spurs. Cut a head of onion in half and pour a drop of tar into the middle of the half. After this, apply the half to the sore spot, secure it, and wrap it up. It should help after 3-5 procedures.
6. Onions and garlic work well for heel spurs. 3-4 cloves of garlic must be crushed (to a pulp) and applied to the sore heel, bandaged. Leave the compress (in the absence of a strong burning sensation) for at least 3 hours. Onions (1 head) should be cut in half and a drop of birch tar should be added to it. Tie a healing bow to the heel and leave for several hours.
7. At home, you can massage with salt. Heat 1 kg of coarse salt, pour on a flat surface. Place your foot on tolerably hot salt and “walk” on the salt with your bare heel for 15 minutes. This tool helps for 2-3 procedures.
8. Swamp cinquefoil- a healing plant that helps with a variety of diseases of bones and joints, including, for example, psoriatic arthritis. It can also be successfully used in the folk treatment of heel spurs - a bone growth on the heel. Buy cinquefoil tincture at the pharmacy (it is produced by the Evalar company). Take 1 tablespoon of tincture and dilute it in one third of a glass of water. Take this solution 3 times a day before meals for 3 weeks. If the pain does not go away, you need to take a break for ten days, and then take the same course again.
9. With the addition of honey, many mixtures are made for compresses for heel spurs: take a teaspoon of honey and sea salt. Mix the ingredients and apply to the heel. Leave overnight, secure with a bandage and wrap in plastic. Honey needs to be mixed with flour so that the gruel has the consistency of not very liquid dough. The cake must be placed on the affected area, previously steamed, wrapped in cellophane and secured with a bandage.

Forecast

With a heel spur, the prognosis is favorable if treatment is started on time and prescribed by a specialist. Long-term development of fasciitis not only brings significant discomfort and pain into everyday life, sometimes with the need to remain in bed for up to 3-4 months or longer, but is also fraught with complications such as damage to nerve fibers, decreased mobility, and osteophyte chipping.

Prevention

Preventive measures must be observed by persons who are predisposed to the formation of spurs on the heels.

Prevention of heel spurs includes:

• promptly treat diseases of the musculoskeletal system (flat feet, pathologies with the spine);
• maintain optimal body weight, do not overeat;
• perform exercises for the ligaments and muscles of the feet;
• wear comfortable shoes with a heel height of no more than 5 cm;
• prevent injuries and overloads of the feet during sports;
• promptly treat diseases of the joints and connective tissue.

Do not forget about preventive exercises, thanks to which you can avoid the appearance of spurs. It is advisable to walk barefoot whenever possible, stomp on your toes, on the outer or inner part of the foot. You can also take foot baths by adding baking soda, soap, salt or essential oils.

This is all about heel spurs: the causes of the disease, symptoms and signs, treatment at home with folk remedies. Be healthy!

Content

Every person has to deal with physical pain in their life. At the same time, the understanding comes that it is a symptom of an emerging disease. Why do my heels hurt? The answer to this question lies in knowledge of the anatomical structure of the feet and the diseases to which they are susceptible. Sharp pain in the heel can be caused by pathologies of the tendons, joints, and connective tissue of the foot. Some common human diseases affect the heel bone, accompanied by swelling and inflammation localized in this place. It is worth understanding what diseases cause heel pain.

What is heel pain

To make it easier for the doctor to diagnose the cause of heel pain, it is necessary to describe the painful sensation as accurately as possible: location, duration, frequency and nature. It is a manifestation of foot disease or a general illness. These tables will help to more accurately characterize heel pain:

Description of pain when it occurs	localization	external manifestations of the disease	presumptive diagnosis
burning, making you want to put your feet in cold water	all over the foot	redness with a bluish tint to the skin	erythromelalgia,
harsh when walking	area of ​​tendon damage extending across the entire sole of the foot		polyneuropathy
pressing after sleep. Dulls with rest, worsens with load on the leg	below the heel	swelling of the arch of the foot	Plantar fasciitis
unbearable	calcaneus	swelling of the foot	calcaneal fracture
strong, unabated. Acute at night.	from ankle to heel bone	inflammation, redness, swelling of the heel and ankle	rheumatoid arthritis

Why does your heel hurt?

The upright position of the human torso causes enormous loads on the legs. Every step he takes puts pressure on his lower limbs with a force of 1.5 body weight. With sudden movements, this force increases 3-4 times. The heel bone and tendons are natural shock absorbers of the human musculoskeletal system. Without preventive measures and control over your own body weight, systematic overload of the legs occurs, which can develop into a disease. Foot and heel pain are associated with many factors.

All causes of heel pain can be divided into several groups:

• not associated with pathological changes in the body:

1. Tension of muscles and ligaments from the need to stay on your feet for a long time, heavy lifting (certain types of professions, training).
2. Constantly wearing uncomfortable or high-heeled shoes.
3. Atrophy of the fat layer, caused by a sharp decrease in body weight or heavy physical activity, flat feet.
4. A person is obese or rapidly gaining excess weight.
5. Corn.

• foot disease:

1. heel spur;
2. tendinitis (inflammation) of the Achilles tendon;
3. apophysitis of the calcaneus;
4. Haglund's deformity;
5. bursitis;
6. calcaneal exostosis;
7. Achillodynia;
8. tarsal tunnel syndrome;
9. Morton's neuralgia;
10. hallux valgus, etc.

• systemic diseases:

1. Bekhterov's disease;
2. osteomyelitis of the calcaneus;
3. bone tuberculosis;
4. gout;
5. rheumatoid and reactive arthritis;
6. tumors, metastases of malignant neoplasms;
7. diabetic angiopathy;
8. infections affecting bone tissue;
9. epiphysitis;
10. cracks caused by diabetes, mycosis or dermatitis.

• injuries:

1. sprain, tendon rupture;
2. injury;
3. ligament damage;
4. fractures, cracks of the calcaneus.

It hurts to step on

With pathologies of the heel zone, pain is felt in the heel when stepping. This is understandable, because it consists of the heel bone, muscles, ligaments, tendons, thick fatty and connective tissue, penetrated by a network of blood vessels and nerve fibers. Any inflammatory process, injury or deformation of the parts that make up the heel under the pressure of a person’s weight leads to pain. It hurts to step on:

• Bekhterov's diseases. Due to genetic predisposition, some people develop chronic inflammation of the joints and vertebrae of the skeleton. The inflammatory lesion spreads first along the spine and then affects the ankle joints, Achilles and heel tendon areas. These processes cause pain, although they do not have such a destructive effect as with rheumatoid arthritis.
• Gout. The cause of this disease is high levels of uric acid in the blood, which occurs in people after 40 years of age. Urate crystals are deposited in the joints, blocking mobility and causing severe inflammation at times, called gouty arthritis. Such processes may involve the toes and ankles. An attack of gout is accompanied by swelling of the joint and adjacent tissues, pressing pain, which intensifies when stepping on the leg.
• Rheumatoid arthritis is a systemic disease in which lymphocytes (immune cells) destroy connective tissue cells of the joints, perceiving them as foreign. In this case, many small and large joints of the human body are simultaneously affected, similar to polyarthritis. The tissues of the ankle and phalanges are destroyed on the foot. At first, the legs ache at night, but as the disease develops, the pain becomes constant.
• Osteomyelitis of the calcaneus is an infectious lesion of all bone elements. This process is long and manifests itself as a secondary disease against the background of diabetic ulcers or injuries to the heel area. It is characterized by the formation of an open, non-healing ulcer on the skin of the heel tubercle. The pain that occurs is not acute, but constant. A characteristic feature is the loss of support on the leg, the inability to walk without aids.

When walking after sleep

Sometimes it is difficult for a person to “unwind” after sleep: heaviness in the legs, numbness and dull pain in the foot are felt. You have to step carefully, choosing a comfortable position for the sole of your foot. Over time, the pain goes away when walking, but may return after the person is sitting or lying down. If these symptoms become a regular occurrence, you should consult a doctor, because the cause may be a disease called plantar fasciitis.

The fascia of the foot is a subcutaneous connective tissue that performs a supporting and trophic function. Constant loads on the lower limbs, unnatural position of the foot associated with wearing uncomfortable shoes or flat feet lead to inflammation of the fascia and their anatomical damage. These processes cause heel pain when walking. Over time, calcium salts are deposited in the area of ​​inflammation, forming a pathological bone growth. Degenerative changes in the heel bone lead to chronic pain.

Heel bone at the back

Exostosis, a non-tumor growth of osteochondral tissue (osteochondroma) on the back surface of the heel bone, brings great discomfort and pain. This growth can reach 2 cm in diameter and causes pain when moving and wearing shoes. It happens that an osteochondral lump forms on the plantar part of the heel bone. People call it a “heel spur.” These pathological changes can compress the nerve endings, which causes pain. There may be numbness in the foot and loss of sensation.

On the inside of the foot

Flat feet cause pain on the inside of the feet. Factors influencing the development of this disease are weak leg ligaments, excessive excess weight and genetic predisposition. Deformation and flattening of the arches of the foot leads to loss of its shock-absorbing function. Because of this, the spine can be bent, and joints often ache. If the feeling of frequent nagging pain inside the foot, radiating to the heel, recurs, you need to consult a doctor to determine flat feet and its treatment.

The heel tubercle on the inside can hurt due to a bruise, sprain of the medial ankle ligaments, or cracks in the heel bone. Less often, but there may be pain in this area with epiphysitis, a childhood disease. By the age of 15, bone, ligaments and tendons are finally formed. Before this, there is a possibility of rupture of the apophysis from the body of the calcaneus during heavy physical activity in children, for example, intense sports.

It hurts inside

In case of infectious diseases, such as osteomyelitis, bone tuberculosis, the patient’s feet ache inside the heel. Doctors note the same symptom for urogenital and intestinal infections. Bone tuberculosis is caused by pathogenic microbacteria. Most often they affect the lungs, but in rare cases, microbes travel through the bloodstream to the heel bone. This form of tuberculosis occurs only in children 10-15 years old with weak immunity.

The child has

Any illness in a child causes fear in parents. In order to act wisely and provide the necessary assistance, you need to know what causes heel pain in children. Pain in the foot does not at all mean the presence of a serious disease, but may be a consequence of:

• child obesity;
• uncomfortable shoes;
• lack of vitamins and minerals in the diet of a growing organism.

If your child often complains that his legs hurt, you should take these complaints seriously. Haglund-Schinz disease can manifest as a similar symptom. The reason is the greater mobility of children and their fragile musculoskeletal system. This disease is more often diagnosed in girls 12-15 years old. Apophysitis of the calcaneus is provoked by repeated childhood injuries and overstrain of the foot from stress during sports. Restriction of movements, massages, and physiotherapy lead to the child’s complete recovery.

Diagnostics

The first signs of pain in the heel should be taken seriously. The doctor will prescribe a general and biochemical blood test. Factors determining the disease will be the level of leukocytes, erythrocyte sedimentation rate and uric acid levels. Depending on the indicators, anemia, gout, and the presence of an inflammatory process in the body can be diagnosed. Microbiological studies of scrapings (serological analysis) from the urethra will help determine the presence of urogenital infections.

Diagnosis of pathological changes in the foot and systemic diseases characterized by pain in the heel area depends on the age of the patient. Diagnostic methods are as follows:

• Ultrasound and magnetic resonance imaging are effective in identifying pathological neoplasms.
• Tumor neoplasms. If their presence is suspected, the patient will be offered tests for tumor markers.
• X-ray examination will help detect pathologies of the heel bone.
• A puncture biopsy will determine osteomyelitis and bone tuberculosis.
• If bursitis is suspected, a puncture is taken from the synovial bursa of the joint.
• Densitometry is used to quantify bone density when osteomyelitis is suspected.
• Bone scintigraphy is used to detect the destruction of bone metastases and their necrosis.

What to do if your heel hurts

Often, when people experience pain in their legs, they turn to a surgeon, but in this case, the choice of a doctor is not entirely correct. You should contact this specialist if:

• leg injury;
• inflammation of muscles, bones, tendons, ligaments;
• ulcers, ulcers on soft tissues;
• subcutaneous hemorrhages;
• joint pathologies;
• tissue necrosis.

A podiatrist should be consulted if flat feet are suspected. This specialist will conduct the necessary diagnostics and recommend orthopedic insoles for therapeutic correction of the foot and reducing the load on it. It is within the competence of the orthopedist to prescribe massage, therapeutic exercises, and the necessary medications. A rheumatologist treats joints. If you have inflammation, pain and deformities in the ankle or small joints of the foot, you should contact this doctor. If you have doubts about which doctor can help, you need to go to a therapist. He will refer you to the right specialist.

Drug treatment

If your heel hurts, you should definitely consult a doctor to get a qualified diagnosis of the disease and the necessary treatment. Medical care may consist of non-drug treatment and physiotherapeutic procedures. If necessary, the doctor will prescribe medications:

Name	readings	release form	therapeutic effect
Viprosal	arthritis, muscle pain due to injury	ointment for external use	warms, relieves pain
Gevkamen	rheumatism, arthritis, neuralgia		has anti-inflammatory, antiseptic effect
	rheumatoid arthritis, articular syndrome due to gout, bursitis, inflammation of tendons and ligaments	gel, non-steroidal agent	acts as an analgesic, removes exudate
Diclofenac	Bechterov's disease, arthritis, osteoarthritis, bursitis	tablets, solution for intramuscular injection, ointment, gel, suppositories	exhibits antipyretic, analgesic, anti-inflammatory effects
Indomethacin	articular syndrome, diffuse connective tissue diseases, tendon inflammation	tablets, ointment, gel, suppositories	relieves pain, relieves inflammation
Ketoprofen	acute pain due to arthritis and other systemic diseases	tablets, drops, granules, injection solution, suppositories, gel	glues platelets together, lowers fever, relieves pain and inflammation
Menovazin	sore joints or muscles	solution, ointment	has an anesthetic effect
Finalgon	arthritis, bursitis, tendonitis		warms, dilates blood vessels, relieves inflammation
Nicoflex	injuries, sprains and muscles		has analgesic and absorbent properties

Diclofenac is an effective, time-tested and clinically tested drug. It perfectly relieves acute pain and has a long-lasting anti-inflammatory effect. In case of severe pain, 3 injections are prescribed intramuscularly, then the tablet form of the drug is used at the rate of 150 mg per day. Advantages: has different release forms, quickly relieves pain. Negative properties: not suitable for long-term use because it causes stomach pain, aggravates peptic ulcers, gastritis.

Ketoprofen is a strong analgesic drug. It has proven itself to be excellent for relieving joint pain due to arthritis. It is well tolerated by patients. Convenient for outpatient use, as it has different forms of release. Advantages: optimal combination of price and quality. With occasional use of side effects does not show. Negative properties: does not help with extensive lesions, has a gastropathic effect.

Surgical treatment

If conservative treatment does not bring the desired result, the patient is prescribed surgical treatment. Surgery is performed when:

• Haglund deformities. The bone outgrowth is removed from the surface of the calcaneal tuber endoscopically. Thanks to a camera embedded in the heel area, the operation is quick and precise. Surgical treatment for this disease is 90% effective. The rehabilitation period is minimal.
• Tarsal tunnel syndrome. Surgical intervention is required for large pathological formations in the tarsal canal. With the help of surgery, the growths are removed, thereby restoring the normal patency of the canal.
• Tuberculosis of the heel bone. In the later stages of the disease, conservative treatment is not effective. In this case, surgical intervention is prescribed: dead tissue is mechanically removed and the cavity that has formed inside the heel bone is disinfected.
• Osteomyelitis. Surgery involves opening the abscess in the heel bone, mechanically clearing the dead tissue and disinfecting the affected area.

Traditional treatment

When the foot hurts as a result of gout, diabetic angiopathy, reactive arthritis, epophysitis, osteomyelitis of the heel bone, etc., serious medical treatment is necessary, which does not exclude surgical intervention. Folk remedies can only be used for:

• bruises;
• sprains of tendons and ligaments of the ankle joint;
• bursitis;
• fasciitis.

If your heel hurts, you should get a positive response from a doctor about using folk remedies to relieve pain. At home, you can prepare tinctures and compresses to relieve pain. Among the effective recipes, the following are recommended:

• For fasciitis:

1. Lubricate the sole of the foot as often as possible with a tincture of white acacia flowers and vodka. The proportion of components is 1:3. Leave for 3-7 days in a dark place.
2. Mix the roots of marsh cinquefoil 1:3 with vodka and leave for 24 hours. Apply 2 tablespoons orally 3 times a day.
3. Garlic compress. Finely grated garlic and apply to the sore spot for 3-4 hours.

• For a heel bruise, sprained Achilles tendon and ankle ligaments, joint bursitis:

1. Apply a compress of grated raw potatoes several times a day.
2. Apply a paste of crushed aloe leaves to the sore spot in the form of a compress. Keep for 6 hours.
3. Peeled, finely chopped onion is mixed with sugar in a ratio of 2: 1, applied to the sore spot with a compress. The dressing is changed after 24 hours.

Prevention

To prevent heel pain, you should take measures that will protect your feet from injury and deformation. Preventive measures to prevent the occurrence of pain in the heel area include:

• Refusal of shoes with high heels or completely flat soles such as ballet shoes. It is advisable to have shoes with a wide heel 5 cm high.
• Timely consultation with a doctor at the first manifestation of painful symptoms in the foot area.
• Control over extra pounds of the body. Excess weight increases the load on the legs, which can provoke the diseases described above.
• Regular foot care.
• The diet should include the necessary trace elements and vitamins.
• The use of relaxing salt baths for the feet.
• Ice skating, skateboarding, skiing using protective equipment to prevent leg injuries.
• Applying nourishing cream to the skin of the feet to avoid excessive drying.

Video

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