heel pain
Introduction
Introduction Pain on one or both sides of the heel, not red or swollen, inconvenient to walk. Also known as heel pain. It is a disease caused by lesions in the bones, joints, bursae, and fascia of the heel. Commonly known as fasciitis, often occurs in long-standing or walking workers, caused by long-term, chronic minor injuries, manifested as fascia fiber rupture and repair process, the fascia at the medial side of the calcaneus And tenderness, the lateral X-ray film shows the calcaneus of the calcaneus. However, there is not necessarily a heel pain in the bone spur, and sacral fasciitis does not necessarily have a spur. Chinese medicine believes that heel pain is mostly caused by liver and kidney yin deficiency, dampness, blood heat and so on. Liver main tendons, kidney main bones, liver and kidney deficiency, musculoskeletal dystrophy, re-sensation of wind and cold dampness or chronic strain can lead to meridian stagnation, blood and blood running blocked, so that the muscles and muscles are dying and the disease.
Cause
Cause
Fasciitis
The most common cause of heel pain is the lesions caused by long-term, chronic, and minor traumatic accumulation, which is characterized by the rupture of fascia fibers and its repair process. There may be bone hyperplasia near the inner fascia below the calcaneus, forming an epiphysis. It is shown as a spur on a lateral radiograph. The latter is often considered to be the cause of heel pain, but clinical studies have shown that its causal relationship with heel pain is difficult to affirm, fasciitis is not necessarily accompanied by spurs, and people with spurs do not necessarily have Heel pain. The heel pain caused by fasciitis can be cured naturally. The high heel is used to reduce the tension of the Achilles tendon on the calcaneus, the forefoot flexion, and the tension of the tendon fascia can alleviate the symptoms. Drug injection can be performed at the local tender point on the medial side of the foot. Once a week, most patients can be cured within two weeks after the injection.
Pain pain
Often occurring in the elderly, the pad is an elastic pad formed by fibrous tissue at the bottom of the calcaneus, formed by adipose tissue and elastic fibers. In youth, the pad is elastic and absorbs oscillations. In old age, the elastic force of the pad is reduced, and the calcaneus bears weight without padding. In severe cases, scars and calcium deposits can form, causing heel pain. Unlike pad pain and fasciitis, there is tenderness under the entire heel. The treatment is by using a sponge pad or a topical drug injection.
Posterior calcaneus bursitis
The sac that most likely occurs between the Achilles tendon and the skin, caused by frictional damage from unsuitable high-heeled shoes. The wall of the sac is variable in hypertrophy, the sac is filled with synovial fluid, local swelling, and tenderness. The treatment should improve the shoe type. If the bursa is swollen, it can be puncture and can be injected with hydrocortisone.
Calcaneal osteoarthritis
Often occurring in boys between the ages of 8 and 12, the lesion is similar to the calf and humerus of the calf. It is a symptom caused by the tendon being pulled during the development of the unhealed epiphysis. The pain is below the attachment point of the Achilles tendon and can be bilateral At the same time. Running and standing on the toes can exacerbate the symptoms. Symptoms naturally disappear after healing of the epiphysis. Generally, symptomatic treatment can reduce the activity of the child, and the heel can also be used to reduce the tension of the Achilles tendon to the calcaneus.
Subtalar arthritis
Often occurs after a calcaneal fracture, is a type of traumatic arthritis. X-ray photographs on the anterior sinus sinus, the pain increased when weight-bearing. If conservative treatment fails, heel joint fusion should be performed.
Older calcaneus fractures or rare calcaneal tumors or tuberculosis are also causes of heel pain. The disease other than the heel causes a heel pain, rheumatoid spondylitis, lumbar disc herniation of the sacral nerve root, and squeezing of the radial nerve in the calf.
How to distinguish the heel pain caused by clinical reasons? Generally speaking, in addition to the corresponding auxiliary examination such as X-ray film, the professional podiatrist can basically confirm the diagnosis after clinical examination. . It is also possible to use therapeutic means to distinguish, for example, the heel pain caused by the atrophy of the plantar fat pad in the elderly, which is not effective when localized closure therapy is applied.
Examine
an examination
Related inspection
Joint examination of bone and joint soft tissue CT examination
Heel pain, which is mainly manifested by unilateral or bilateral heel or fundar soreness or acupuncture-like pain, difficulty walking. Due to traumatic inflammation of the fascia, periorbital inflammation, calcane bursitis, calcaneal spurs and fat pad degeneration, the incidence is mostly related to chronic strain. Clinically, there are mainly:
(1) inflammation around the Achilles tendon.
(2) calcaneus of the calcaneus.
(3) calcaneus periostitis.
(4) Injury to the lower fat pad of the calcaneus.
(5) Fracture of the calcaneus.
(6) cutaneous bursitis.
(7) Stenosis of the sacral sinus soft tissue.
(8) calcaneus tuberculosis, tumors, etc.
Diagnosis
Differential diagnosis
Differential diagnosis of heel pain:
1, foot pain: common symptoms of ankylosing spondylitis include heel pain, foot pain, intercostal muscle pain.
2. Swelling and pain in front of the lateral malleolus: Most of the acute ligament injuries of the ankle joint have a clear history of trauma. Clinically, the patient's anterior and posterior sacral swelling and pain, local tenderness, subcutaneous ecchymosis, limited joint activity, and lameness can be found.
3, toe pain: gout toe pain occurs mostly in middle-aged men. Often acute onset. Most of the patients with toe, sputum and other joint swelling and heat pain.
