Pain under the heel

There are not only nerves distributed in the human foot, but also many Achilles tendons. The main function of the Achilles tendon is to support the normal movement of the entire foot. Although the skin on the feet is relatively rough, which leads to the fact that people ignore the existence of the feet most of the time, we still need to pay attention to protecting our feet in daily life, because problems with the feet will affect our ability to move. But what if you feel pain under your heel?

Baxter's Nerve Entrapment Syndrome:

Baxter's nerve entrapment syndrome. Baxter's nerve is the first branch of the lateral plantar nerve, which is a branch of the tibial nerve and innervates the muscles and skin of the sole of the foot.

Baxter's nerve block can cause heel pain and discomfort, which may be manifested as a strange feeling at the end of the heel and pain when pressing the inside of the heel. The pain is usually located 4-5 cm in front of the calcaneus or at the distal end of the calcaneal tuberosity. The pain is usually burning and radiates along the lateral sole of the foot.

This disease is common in sprinters, ballet dancers, gymnasts and football players because they frequently use their toes, which causes the abductor halluces to develop abnormally, thereby compressing the Baxter nerve for a long time and eventually causing nerve damage.

Common treatments include heel stretching exercises, nonsteroidal anti-inflammatory drugs (NSAIDS), correction of posterior foot alignment abnormalities, and surgical release of the deep and superficial fascia between the abductor hallucis and quadratus muscles covering the nerve surface.

Plantar Fasciitis:

Plantar fasciitis is caused by irritation and swelling of the fibrous tissue on the sole of the foot. The plantar fascia becomes inflamed, red, swollen and painful, making it difficult to walk.

This pain is most obvious when you take the first step out of bed in the morning, and the pain will ease after walking a few steps.

Stretching exercises and walking can also help relieve pain;

However, the pain becomes more severe as the walking time or standing time increases. Long-term exercise, standing and running will aggravate the pain symptoms.

You will also find a tubercle on the medial side of the calcaneus, along with a tight Achilles tendon;

Treatment options include anti-inflammatory medication, heel stretching, orthotic shoes and insoles, or surgery.

Stretching exercises:

(1) Lean against a wall and stretch your upper arms forward to shoulder height. Press the wall with your palms. Bend one knee and push it toward the wall while keeping the other knee straight. Bend your knee and slowly lean forward while trying to keep your heel flat on the ground. When you feel the Achilles tendon and arch of the foot stretching, maintain this position for 10 seconds, then relax and stand upright.

(2) Lean forward against a fixed object and slowly squat down, keeping your heels on the ground. When you feel your Achilles tendon and arch of your foot rising off the ground and your muscles fully stretched, hold this position for 10 seconds and then stand up. Can be practiced repeatedly.

(3) Stand on the bottom step of the stairs balancing on your front foot. Slowly lower your heel until you begin to feel the stretch in your calf muscles. Hold this position for 10 seconds, then stand up and repeat.

Other treatments:

(1) Oral nonsteroidal anti-inflammatory analgesics.

(2) Local blockade treatment.

(3) Applying a topical patch to the heel muscle can stimulate nerve endings, reduce irritation, and relieve pain.

(4) Soaking your feet in hot water regularly can relieve pain.

Heel pad atrophy:

The heel pad is a piece of fat-rich tissue under the calcaneus. Heel pad atrophy is due to the loss of water, collagen and elasticity, causing the heel pad to become thinner and atrophy. Patients with a history of steroid injections often suffer from symptoms of heel pad atrophy.

This condition often occurs in older people and causes significant pain when walking. The pain is usually deep and concentrated in the central weight-bearing area of ​​the calcaneal tuberosity, which can easily be misdiagnosed as plantar fasciitis.

Treatment includes anti-inflammatory medications and custom orthotic shoes and orthotic insoles;

Treatment: NSAIDs, custom-made orthotic shoes, and orthotic insoles are best. Since this disease is mostly caused by mechanical reasons, reducing squeezing and weight-bearing is an effective method. Local injections of corticosteroids should be avoided because they tend to cause further atrophy in the long term. Surgery is not recommended either, as there is no effective way to treat or replace the heel pad. On the contrary, it is easy to cause other complications such as skin necrosis.

Achilles tendinitis:

Achilles tendinitis is a sterile inflammation caused by acute or chronic strain of the Achilles tendon. During exercise, the calf gastrocnemius and Achilles tendon are subjected to repeated excessive stretching.

When the Achilles tendon becomes inflamed or overused, walking can cause significant pain and make gait difficult.

The main treatment methods include anti-inflammatory drugs, clinical physical therapy, massage therapy, ice therapy and solidification therapy.

1. Self-help methods

(1) Warm up before exercise, stop exercise gradually, and do appropriate relaxation activities after exercise.

(2) Get enough rest, avoid weight bearing, and exercise properly.

(3) Wear appropriate shoes when exercising. Choose shoes that are appropriate for the frequency, surface, and conditions of your exercise.

(4) Stretch and strengthen the calf muscles regularly, and gradually add mountain climbing and stair climbing to your daily exercise. Gradually increase speed and distance if necessary.

2. Use support pads

The support pad can elevate the ankle to reduce stretch on the Achilles tendon. A splint may also be used during sleep to keep the Achilles tendon immobilized. If the condition is severe, a walking boot or crutches may be recommended to help the Achilles tendon heal.

3. Surgery

Nonsurgical treatment, including physical therapy, can allow Achilles tendinitis to heal and repair itself within a few weeks. If treatment is not effective, surgery may be needed to remove the inflamed tissue around the Achilles tendon.

4. Topical medications

Choose anti-inflammatory and analgesic drugs for external application.

Stress fractures:

A stress fracture is a stress fracture injury in a bone caused by overuse;

When muscles become fatigued from overuse, they cannot absorb the shock caused by repeated collisions in time, and the stress is transmitted to the bones, causing small bone cracks or fractures.

This type of calcaneal compression fracture is usually very painful and excruciating, aggravated by activity and weight-bearing and not relieved by rest. There is tenderness along the lateral side of the calcaneus and medical attention is required as soon as possible once it is recognized.

Treatment options include rest, immobilization, and activity restriction.