COMMON QUESTIONS ANSWERED
Heel pain is the commonest condition for which patient visits doctor especially orthopaedic surgeons. There are various causes for this and the most common condition is:
PLANTAR FASCITIS
This is basically swelling of a thick layer of soft tissue under the sole of the foot which spreads to entire foot starting from the underside of the heel. This occurs commonly because of overuse and seen in the population who stand for long durations like teachers policemen, athletes, improper footwear. This can increase in intensity in cases with weak bones like vitamin D deficiency, high uric acid levels, low thyroid level patients etc. Rarely this can arise from nerve entrapment.
The other heel pain condition is back sided heel pain which is commonly referred to as:
ACHILLES TENDINITIS OR RETRO CALCANEAL BURSITIS
This also is an overuse injury caused by the pull of one tough muscle attachment to the bone called ACHILLES. Causes will be from bony bump over the heel bone called HAGLUND DEFORMITY. More or less the other causes remain the same as described in the earlier paragraphs.
One should always be confident that these are common conditions and definitely treatable. Most of them can be managed by non-operative means like the modification of footwear like:
- Custom Insoles
- Soft Microcellular Rubber Footwear
- Silicone Heel Cups
- Insoles
- Also some exercises, which include plantar fascia stretching, calf stretching.
plantar fasciitis is a self-resolving condition and resolves spontaneously in 3 to 4 months. At the same time, back sided heel pain also resolves by exercises and non-operative measures.
If the pain is not coming down nowadays ultrasound guided injections are given which include steroid+local anaesthetic (only for plantar fasciitis non-diabetic population) or stem cell injections like PLATELET-RICH PLASMA are also being administered with high success rate.
Surgical intervention is very rare especially in plantar fasciitis rarely in less than 1% may need calf muscle release for reducing the tight heel cord muscle. Surgery is done backside heel pain with a bump over it when the heel cord (ACHILLES) is torn or weak where the bone bump is removed and heel cord is reattached to the bone.
Following the doctors' orders and systematically treated by trained doctors in foot and ankle problems like the author himself will relieve the patient problem and reassurance from doctor is also very important in this chronic disabling condition which is very much treatable