HEEL PAIN (Heel Spur; Calcaneal Bursitis or Neuritis) |
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General Information
DEFINITION--Heel pain or discomfort of the following types:
Contusion or bone bruise--Inflammation of the tissue that covers bone (periosteum).
Heel spur--A hard bony shelf as wide as the width of the heelbone caused by repeated pulling away of periosteum from the heelbone (calcaneus). The repeated stress or injury causes inflammation and calcification of tendons and ligaments in the foot.
Plantar fasciitis--Inflammation of the fibrous band that originates at the bottom of the calcaneus. This hurts worse when running faster or when weight is on the ball of the foot.
Heel bursitis--Formation in the heel area of an irritated or inflamed protective sac of fluid due to irritation caused by a heel spur.
SIGNS & SYMPTOMS
Deep discomfort under the heel while walking, running or at rest.
Redness.
Tenderness.
Increased heat.
CAUSES & RISK FACTORS
Running, jogging or fast walking.
Previous serious foot, ankle or heel injury.
Repeated heel injury from any cause.
Prolonged standing.
Obesity.
HOW TO PREVENT
Avoid activities that cause constant foot strain.
Wear athletic shoes with good shock absorption in the heel, good flexibility and good support to control side-to-side motion.
Don't wear everyday shoes with more than 1-1/2-inch heels.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the heel.
SURGERYOccasionally necessary to remove a heel spur, if home treatment does not cure it.
NORMAL COURSE OF ILLNESSUsually curable with conservative treatment (see How to Treat).
POSSIBLE COMPLICATIONSInflammation and arthritic changes in the heel that place abnormal stress on previously pain-free joints, such as those in the knee, hip and spine.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTUsually not necessary.
HOME TREATMENT
Use ice massage. Fill a large styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the heel in a circle. Do this for 15 minutes at a time, 3 or 4 times a day.
Elevate the foot above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping, or elevate the foot of the bed.
Use doughnutlike or horseshoelike padding in shoes, such as cushion pads, homemade felt inlays, sponge-rubber heel pads or shaped pieces of indoor/outdoor carpeting. Put in both shoes, even if only one heel hurts. Otherwise, normal mechanics of standing and moving will be altered and may cause pain in other areas.
Try a plastic or rubber heel cup (available at sporting-goods stores and drug stores).
Don't walk on toes while treating heel pain.
Do this stretch exercise:
Sit on the floor with legs straight.
Grasp the toes with your hands.
Pull toes slowly toward you for 30 seconds.
Repeat several times for 5 to 10 minutes.
When returning to athletics or exercise, use ice massage for 10 minutes before warmup and after exercise.
MEDICATIONTo relieve minor pain, you may use non-prescription drugs, such as ibuprofen, acetaminophen or aspirin.
ACTIVITYStay off your feet as much as possible, especially at beginning of treatment.
DIETNo special diet, unless you are overweight. If so, lose weight to reduce stress on the foot.
CALL YOUR DOCTOR IF
You have persistent heel pain, despite treatment.
Any of the following occur after surgery:
Pain, swelling, redness, drainage or bleeding increases in surgical area.
You develop signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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