When the heel hurts, it hurts to step on, the reason for this can be hidden anywhere. Unpleasant sensations are caused by various factors, including those that pose a real threat to health, therefore, in order to avoid trouble, it is recommended to contact a specialist when the first suspicious symptoms appear.

Why do heels hurt?

With a problem when the heel hurts, it hurts to attack, the reason is not clear, a large number of people face. The problem is that there are serious loads on the feet throughout life. According to statistics, on average, every day a person walks 3-4 thousand steps. At the same time, the feet have to bear the load 1.5-2.5 times more than their own body weight. In this, when the heels hurt, the reason may be hidden, but besides it, there are other factors conducive to the appearance of unpleasant sensations.

Pain in the heel when stepping on

When the heel hurts, it hurts to step on, what is the reason I want to find out as soon as possible. The most common triggers for pain are:

1. Fracture of the calcaneus. In this case, not only the heel hurts, it hurts to step on it, but you can also notice the deformation of a part of the limb. At the same time, the foot swells, hematomas appear on it.
2. Injury. The pain with such damage is burning and it is impossible to stand on the injured leg.
3. Bechterew's disease. If the heel hurts, it hurts to step on, the reason may be this. Symptoms appear against the background of a hostile attitude of the immune system to the ligamentous and articular tissues.
4. Calcaneal epiphysitis. When the heel hurts, it hurts to attack, the cause can sometimes be hidden in this ailment, which is a micro-rupture of the connective tissues in the calcaneus.
5. Gout. Pain is the result of excess urate. As a rule, the joints of the big toes suffer from the disease, but sometimes the heels get it.

Heel pain when walking

When the heels hurt when walking, the reasons are as follows:

1. Bursitis. Inflammation that develops against the background of trauma or methodical irritations.
2. Tendinitis of the Achilles tendon. At the same time, the heel hurts when walking due to excessive loads on the calf muscles.
3. Diabetes. Symptoms occur as a result of impaired circulation in the foot.
4. reactive arthritis. The cause of the disease is open infections - urogenital or intestinal. Pain in the heel reminds of itself not only when walking, but also at night.
5. tuberculosis of the bones. Starting with the death of small areas, the infectious process gradually spreads to large areas.
6. Malignant tumors.

Heel pain after running

This is a common complaint. As practice shows, the heel often hurts after running due to a violation of technique. To be precise, unpleasant sensations appear when a person puts his feet incorrectly. For many, the main load falls on the heels, which negatively affects its condition and is wrong - the limb should land exclusively on the forefoot.

Another likely reason why the heel hurts, it hurts to step on a limb is sexually transmitted infections. Gonorrhea or chlamydia - to be specific. It often happens that latent pathological processes manifest themselves as reactive inflammation. Among other things, soreness may indicate.

Heel pain at rest

This symptom is dangerous. When heel pain occurs at rest, it may indicate developing rheumatoid arthritis. In the early stages, pain bothers only during exertion, but over time, discomfort becomes constant and torments from morning to morning. Sometimes a symptom appears as a result of fatigue, against the background of infectious diseases of the genitourinary system or intestines.

Heel pain after sleep

The likely reason for this is the fascia of the sole. The heel hurts, it hurts to step on it in the morning after sleep due to the dense formation that forms in the connective tissues. Negative changes occur as a result of prolonged standing or wearing uncomfortable shoes. If the fascia is left untreated, it transforms into a heel spur. The structure of the latter is more dense, and pain, if present, can appear not only in the morning, but also during the day.

In some patients, soreness after sleep occurs due to osteoporosis. Stimulate the development of the disease can:

• wrong diet;
• early onset of menopause;
• prolonged lactation period;
• nicotine addiction.

Heel pain after ankle injury

Severe bruises or other injuries - heel pain causes and has such. Feelings in this case are pronounced. The pain is burning, it feels like a needle is stuck in the leg. And it seems that with every step she digs deeper and deeper into the body. If such sensations appear, you should try not to step on the diseased limb and seek the advice of a specialist as soon as possible.

Sore heel - what to do?

Complaints in the diagnosis of discomfort in the foot are very important. When the heels hurt, it hurts to attack, how to treat this problem is determined taking into account all the symptoms, the patient's sensations and the history of his disease. If it is not possible to find the cause of the pain, or it requires confirmation, additional examinations are prescribed, such as:

• general blood analysis;
• x-ray studies;
• microbiological research;
• bone biopsy (if bone tuberculosis is suspected);
• serological analysis;
• (with suspicion of oncology).

How to relieve heel pain?

The choice of treatment directly depends on what caused severe heel pain:

1. If the symptoms are due to wearing uncomfortable shoes, the latter should be replaced with something more comfortable. It is best that she be on a small comfortable heel. Shoes with absolutely flat soles are contraindicated.
2. Fasciitis. This disease is treated by reducing the load on the leg, cooling the heel. After 10 - 15 minutes, an ice compress will noticeably improve the condition. If necessary, you can take Ibuprofen.
3. Injuries. The injured limb should be immobilized. In case of damage, compresses with antiseptics help well. Effective wound healing agents. It also helps develop muscles. In the morning, the fascia can be pulled with a towel - grab your foot with it and pull it over yourself without bending your knees.
4. . Therapy involves the use of orthopedic insoles, physiotherapy, and the use of topical corticosteroids.

The heel, or heel, is a convex part of the body on the back of the foot, consisting of bone, fatty tissue and skin. considered the largest of all 26 bones that make up the foot. The main function of the heel is cushioning during any movement of a person. It has a good blood supply, many nerve endings. The bone is surrounded by a fat pad, due to which depreciation is carried out - softening the impact force when walking and jumping. So why does the heel on the left leg hurt?

Today, a person has a very intense rhythm of life, which makes him spend a lot of time on his feet. The heel already withstands heavy loads, and with prolonged standing, the load increases. Interestingly, the left leg suffers more. The symmetry of the human body is not absolute. This is due to evolution, during which the right arm and leg became predominant in humans, which are controlled by the dominant left hemisphere of the brain. Human legs are never perfectly symmetrical. Right-handers have a more developed right limb. The muscles on it are more developed, often the fullness of the leg is also greater. The tone on the weak leg decreases faster. As a rule, this is the left limb. Loads create discomfort, and pain appears in the left heel. There is no causeless pain.

Physiological causes

Why does the heel on the left leg hurt? For reference: discomfort and pain do not always indicate the presence of pathology. They can be physiological and are due to the following factors:

• uncomfortable or new shoes: high heels, tight shoes, in which there is an overstrain or squeezing of the muscles;
• when dieting or increased physical activity, the amount of subcutaneous fat under the sole of the foot may decrease, which will immediately affect depreciation;
• prolonged standing or long walking;
• rapid weight gain.

When the heel on the left leg hurts for a long time, the causes are most often more serious. Perhaps some pathological process begins. Pathological pain can be distinguished by the following signs:

• the pain is burning, stabbing or aching in the foot or on the side of the heel;
• when walking, the pain intensifies;
• there are signs of inflammation in the form of redness, swelling and local hyperthermia;
• if burning pain on one side of the heel increases in the evening and in the morning, then this may be the primary sign of arthritis or gout;
• throbbing pain on the side is a sign of injury.

Causes of heel pain

The heel is a bioshock absorber, thanks to which a person's upright posture became possible. In addition to fatty tissue, it is surrounded by muscles, ligaments and tendons. Why does the heel on the left leg hurt? Despite its enormous potential in terms of loads, the integrity of the bone can be compromised. This can be facilitated by strong physical exertion, malnutrition, injuries to the foot and surrounding tissues, and inflammation.

Important! Heel deformity does not pass without a trace, the spine and other joints begin to suffer. The heel itself, if left untreated, begins to cause severe discomfort, limits motor activity.

Causes of pain in the lateral part of the heel

Why does the heel hurt on the left leg or right? The symptom can be expressed, both with a load on one of the limbs, and on both. The most common reasons:

• shoes not in size;
• high stiletto heel;
• enhanced sports training or dancing;
• prolonged standing;
• trauma to the tissues surrounding the heel;
• gout;
• osteoporosis;
• foot mycosis;
• foreign body under the skin of the heel;
• leg injury when walking barefoot on pebbles, sand;
• arthritis;
• deformity of the calcaneus;
• heel spur.

About pathologies in more detail:

1. Foot injury. Stretching or rupture of tendon tissues - occurs with a direct blow or a sharp contraction of the muscles of the foot. First there is acute pain, after - swelling, the impossibility of bending the foot.
2. A bruise - can occur as a result of an unsuccessful landing after a jump from a great height on the heel. Pain, swelling and redness occur at the site of injury. It hurts to step on the heel, lameness joins. The pain is severe, dull and constant.
3. Fracture. If the heel on the left leg hurts, it hurts to step on it, then you may be dealing with a fracture. It is extremely rare - about 4% of the total number of injuries of this kind. Most often, a calcaneus fracture is the result of a fall from a height while standing. From severe pain, a person cannot step on the heel, the bone is deformed, expands, swells, the sole is covered with bruises. The foot changes in shape, the heel, as it were, folds to the side.

Inflammatory diseases

Tendinitis is inflammation of the tendon. Doctors have established the main causes of the disease: mechanical damage, impaired metabolism, age-related changes, pathology of the skeletal structure, inflammation in the tendons of the joints, adverse reactions from the use of certain drugs, as well as excessive physical exertion, because it is not for nothing that tendenitis is called a professional disease of runners.

The main symptoms are swelling, nodules under the skin, redness and pain. Through a stethoscope, the doctor can hear the friction of the tendon muscles during movement. Left untreated, the tendon can rupture, leaving the person unable to move. Pain with tendinitis is local, near the heel, it hurts to stand on toes, jump.

Bursitis is an inflammation of the synovial sac. It is often preceded by trauma. The heel turns red, swells, hurts, hot to the touch. Without treatment, the swelling grows and thickens.

Gaglund-Shinz disease - necrosis of the spongy bone of the heel. The disease is manifested by gradually increasing pain in the area of ​​​​the heel tubercle. It becomes most intense during exercise and walking. Over time, a person, due to constant pain, can walk only by leaning on the front of the foot. Treatment is conservative, if it is started on time, the prognosis is favorable.

Fasciitis is the most common pathology. More typical for the elderly. In the people, the disease is known as a heel spur. When it occurs on the right or left leg, the heel hurts when walking. Plantar fasciitis is between the heel and middle bones of the foot. The fascia of the foot in the form of a strip supports the arch and heel. It develops with increased weight, arthritis, osteochondrosis, flat feet, microtrauma of the fascia, most often it is torn at the point of attachment to the heel. With this pathology, it hurts under the heel of the left leg, a person cannot step on, walk, the pain appears in the morning, subsides during the day and only at rest and during a night's sleep. The fascia regenerates and fuses a little overnight. The very first steps in the morning tear it apart again.

The name "calcaneal spur" is given because of the similarity of the bone that has grown in the form of a wedge or beak under the heel or behind it. Pathology develops as a result of other diseases as a consequence. Provoking factors - overweight, rheumatism, arthritis, flat feet, increased stress on the legs. A person does not feel the growth of the wedge, pain occurs only when inflammation passes to the bone - periostitis and bursitis.

If the heel of the left leg hurts a lot and there is a feeling of a nail in it, especially when walking, in the evening or in the morning, then this is probably a spur. Note that it can also develop as a result of tendinitis, in which the growth of new tissue cells is stimulated, which gradually die off and accumulate. More often the lesion is observed on one side.

Heel tumor is a very rare disease, although there are quite a few types of cancer that affect the foot. It is often possible to identify them only after an injury or a close examination by a specialist. All tumors can be conditionally divided into two groups. The first - skin cancer - include squamous neoplasm, malignant melanoma, basalioma. The second group is foot bone cancer (osteosarcoma, Ewing's sarcoma, chondrosarcoma). The third type includes soft tissue tumors: fibrosarcomas, epithelioid and synovial sarcomas, malignant fibrous histicytoma. It is difficult to recognize the development of a malignant process in this area. The main thing to pay attention to is compaction of any kind, asymmetry, a tendency to form ulcers with torn edges, uneven staining of the tumor and progressive pain on palpation and walking, which does not stop even during rest.

Why does the heel on the left leg hurt inside

Inside the heel can hurt with infectious diseases. Among them, reactive arthritis is the most common. Pain does not depend on the load, intensifies at night.

Osteomyelitis is a purulent-necrotic process developing in the bone. First, the muscles hurt, then the temperature rises, but the pain in the heel has been present since the first day. This is the answer to the question of why the heel on the left leg hurts inside. There is a purulent destruction of the bone, and therefore the pain is localized inside the heel. It is aching, dull, constant, occurs after 3-4 days, lameness quickly joins. The heel is slightly swollen.

What else hurts the heel on the left leg? The reason may be very serious. In particular, bone tuberculosis, in which the pain inside the heel is permanent. If left untreated, a fistula with pus forms in the bone. Some areas of the skin become dead. Important! Treatment for a long time gives remission of the disease.

One of the most common causes of heel pain is a callus. It can be bone and plantar (spike). result from intense and prolonged friction of the heel against the shoe. It has the appearance of a yellowish seal. Pain joins only with infection or inflammation. Bone callus gives sharp and unbearable pain. Treatment is surgical only.

Systemic diseases

Another serious disease that can hurt the heel on the left or right foot is rheumatoid arthritis. It can affect the joints of the foot. At first, soreness and stiffness is felt only in the morning, but then the pain becomes constant, present even during sleep. Additionally, there are signs of intoxication - pallor, fever, loss of appetite, lethargy, etc.

Gout is a joint disease in which uric acid builds up in the joints. Painful sensations often occur at night, in a dream. The color of the joint is brown-red, it is swollen and very painful, hot on palpation.

Arthritis is a disease that most often results in inflammation of both the heel and surrounding tissues. The pains are strong and constant, unbearable in the morning.

Osteoporosis - voids in the bone due to its demineralization and a decrease in calcium content. The strength of the bones drops markedly, and fractures occur more often. Contribute pathology hypodynamia, violation of diet, menopause, taking medications containing aluminum.

Sever's disease, or calcaneal epiphysitis, is a pathology that occurs in children. Symptoms - pain on the lateral surfaces of the heel after physical exertion, slight swelling, the surface of the heel is hot to the touch. Until the age of 8-16, two parts of the calcaneus are connected by cartilage. It happens that excessive physical activity leads to its rupture, and then on the right or left leg, the heel hurts both on the inside and outside (along the entire perimeter).

Why do my heels hurt after walking?

In some cases, pain appears after, and not during, walking. A very common reason is the wrong shoes with a bad last, high heels. Forced standing posture throughout the day or most of it in certain professions (hairdressers, cooks, etc.) can also cause pain. In such cases, the legs should be allowed to rest more often at any, even minute, opportunity.

Jumping and running workouts can also cause heel pain. Especially if there is a problem of excess weight. But drastic weight loss can also have negative consequences for heel health. It is best to lose weight gradually.

Diagnostic measures

Mandatory is KLA, OAM, blood biochemistry. If we are talking about inflammation, there will be an increased ESR, an increase in leukocytes, and a decrease in hemoglobin. Biochemistry will show the level of inflammatory proteins, the presence of uric acid, etc. If reactive arthritis is suspected, a scraping from the urethra may be taken. Tuberculosis will be determined by an X-ray of the lungs and a puncture biopsy.

With osteomyelitis, a biopsy is also performed. With bursitis, I do a puncture of the synovial bag. Oncology will help determine tumor markers, ultrasound, MRI, and osteoporosis - densitometry. However, the most important and most common diagnostic method is still an ankle x-ray in two projections.

First aid for heel pain

When the heel of the left leg hurts, what to do at home? NSAIDs and analgesics can often help - Ortofen, Diclofenac and even Analgin. These products in the form of ointments and gels can be used topically. Traditional medicine recommends applying a compress of onion and garlic with the addition of oil for inflammation so that there is no burning sensation. After an hour, the pain goes away.

In case of bruising, cold should be applied: ice or a hypothermic cooling pack should be kept for 15 minutes hourly 3 times a day. Then rub in an anti-inflammatory ointment. Foot baths with salt in a ratio of 1:5 or a solution with vodka help well. They can be taken for 10 days.

Principles of treatment

Treatment can be drug and non-drug: herbal medicine, physiotherapy, exercise therapy, etc. If there is no effect, surgical intervention is practiced.

So, if the heel of the left leg hurts, how to treat it? Conservative therapy involves taking NSAIDs locally and orally, analgesics, cytostatics, gold preparations (for systemic diseases). If the disease is inflammatory in nature, antibiotic therapy is required. To improve microcirculation and tissue regeneration, angioprotectors are used - Actovegin, Tivortin.

We must not forget about the periodic intake of vitamins and minerals. With constant pain, blockades with "Diprospan" and "Lidocaine", etc. are prescribed. For corns, special patches with acids (lactic, salicylic) are used.

With gout, as a rule, drugs are prescribed that help reduce the amount of uric acid, for example, Thiopurinol.

In case of injury, the foot must be secured. If your calcaneal tendon is stretched, you will need a compression bandage. If a rupture occurs, surgery is indicated.

Physiotherapy

Physiotherapeutic methods include ultrasound treatment, laser therapy, UHF, electrophoresis, phonophoresis, magnetotherapy and shock wave treatment. All this is very effective in relieving the symptoms of the disease.

Non-drug treatment

Non-drug therapy includes:

• Therapeutic gymnastics for the foot - exercises for stretching the ligaments, rolling a ball with spikes. Useful and effective walking on toes or the edge of the foot.
• Massage improves blood flow, relieves inflammation and swelling.
• Exercise therapy - the development of ligaments and tendons. This is flexion and extension of the joints of the foot and knee.
• The use of arch supports and heel pads, orthopedic insoles. They soften the blows, relieve the load on the heels.
• The alternation of warming and ice massage several times during the day relieves pain and trains blood vessels.

Proper footwear is the key to healthy feet. The height of the heel should be no more than 3-4 cm.

Surgical treatment

Surgery is practiced in the treatment of heel spurs in the absence of the effect of drug therapy. The plantar fascia is excised, part of the bone, spur or sequester is removed. The operation can be performed endoscopically or openly.

In case of fractures in the heel area, a plaster cast is required for 1.5 months. Walking only with crutches. The forefoot can only be loaded one month after the cast has been removed. The rehabilitation period includes exercise therapy, massage, physiotherapy.

If the recovery is slow, the patient wears an orthosis in the form of a boot, which reduces the load on the bone, prevents muscle atrophy, and reduces swelling. The recovery period generally takes 3 months. Even if the movements are difficult, doctors recommend developing the leg from the first days of rehabilitation.

When diagnosing chronic inflammatory diseases, their exacerbation should not be allowed. Such patients should avoid strenuous exercise. They can't walk for a long time. It is necessary to normalize the weight, choose comfortable shoes. Be sure to strengthen the muscles and ligaments of the foot, regularly massage the feet, use orthopedic devices to reduce the load on the heel, strengthen the vessels of the legs with contrast baths.

In most cases, discomfort in the heel does not require urgent medical attention. But there are exceptions.

When to see a doctor as soon as possible

Immediately Heel Pain go to the emergency room, or even call an ambulance if:

• severe, sharp pain in the heel occurred immediately after the injury;
• you experience severe pain and notice that an obvious has appeared in the heel area;
• you cannot stretch your foot, stand on your leg, or walk normally;
• pain (even if not sharp) in the heel is accompanied by fever, numbness and palpable tingling in the foot.

If you have no symptoms of an emergency, let's figure out what could lead to discomfort.

Why do heels hurt

The most common Heel Pain The reason is excessive physical stress on the foot. It is most common in those who:

• is overweight;
• spends a lot of time standing (for example, working behind the counter);
• It has ;
• bears weight;
• engages in jogging or other physical activities in uncomfortable shoes with poor cushioning;
• wears very tight shoes, as well as shoes with the wrong last, instep, or too high heels.

Any of these situations can lead to the fact that soft tissues are squeezed in the foot or nerve endings are pinched. And this comes back to haunt the pain that occurs immediately after physical exertion or walking in uncomfortable shoes.

Such pain is not dangerous. In most cases, it goes away by itself and only calls to be more attentive to the feet: do not torture the feet with excessive loads or uncomfortable shoes.

However, sometimes serious injuries can be the cause of pain. Or developed against the background of a constant load or other factors of the disease.

The heel bone is the largest in the foot. It is very strong and able to withstand heavy loads. But if you decide to jump from a height and land on straight legs, the impact may be too strong, the bone will crack. The fracture is accompanied by a slight crunch and makes itself felt with acute pain, swelling, and the inability to step on the foot. Such an injury requires immediate medical attention.

2. Plantar fasciitis

This is the name of the inflammation of the flat ligament (fascia) that connects the calcaneus to the bases of the fingers. As a rule, fasciitis occurs due to regular sprains and loads on the foot, which cause permanent micro-tears of the ligament.

Fasciitis can be recognized by several characteristic features:

• the pain is localized in the gap between the arch of the foot and the heel proper;
• if you are standing, it is difficult and painful for you to raise your fingers above the floor;
• the pain subsides when you lie down or sit, and gets worse as soon as you start walking.

3. Achilles tendinitis

Grasp your heel with two fingers, and then slide them up to the calf. Just above the heel, in the thinnest part of the leg, you will find it - the Achilles tendon.

It is considered the strongest and most enduring tendon in the human body. However, its resource is not infinite. With age, the tendon loses its elasticity and becomes less durable. Because of this, under loads, microtears occur in it, which lead to the development of inflammation - tendinitis.

Achilles tendonitis often occurs in people who suddenly decide to exercise after the age of 40. Inflammation can also be provoked by flat feet, the habit of playing sports without a preliminary warm-up, or long-term, long-term wearing of uncomfortable shoes.

You can suspect tendinitis by the following symptoms:

• you have pain not only in your heels, but also in your ankles;
• when trying to stand on tiptoe, pain covers the calf muscles.

4. Calcaneal bursitis

Bursitis (from Latin bursa - bag) is called inflammation of the periarticular bags (burs) - capsules with fluids that surround the joints. There are three such bags in the heel area. One is located where the Achilles tendon attaches to the heel bone. The second is between the heel bone and the skin of the sole of the foot. The third is between the Achilles tendon and the skin. Inflammation of any of these bursae is called calcaneal bursitis.

It is caused by various factors. So, calcaneal bursitis is considered an occupational disease of athletes - the same football players or athletes who overload their legs and often get injured. Inflammation also develops in women who have been walking in uncomfortable shoes with thin and long heels for years. However, an infection that has got into the periarticular bags sometimes leads to bursitis.

Bursitis can be recognized by dull aching pain in the heel and slightly higher, in the lower part of the Achilles tendon.

5. Other diseases

Rarely, heel pain can be caused by Heel Pain:

• and reactive arthritis;
• gout;
• osteomyelitis (bone infection);
• bone tumor;
• sarcoidosis.

What to do if your heels hurt

The nature of the pain is important. If it appears only from time to time, after physical exertion or long walks in uncomfortable shoes, most likely it can be dealt with at home. Experts from the reputable medical resource Mayo Clinic recommend doing so.

• Let your feet rest. Avoid activities that put more stress on your heels: try not to run, lift heavy things, or stand in one place for too long.
• To relieve pain, put something cold on your heels. For example, a bag of ice or frozen vegetables wrapped in a thin napkin. Repeat the procedure three times a day for 15-20 minutes until the discomfort disappears.
• Choose the most comfortable shoes. It should not press, but it must provide good cushioning when walking. And it would be nice if the heel had a height of no more than 2.5 cm.
• If the pain is bothering you, take an over-the-counter pain reliever. For example, based on ibuprofen.

If the heels hurt constantly for two or more weeks, and the discomfort does not subside, even when you are lying down, consult a therapist, traumatologist or orthopedist. Consultation with a specialist is necessary to exclude possible foot diseases. The doctor will find out what exactly is the cause of the prolonged pain, and prescribe the necessary treatment.

This may include physical therapy, anti-inflammatory drugs, and even surgery. However, the last point is used only in the most extreme cases. You will most likely be able to get rid of the pain with less complicated methods. Just do not delay the visit to the doctor.

Pain in the heels when walking and after sleep is a very common phenomenon. In most cases, this symptom is associated with plantar (plantar) fasciitis or heel spurs, but other causes are possible.

According to some estimates, about 10% of people complain of heel pain at least once in their lives. Most often, heels hurt in runners, as well as in people aged 40 to 60 years. In most cases, only one heel hurts, both legs are affected in about a third of people. Usually, heel pain is most severe in the morning or with the first steps after sleep. If you disperse, the discomfort subsides, but reappears after a long walk or heavy loads. Some people develop a limp or an odd gait as they try to spare the injured leg.

The most common cause of heel pain is damage and thickening of the bundle of connective tissue fibers that support the arch of the foot - the plantar fascia. It connects the heel bone to the bones of the foot and also acts as a shock absorber. Due to trauma or gradual wear, micro-tears can appear in the structure of the plantar fascia. Because of this, it thickens and hurts. The scientific name for this phenomenon is plantar fasciitis. Surrounding tissues and the heel bone may also become inflamed. A bone spike often grows on the heel - a heel spur, which injures the surrounding tissues when walking and causes pain.

For the treatment of pain in the heel, physiotherapy, physiotherapy exercises, various fixing devices and foot bandaging, as well as medications are used. In rare cases, resort to surgery. Approximately 80% of people get sick within a year.

To prevent foot problems or get rid of heel pain sooner, wear comfortable shoes with a small heel that protect the arches of the foot. Of great importance is the control of body weight, as excess weight creates additional stress on the heels.

Why does the heel hurt?

The most common cause of heel pain (in about 80% of cases) is plantar (plantar) fasciitis. This is damage and thickening of the calcaneal fascia - a thick bundle of fibers that connects the calcaneus to the rest of the foot. Injury to the heel fascia can occur in the following ways:

• as a result of an injury, for example, while running or dancing - such damage is more common in young and physically active people;
• during the gradual wear of the tissues of the plantar fascia - typical for people over 40 years old.

The risk of gradual wear and consequent damage to the plantar fascia increases in people who are overweight or obese, for those who spend most of the day on their feet, as well as for lovers of flat shoes - flip flops or slippers.

With plantar fasciitis, pain in the heel after sleep is more common. After some time, it becomes easier, but by the middle of the day, with a long walk, the pain in the heel intensifies again.

Less common causes of heel pain

Heel spur- this is the growth of bone tissue in the form of a spike on the heel. A heel spur often co-occurs with plantar fasciitis as a consequence, but it can develop on its own without causing heel pain.

Fatigue (stress) fracture occurs as a result of long-acting excessive loads on the calcaneus when walking, running, jumping, etc. It is more common in people who play sports. Happens less frequently with osteoporosis- when the heel bone loses strength and even ordinary walking or light jogging can lead to the destruction of its structure. A stress fracture is accompanied by aching pain, aggravated by pressure on the heel. There may be slight swelling at the fracture site.

Atrophy of the fat pad- thinning of the layer of adipose tissue under the heel bone under the influence of excessive pressure on it. The layer of fat between the bones of the foot and the skin plays an important role as a shock absorber when walking, softening the impact on the ground. The risk of developing atrophy of the fat pad is increased in women who walk in high heels for a long time, as well as in the elderly. In rare cases, atrophy of the fat layer on the foot develops after injections of corticosteroids into the joints, as well as after fractures. Orthopedic insoles help to cope with this cause of heel pain.

Bursitis is an inflammation of one or more bursae (small sacs of fluid, usually located around joints and between tendons and bones). Near the heel there are three synovial bags, each of which can become inflamed under the influence of large loads on the foot or infection.

Tarsal (tarsal) tunnel syndrome- tunnel syndrome associated with compression of the tibial nerve in the connective tissue canal near the inner ankle of the foot. The cause of the narrowing of the canal may be damage after dislocations, fractures, or the formation of a cyst in it. Tarsal tunnel syndrome is characterized by a violation of sensitivity (from pain to numbness) in the foot and fingers, including at night, weakness in the muscles of the foot. When probing the inner ankle of the leg and the area around it, the pain and discomfort in the foot intensify. Sometimes there is pain in the heel.

Aseptic necrosis of the calcaneus can cause heel pain in children. Most often, necrosis develops as a result of stretching and contraction of the muscles and tendons under the knees and ankles due to the rapid growth of the child. When stretched, the calf muscle pulls the calcaneal (Achilles) tendon behind it. This causes the growing area of ​​the bone on the back of the heel (growth plate) to stretch, causing pain. This pain is aggravated by playing football or doing gymnastics. Often the pain appears on the side of the heel, but can also be felt under it. As a rule, aseptic necrosis of the calcaneus is well treated with exercises for stretching the hamstrings and calf muscles and tendons, as well as, if necessary, wearing special pads under the heel.

Diagnosis of heel pain

To diagnose heel diseases, you need to contact. In most cases, this specialist will deal with your further treatment. If it is difficult to get an appointment with this specialist, you can start with a visit. It is possible that during the examination you will need to consult other doctors: - to exclude systemic diseases of the joints, - to exclude diseases of the nerves of the foot.

There are some additional signs that can help you and your doctor suspect the cause of your heel pain. So, numbness or tingling in the leg is more likely to indicate nerve damage. This may be the tarsal tunnel syndrome described above, or a manifestation of a general lesion of the peripheral nerves, which happens, for example, with diabetes. If the foot is hot to the touch and swollen, there may be an infection in the soft tissues or heel bone. In these cases, the help of a surgeon will be required. Limitation of mobility and pain in the joints of the foot indicate the likely development of arthritis - inflammation of the joint.

To clarify the diagnosis, the doctor may prescribe the following examinations:

• blood tests;
• radiography - the use of a small dose of radiation to detect pathologies in the bones;
• magnetic resonance imaging (MRI) or ultrasound (ultrasound) - methods for more detailed scanning of soft tissues.

How to treat sore heels?

As a rule, heel pain is treated in a complex way, for example, stretching exercises and painkillers. This can be a lengthy process, sometimes up to a year. If after this time the pain has not gone away, surgery is recommended as a last resort. This happens only in 0.5% of cases.

The success of heel pain treatment depends largely on the lifestyle you lead. Regardless of its cause, you will need to wear the “right” shoes, make time for physical exercise and get enough rest. Most of the manipulations for the treatment of heel pain can be performed independently, without the participation of a doctor.

If possible, spare the sore heel - try not to walk long distances on foot and not stand for a long time. In this case, you should regularly perform special exercises for stretching the feet and calves.

Therapeutic exercise for heels

Stretching exercises for the calf muscles and plantar fascia can help relieve pain and increase the flexibility of a sore foot. As a rule, exercises are recommended to be performed with both legs, even if only one of them hurts.

Stretching with a towel. Keep a long towel near the bed. In the morning, before you get up, drape a towel over your foot and use it to pull your toes towards you, keeping your knee straight. Repeat three times with each leg.

Stretch against the wall. Place your hands on the wall at shoulder height, placing one foot in front of the other. The front foot should be about 30 cm from the wall. Keeping your back straight, bend your front leg at the knee as you lean against the wall until you feel a stretch in the calf muscles of your other leg. Relax. Repeat 10 times with one leg, then the same number with the other. Do this exercise twice a day.

Stretching on the stairs. Stand on the step, facing the stairs, lean on the railing. The legs should be slightly apart, the heels should hang down from the step. Lower your heels until you feel a stretch in your calf muscles. Stay in this position for about 40 seconds, then return to the starting position. Repeat six times, at least twice a day.

Chair stretch. Sit on a chair, bend your knees at a right angle. Turn your feet so that your heels are touching and your toes are turned in opposite directions. Raise your toes on the sore foot, pressing the heel firmly to the floor. You should feel a stretch in your calf muscles and in your Achilles tendon (the bundle of fibers that connects your heel bone to your calf muscles). Stay in this position for a few seconds, then relax. Repeat 10 times, 5-6 sets per day.

Dynamic stretch. While sitting, drive the arch of the foot (the concave part of the sole) over a round object, such as a rolling pin, tennis ball, or can. Some people report that using a cold jar also helps relieve pain. Move your foot in all directions on the object for several minutes. Repeat twice a day.

Painkillers for heel pain

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be used to relieve pain. Applying a cold compress to the affected heel for 5-10 minutes can also sometimes help relieve pain and inflammation. However, you can not apply ice directly to the skin, it must be wrapped in a towel. Instead of ice, you can use a bag of frozen vegetables.

Orthopedic insoles

Orthopedic insoles are inserted into shoes in order to support the foot in the correct position and soften the impact of the heel when walking. Ready-made insoles can be purchased at sporting goods stores, large pharmacies and orthopedic salons. Sometimes your doctor can recommend custom insoles that fit your feet perfectly. They are made to order. However, at present there is no reason to believe that custom-made insoles are more effective than standard ones.

Bandaging or taping feet for heel pain

To reduce the load on the plantar fascia and the pain in the heel associated with its inflammation, you can bandage the foot with an elastic bandage. The orthopedist will show you the bandaging technique. Instead of a bandage, you can use an adhesive plaster or a special sports tape - teip. Applying strips of plaster or tape to the foot is called taping. The patch creates additional support for the foot, imitating the supporting role of the fascia. You can find the foot taping technique for heel pain on the Internet or check with your doctor.

Some podiatrists recommend using special night orthoses or brace to stretch the ligaments of the foot while you sleep. Most people sleep with their toes pointing down, causing the plantar fascia to contract. Pain after waking up is associated with its sharp stretching and microtrauma.

The brace on the foot is made in such a way that during sleep the toes and feet are turned up. This helps stretch the Achilles tendon and plantar fascia, allowing the torn ligament fibers to fuse in the correct position and speed up recovery. As a rule, such orthoses or brace can be bought only in specialized stores or on the Internet.

Corticosteroid shots

If the above methods do not help relieve pain, the doctor may prescribe corticosteroid injections. These are potent anti-inflammatory drugs and should be used with caution as they have severe side effects such as weight gain and high blood pressure(hypertension). Therefore, it is not recommended to give more than three injections of corticosteroids per year in any part of the body. Before giving a corticosteroid shot, your doctor may give you a local anesthetic.

Surgery for heel pain

If none of the treatments worked and you are still in pain after a year, you may be referred for surgery. Surgery is sometimes recommended for professional athletes and other athletes if heel pain is negatively impacting their career.

Surgery to excise the plantar fascia- the most widely used type of surgery for heel pain. The surgeon cuts the fascia to separate it from the heel bone and relieve tension in it. This should eliminate inflammation and relieve pain. The operation can be carried out in two ways:

• open - when a section of the calcaneal fascia is dissected through an incision in the heel;
• endoscopic, or minimal intervention surgery - when a small incision is made through which microsurgical instruments are inserted under the skin.

The recovery period after endoscopic surgery is shorter, so you will be able to walk normally much earlier (almost immediately), while recovery after open surgery takes 2 to 3 weeks. The disadvantage of minimal intervention surgery is that it is performed only by a trained surgical team and with special equipment, so the waiting time for such an operation can be longer. Endoscopic surgery also comes with an increased risk of damage to nearby nerves, which can cause symptoms such as numbness, tingling, and loss of motion in the foot.

Like any other surgery, plantar fascia excision can have complications such as infection, nerve damage, and worsening of symptoms after surgery (although this is rare). Discuss the advantages and disadvantages of both types of surgery with your doctor.

Shock wave therapy for heel spurs

This is a relatively new method of non-invasive treatment, that is, it does not involve surgical intervention. Shock wave therapy is especially effective in cases where heel pain is associated with a heel spur. The method consists in sending high-energy sound pulses to the heel using a special apparatus. This can be painful, so the doctor may inject a local anesthetic into the foot.

It is believed that shock wave therapy works in two directions, namely:

• has an analgesic effect;
• stimulates and accelerates the healing process.

However, there is no exact evidence for this. Some studies have shown that shock wave therapy is more effective than surgery and other treatments for heel pain, while others have shown that this procedure is no different in effectiveness from placebo (pseudo-treatment).

Prevention of heel pain

It is not always possible to avoid heel pain, but there are certain steps you can take to avoid such problems in the future. Being overweight is known to place additional stress on the feet, especially the heels, increasing the risk of injury. If you are overweight, losing weight and maintaining a normal body weight by combining regular physical activity co healthy balanced diet will be good for the legs. (BMI) to see if your weight matches your height and body type.

Of great importance for the prevention of heel diseases is the choice of the "right" shoes. Wearing high heels to a party is unlikely to hurt you, but wearing them all week at work can hurt your feet, especially if you have to walk or stand a lot. It is best to choose shoes with laces and low or medium heels that support and protect the arches of the feet and heels. Do not wear flat shoes.

Do not walk barefoot on asphalt and hard ground. Often, heel pain occurs when a person begins to walk barefoot on vacation, after walking in shoes all year. In this case, the feet are not used to the extra pressure, which causes heel pain.

If you lead an active lifestyle, such as running or any other sport, change your running shoes regularly. Most experts recommend changing your running shoes after you've run about 500 miles in them. Be sure to stretch after your workouts, and incorporate regular strength and flexibility exercises into your workouts.

Which doctor should I contact if the heel hurts?

In most cases, heel pain requires a doctor's consultation. With the help of the NaPopravku service, you can quickly find someone who will deal with your diagnosis and treatment. If it is difficult to get to a specialist of this profile, contact for help.

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Copyright notice: “Department of Health original content 2020”

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. Articles are prepared for informational purposes and are advisory in nature.