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Heel Pain - Causes and Effective Treatment
Pain on the heel
Heel pain refers to discomfort in the back of the foot, which is usually very uncomfortable, since simple walking can already cause great difficulties. The heel carries most of the body weight and is thus heavily loaded anyway. As a result, the heel reacts quickly to pain when the body is overburdened, which can increase the load on the foot, knee and hip joints as well as the lumbar and cervical spine. Heel pain is a common foot problem, which is usually caused by Achilles tendon inflammation, heel spur or bursitis, but can usually be relieved quickly and effectively with relatively simple measures.
contents
- Pain on the heel
- Symptoms and complaints
- Functional causes of pain on the heel
- Inflammation at Achilles tendon insertion
- Inflammation of the tendon plate
- Other causes of heel pain
- diagnosis
- Treatment options for heel pain
- Naturopathy in case of heel pain
Symptoms and complaints
Pain in the heel occurs in different forms. Typical is the so-called "onset pain" that occurs in the morning or after prolonged lying or sitting after the foot has not been moved for a while. This form of heel pain often fades in the course of the movement, but returns after another rest period.
Heel pain can lead to significant impairment while walking. (Image: SENTELLO / fotolia.com) In part, the pain is so severe that the first go is almost impossible and a walker is required. In addition, heel pain, for example, as severe pressure pain on the tendon attachments or as a sharp pain inside to the middle in the sole area of the heel. Other sufferers report rather dull foot pain in the heel, which can also occur at rest.
Functional causes of pain on the heel
The most common cause of heel pain is overstressing the Achilles tendon. This can be caused, for example, by muscle imbalance, ligament weakness in the hocks or deformations of the foot. If there is permanent overstress, chronic inflammation (tendinitis) occurs in many cases, which can cause tissue damage and partial tears. In severe cases, this can even lead to tendon rupture.
Triggers for a permanent overload of the tendon are mostly sports activities, in which one runs or jumps. Because the muscles work e.g. not compensated by tension or shortening, this has a unilateral and thus unfavorable burden on the Achilles tendon result. Added to this - especially in sports - are other factors that can promote Achilles tendon pain. These include, for example, bad-fitting shoes, lack of warm-up exercises and a wrong technique in the exercise of the sport.
Pain in the heel area is often caused by overstressing the Achilles tendon. This happens quickly, e.g. by too small sneakers or a wrong technique when practicing the sport. (Image: underdogstudios / fotolia.com) In the case of inflammation of the tendon occur in connection with physical stress (walking, running, jumping, etc.) stinging pain and visible swelling in the tendon, which are usually intense in the course of activity. If there is already a permanent inflammation, the symptoms are usually already on getting up, then only once less, to return to the next resting phase. In this case, the tendon is already thickened in some places and extremely sensitive to pressure in the affected areas.
Inflammation at Achilles tendon insertion
Another cause may be an inflamed Achilles tendon approach, which often occurs in combination with bursitis and bone outgrowth, a so-called "heel spur".
An inflammation of the tendon insertion also causes pain when starting up, especially when climbing. Here is a pressing pain rather punctually inside, outside or behind in the heel center. In bursitis, however, is usually reported by severe local pain.
Inflammation of the tendon plate
Inflammation of the tendon plate on the sole of the foot (also called "plantar fasciitis") is often responsible for pain in the heel. In this form of inflammation, changes in the connective tissue of the tendon, fine tears, calcifications and swelling show.
The cause of the plantar fasciitis is not yet clear. There is agreement among experts, however, that running can promote inflammation of the tendon plate. On the other hand, misalignments of the foot (e.g., countersink or kink-lowering foot, spread-countersunk foot), shortened calf muscles, rheumatic complaints, obesity, or occupations where walking or standing is considered as risk factors.
Here too, a heel spur can develop in parallel, which applies to every second affected person. Compared to the heel spurs, which may occur as part of an inflammation of the approach of the Achilles tendon, but this is a lower or front spur fussohlenseitig, which occurs more frequently than an upper spur.
The hallmarks of plantar fasciitis are foot-heel pain in the heel area, which usually occurs in the morning during the first steps after getting up and intensifies as the movement progresses. The pain can radiate not only in the entire foot, but also in the lower leg. Often, these also occur on the inner edge of the foot, the frequently occurring heel spurs also cause a sharp pain in the heel when walking and standing.
Other causes of heel pain
The cause of the discomfort may be a so-called overbone, as well as genetic predisposition and wear or a declining tissue quality into consideration. In some cases, injuries that occurred years ago are the reason for the pain in the heel. Other possible causes include rheumatic complaints and certain metabolic and circulatory disorders such as diabetes or gout.
The cause of heel pain may be leg deformities such as the so-called X or O legs. (Image: MichaelJBerlin / fotolia.com) Ligament weakness on the foot or ankle osteoarthritis, foot deformities (kinking or splay foot etc.) as well as misalignment of the legs in the form of so-called X-legs and O-legs can lead to heel pain. The same applies to wrong, inappropriate footwear. Furthermore, obesity is considered as a trigger, since the feet are exposed in this case, a permanently stronger load.
diagnosis
In the case of inflammation of the tendon or the tendon sheath usually in the lower part of the Achilles tendon (about two to seven centimeters above the tendon insertion) by means of the so-called forceps handle trigger a pressure pain, also shows when moving the foot a pain. If the foot is moved, thickening of the tendon can be felt, in some cases even a slight crunching sound can be heard.
When an inflammation of the tendon attachment arises when pressure is applied to this a strong pain, which occurs when the forceps handle on the tendon margin between the tendon and heel bone. Stretching the tendon, for example by pulling up the foot, intensifies the pain significantly.
When ultrasound is used, tendonitis is often accompanied by calcifications, inflammatory compaction or tears. With the help of the so-called magnetic resonance tomography even minimal defects of the tendon can be recognized. Further information on the clinical picture can be obtained from X-rays of the foot (heel, upper ankle joint), whereby a heel spur would also be detected here.
If an inflamed plantar plate is responsible for the discomfort, applying pressure to the affected areas causes pain, which increases as the affected person pulls his toes up and tightens the tendon plate. Ultrasound can be used to visualize thickening in the tendon plate and to detect heel spurs.
Treatment options for heel pain
Heel pain caused by an acute overburden can in most cases be treated effectively with simple, non-surgical measures. These include first and foremost a consistent protection of the foot by avoiding longer and demanding activities such as running, jogging or sports and the wearing of "healthy", i. not too small or too high shoes.
Other useful measures are, for example, a treatment of the heel with cold by cooling pads or wrapped in a towel ice cubes are placed on the painful area for about five minutes. In case of overweight a consistent weight reduction is advisable.
Orthopedic shoe inserts can compensate for foot deformities and relieve heel pain. (Image: pix4U / fotolia.com) One of the classic therapeutic measures is the wearing of individually adjusted insoles, which have a supportive effect by correcting incorrect foot functions and thereby relieving pain. On the other hand, a regular, daily training in the form of stretching exercises is recommended to stretch calf muscles and Achilles tendons, thereby minimizing heel pain and effectively prevent it.
Calf stretching against heel pain:
Tip: Alternatively, the bent knee exercise can be performed to stretch the Achilles tendon. |
For existing complaints, it is important to do the exercises regularly, i. at least twice a day and over a longer period of time. If the pain is severe or has been persisting for some time, first and foremost a doctor should be consulted.
Stair Exercise for heel complaints:
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Additional support is provided by heel pads or heel pads, through which an effective pressure relief can be achieved. Alternatively, so-called foot cuffs, which relieve not only the heel, but the entire foot.
Orthopedic aids for the foot as well as consistent physiotherapy are especially important for chronic complaints. There are a variety of offers, from special connective tissue massages, foot and calf gymnastics, special insoles and shoe corrections (such as a heel lift), which can compensate for different leg lengths.
If major damage has already occurred, in some cases surgery can not be avoided. In this case, the affected tissue is removed and used if necessary, an endogenous tendon transplant for stabilization. Following the operation, the "normal function" of the foot is restored step by step and usually for weeks using physiotherapy exercises and a high heel orthopedic shoe.
Naturopathy in case of heel pain
In addition to the conventional medical approach, naturopathy offers help with heel pain: In transcutaneous electrical nerve stimulation (TENS), for example, electrical impulses are generated by a device and transmitted through the skin to the nerves, whereby these impulses stimulate the body's own, pain-relieving systems and the irritated nervous system again calm. As a result, the pain loses its intensity and less medication is usually needed to treat it. The TENS device is practically without any risk for the person concerned and can be used well after a briefing by the therapist from home.
In addition to transcutaneous electrical nerve stimulation, homeopathy offers various means of treating the symptoms naturally. In general overuse, touch sensitivity and pain (including external use) Arnica is recommended. After over exercise (also for external use) Ruta graveolens (garden rue) is considered, while drilling, periodic pain or numbness Hekla lava (volcanic ash of the Hekla volcano) may be the drug of choice.
In homeopathy, the heel of the garden (Ruta graveolens) is mainly used for heel pain due to sportive overexertion. (Image: Maren Winter / fotolia.com) Osteopathy is often used by patients with heel pain as an alternative or supplement to traditional medical treatments. In this concept of manual diagnostics and treatment is usually considered beyond the heel, as the general body tension and the statics of the person concerned are designed. On the basis of this, Rolfing's method is then used to release adhesively bonded connective tissue structures through gentle, but targeted pressure, thereby providing an overall better, more upright posture.
In osteopathy it is assumed that irritation of the supplying nerves on the spine or on the way to the heel can cause pain. Accordingly, it is clarified in the treatment whether back pain, low back pain, buttocks pain or pre-existing conditions such as eddy gliding or ankylosing spondylitis or have existed. (nr, last updated on 8.3.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor) 