HEEL PAIN (Heel Spur; Calcaneal Bursitis or Neuritis)
(Heel Spur; Calcaneal Bursitis or Neuritis)
Heel pain involves 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. Appropriate health care includes self-care; doctor's diagnosis and treatment.
SIGNS & SYMPTOMSDeep discomfort under the heel while the child is walking, running, or at rest.
Running, jogging, or fast walking.
Previous serious foot, ankle, or heel injury; repeated heel injury from any cause; prolonged standing; obesity.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your child:
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.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the heel.
POSSIBLE COMPLICATIONSInflammation and arthritic changes in the child's heel that place abnormal stress on previously pain-free joints, such as those in the knee, hip, and spine.
Usually curable with conservative treatment (See TREATMENT).
HOME CAREInstructions for your child:
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 your foot above the level of your 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 your 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, the 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 your toes while treating heel pain.
Do this stretch exercise:
-- Sit on the floor with your legs straight.
-- Grasp your toes with your hands.
-- Pull your 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.
To relieve minor pain, use non-prescription drugs, such as ibuprofen, acetaminophen, or aspirin.
Your child should stay off his feet as much as possible, especially at the beginning of treatment.
DIET & FLUIDS
No special diet, unless your child is overweight. If so, the child should lose weight to reduce stress on the foot.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has persistent heel pain, despite treatment.
Any of the following occur after surgery:
-- Pain, swelling, redness, drainage, or bleeding increases in the surgical area.
-- Your child develops signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).