 Common
Causes |
Planter Fascitis
Retrocalcaneal Bursitis
Tendoachilles Tendinitis
Tarsal Tunnel Syndrome
Lesion in the Calcaneus ( Heel Bone )
Calcaneus apophysitis in growing children
Lesion
in the Calcaneus ( Heel Bone )
|
Tuberculosis
Osteomyelitis
Cyst
Fracture
Less
Common Causes
|
Rupture
of Tendoachilles (Heel Cord)
|
Partial
Complete
Less
Common Causes
|
Subtalar Joint Arthritis
Referred Pain Due to L5-S1 Disc/Tumour
Eight
Causes of Painful Heel
|
- Lesion in the
heel bone
- Arthritis of
subtalar joint
- Rupture of the
Tendoachilles
- Pathology of
the Tendoachilles
- Retrocalcaneal
bursitis
- Calcaneal periosteitis
- Fat pad lesions
- Plantar fascitis
Plantar
Fascitis
|
- Common
in the middle age.
- Women
are frequently affected.
- Higher
incidence in obese individuals, diabetics, calcium deficiency.
- Symptoms
include, pain which is worse in mornings, or after beginning to walk
after sitting for a while, diminishes after few steps.
- X-ray
may or may not show bony spur.
Plantar
Fascitis
- Treatment
|
- Use of
shoe inserts and pads.
- Non-steroidal
anti-inflammatory drugs.
- Hot fomentation,
Ultrasonic rays
- Injection
of steroid locally.
- Surgery only
in intractable cases.
Calcaneal
Apophysitis
|
- Common cause
of heel pain in children
- Common in very
playful or obese child
- Due to repeated
minor trauma to the calcaneus apophysis due to weight or running, jumping.
- X-ray shows
sclerosis, fragmentation of the apophysis.
- Treatment is
conservative, similar to that of plantar fascitis.
Retrocalcaneal
Bursitis
|
- Common in middle
age.
- Due to inflammation
of bursa at the back of the heel.
- Bursal inflammation
may be specific as in gout, Rheumatoid arthritis or non specific.
- May predispose
to rupture of Tendoachilles
- X-ray may reveal
retrocalcaneal spur.
Retrocalcaneal
- Treatment
|
- Use of
shoe pads.
- Non-steroidal
anti-inflammatory drugs.
- Hot fomentation,
Ultrasonic rays
- Injection
of steroid locally. ( Avoid injection in tendon to avoid complication
of tendon rupture)
- Surgery only
in intractable cases.
Tarsal
Tunnel Syndrome
|
- Due to compression
of nerve under the flexor retinaculum behind medial malleolus
- Causes tingling
numbness and burning in the sole and toes
- Non specific
or specific inflammation like Rheumatoid arthritis, may be the cause.
- X-rays usually
normal.
- Nerve conduction
studies and EMG are diagnostic.
Tarsal
Tunnel Syndrome - Treatment
|
- Treatment is
initially non operative in the form of anti inflammatory medicines,
local heat.
- Surgical release
if no relief with non operative treatment
|
