Heel hurts when walking: what could it be and what should be done?

- a frequent companion of a modern person, especially if, due to the nature of his work, he spends a lot of time on his feet. Heel pain can be caused not only by fatigue, but also by soft tissue bruises caused by an uncomfortable heel or direct injury. But most often, discomfort that lasts for weeks indicates the presence of a disease.

Most patients manage to ignore the onset of diseases localized in the sole area: pain in the heel when stepping is attributed to work loads, uncomfortable shoes, varicose veins and age-related changes. However, frequent, daily and, especially, acute pain that intensifies over time is a sure sign of a disease that can affect the tendons, articular cartilage and bones in the heel area.

You should be especially alert to severe pain in the heels, which begins in the morning, immediately after waking up and walking for a short time.

. If you didn’t conquer the mountains yesterday and spent a normal day, but your feet are “humming” - read the article to find out how to treat heel pain when you step.

Heel pain often bothers modern people who lead an active lifestyle.

Causes of heel pain

Although the exact cause of heel pain can only be determined after a diagnostic test by a podiatrist or rheumatologist, the nature of the pain can tell a lot.

Heel pain in the morning usually indicates the presence of an inflammatory process. If it does not stop after 2-3 weeks, it means that the process has become chronic.

— and therefore you shouldn’t put off going to the doctor, hoping for chance.
Some acute inflammatory diseases can lead to irreversible changes in the joints within a few days
.

Pain in the heel, which is accompanied by numbness, deterioration of sensitivity, change in skin color, and ankle cramps, indicates compression of the nerve and/or disruption of tissue trophism. They can occur due to varicose veins, muscle and ligament sprains, and traumatic injuries.

In summary, the causes of heel pain include:

• injuries
  ;
• circulatory disorders in the legs
  (often accompanied by roughening of the skin)
  and hypovitaminosis
  (its frequent symptom is cracking of the skin on the heels, dry calluses);
• diseases of bones and tendons
  (calcaneal epiphysitis, achillobursitis);
• diseases of the spine
  (in particular, the lumbosacral region);
• metabolic disorders
  (osteoporosis, gout, diabetes and other metabolic diseases);
• fungal diseases
  ;
• infectious diseases
  (including tuberculosis).

Heel pain can also be caused by more harmless factors - for example, rapid weight loss, which sometimes thins out the fatty “cushion” of the heel.

Injuries

Due to its shock-absorbing role, the heel is exposed not only to high pressure, but also to frequent impacts, which leads to injury. Contrary to popular belief, injury can occur not only as a result of a strong blow or traction, but also as a result of a series of repeated microdamages (for example, due to vibration or uncomfortable shoes.

Any injury to the heel area - be it damage to the muscles, ligaments, tendons, heel bone, nerve fibers, or even severe bruising of the subcutaneous fat or blood vessel - disrupts the physiological position of the foot (for example, when the patient “saves” part of the sole due to pain ).

Traumatic heel pain when stepping usually occurs due to:

• tendon rupture or sprain;
• cracks in the spongy calcaneus, fracture;
• bruise of the soft tissues of the heel.

Treatment of traumatic heel pain should be carried out by a qualified traumatologist.

. Patients are prescribed rest for the affected limb (fixation with a bandage, plaster, splint), drugs to improve tissue trophism, chondroprotectors for better healing and prevention of changes in the joints.

Heel spur

A striking example of a disease that is accompanied by inflammation and severe pain in the heel when stepping is a heel spur. The pathology often develops against the background of flat feet and other curvatures of the foot, uncomfortable shoes, or under the influence of other factors in which the load on the plantar part of the foot is unevenly distributed. This leads to an unnatural position and deformation of the tendon.

, due to which inflammation begins in the places where it is attached to the head of the bone. To compensate for the load, the body triggers ossification of the tendon tissue - as a result of which it takes on the shape of a spike (spur).

Heel spurs are characterized by a gradual increase in pain in the heel when walking and throbbing in the leg. The peak of pain occurs in the morning and evening, and in the middle of the day the pain usually becomes moderate and tolerable. Many patients complain of a feeling of “walking on glass” - the pain in the heel can be so intense when stepping on it.

If left untreated, patients may develop difficulty moving independently. ankle orthosis helps

(bandage), which helps distribute the load, reduce pain and inhibit
ossification
(ossification) of the tendon.
Also, for heel pain in the morning, doctors recommend taking anti-inflammatory drugs, correctors of cartilage and bone metabolism, physiotherapeutic procedures, and therapeutic massage. In advanced cases, surgical treatment is indicated
.

Bursitis

Often bursitis

affects the so-called
Achilles tendon
(Achilles bursitis). This disease, which is accompanied by heel pain, is most susceptible to athletes (especially runners), overweight people and lovers of high heels.

With bursitis, there is swelling, pain in the heel when stepping, and swelling of the foot due to the accumulation of synovial fluid. The skin over the ankle joint becomes red and hot. Patients are prescribed a strict rest regimen, a pressure bandage made from an elastic bandage, and adherence to clinical recommendations.

. If the disease does not recede, a puncture is performed (fluid drainage through a puncture), the patient receives glucocorticoids to relieve inflammation.

If conservative treatment of heel pain when walking does not have an effect, the affected fragment of the synovial bursa is removed through a microscopic puncture with a diameter of about 4 mm. After 2 days the patient can already walk.

Ankylosing spondylitis

Ankylosing spondylitis

is a chronic disease that affects not only the joints of the foot, but also other joints of the body. As a rule, the disease begins in the spine and affects the intervertebral joints of the lumbar region.

Men are more susceptible to ankylosing spondylitis than women. Although its exact causes have not been established, an increased risk of development is observed in people with a hereditary predisposition, injuries, frequent colds and infectious diseases

(including foci of chronic infection in the body).

In addition to pain in the heels when walking, there is stiffness of movement, inflammation in the knees and lower back. Treatment, due to the incurability of the disease, is symptomatic and consists of taking painkillers and symptomatic medications. Since the “cartilaginous” type joints are primarily affected, the use of chondroprotectors is recommended.

Rheumatoid arthritis

Rheumatoid arthritis of the foot

often observed in female patients aged 30+.
This is a chronic autoimmune disease, which is accompanied by inflammatory erosive lesions of the articular surfaces
(in this case, the joint is destroyed by the body’s own immune cells, considering its cells hostile). In addition to heel pain in the morning, arthritis is indicated by swelling of the foot and hot, reddened skin over the joints, increased fatigue of the legs and other signs of inflammation. The onset of heel pain in rheumatoid arthritis is usually preceded by an infection, stress, or other shock to the immune system.

The disease is characterized by a high degree of disability

, so you need to seek help at the first symptoms of heel pain.
Treatment consists of the use of immunosuppressants
,
anti-inflammatory drugs
and
chondroprotectors
.

Gout

Gout

is a severe metabolic disease that often
affects the interphalangeal joints of the legs
and can cause severe heel pain.
Pain syndrome is caused by uric acid crystals, which are deposited in the joints and provoke chronic inflammation due to mechanical trauma to tissues. Gout is often a hereditary disease
and is observed in relatives of patients.

Heel pain when walking and heel pain in the morning, at night increases after consuming fatty meat foods and alcohol.

Treatment of heel pain due to gout involves following a diet, taking medications that reduce the level of uric acid in the blood, anti-inflammatory drugs and chondroprotectors.

There are many causes of heel pain

Signs of damage

A bruised heel does not go unnoticed, accompanied by pain and physical discomfort.

The problem can be recognized if the following symptoms are present:

• Blue discoloration, hematoma. This is explained by vascular damage that occurs as a result of a bruise. Blood penetrates into the muscle and subcutaneous layer, forming a bruise.
• Pronounced pain. If the heel is very sore after an injury, one can judge that there is compression of the nerve endings in the indicated area. Blood penetrating into the tissues provokes their delamination.
• Swelling. It occurs as a result of a disruption in blood circulation, which also increases pain. If, in addition to swelling, there is a lump in the damaged area, you can judge the development of any complications.
• Limping. Often the victim limps somewhat, protecting the injured area.

The nature of the pain is different from a fracture of the heel bone. In the case of the latter, the victim’s pain does not decrease at all. With a bruise, the worst is the first few hours immediately after the injury. Over time, the pain goes from acute to dull, gradually subsiding.

Diagnosis of heel pain

Diagnosis and determination of the cause of heel pain is carried out by an orthopedic traumatologist or rheumatologist; consultation with other specialized specialists (neurologist, oncologist, infectious disease specialist) may also be required.

Diagnosis begins with an oral questioning of the patient about the specifics of heel pain, history taking, palpation, and motor tests. Based on preliminary observations, the doctor issues further directions.

To confirm or refute existing hypotheses regarding heel pain when stepping, the following is used:

• general and biochemical blood test, analysis for tumor markers and rheumatic factor;
• microbiological and bacterioscopic studies (synovial fluid, sputum, etc.);
• determination of blood glucose levels;
• X-ray of the affected limb;
• puncture biopsy (if bone tuberculosis is suspected);
• Ultrasound (to detect damage to bones, blood vessels, etc.);
• magnetic resonance or computed tomography;
• electroneuromyography.

Complications

Often, the symptoms subside, and the bruised heel stops bothering you after 14-21 days. Although there are cases when similar injuries become the beginning of more serious illnesses.

The most common complications are:

• Neuritis.
• Periarthritis.
• Failure of functioning and mobility of the joint.
• Etc.

If the desired effect from the prescribed treatment has not been achieved, and some symptoms (hematoma, pain) still make themselves felt, an immediate examination of the limb by a specialist is recommended. The doctor will determine the causes of the situation and take appropriate measures to eliminate it.

Treatment for heel pain

The question of how to treat heel pain when stepping is decided after determining the cause of heel pain.

If heel pain is infectious in nature, antibiotics

. In case of injuries, as a rule, conservative treatment is carried out using bandages, blood microcirculation correctors, bone and cartilage metabolism correctors. For autoimmune causes of heel pain, basic therapy drugs, NSAIDs, and glucocorticoids are recommended. In case of metabolic diseases, therapy of the underlying disease is necessary.

Surgery

Surgery

heel pain is used for displaced fractures of the calcaneus, as well as in severe cases, in the later stages of diseases of the musculoskeletal system. Indications for surgery are:

• tendon rupture
  ;
• advanced heel spur
  ;
• bursitis that cannot be treated with medication
  .

Also, partial excision of synovial cartilage may be recommended in some cases of rheumatoid arthritis.

Modern medicine uses minimally invasive methods for treating heel pain when stepping - most operations are performed through small punctures, last no more than 30 minutes, and the recovery period takes only a few days. Surgery for heel pain when walking helps relieve pain and inflammation.

Physiotherapy

Physiotherapy in the treatment of heel pain helps relieve swelling and inflammation in the acute stages of the disease, normalize tissue nutrition and restore impaired metabolism. If you have severe heel pain, you should consult your doctor about the choice of technique: some types of physiotherapy can only be performed in a state of remission

.

For heel pain when stepping, the following may be prescribed:

• electrophoresis
  (especially medicinal);
• magnetotherapy
  ;
• laser therapy
  ;
• ultrasound therapy
  ;
• phonophoresis
  ;
• thermotherapy, cryotherapy
  ;
• mud therapy and balneological procedures
  ;
• taping
  ;
• manual therapy
  ;
• shock wave therapy
  ;
• ultra high frequency therapy
  ;
• therapeutic massage
  (on the foot, lower leg, thigh);
• physiotherapy
  .

orthoses is also recommended for heel pain when walking.

or
tires
.

Drug treatment

In addition to specialized medications, if heel pain when walking is secondary (caused by a systemic disease), the following are used:

• Nonsteroidal anti-inflammatory drugs
  . NSAIDs (Diclofenac, Nimesulide, Ibuprofen, Indomethacin, Meloxicam, Lornoxicam and others) are usually prescribed in courses of 10-12 days to relieve acute heel pain when walking. Longer use of drugs in this group can cause erosive lesions of the mucous membranes of the stomach and intestines.
• Analgesics and glucocorticoids
  . If other methods for heel pain are ineffective, extra-articular drug blockades with novocaine, lidocaine and glucocorticoids (Hydrocortisone, Diprospan, Prednisolone and others) are used.
• Chondroprotectors
  . Correctors of bone and cartilage metabolism help relieve inflammation in bursitis, arthritis and other causes of heel pain when stepping. They improve the elasticity of connective tissue, promote the synthesis of collagen and proteoglycans, and prevent joint complications from developing. Taking this group of drugs promotes the healing of cracks and fractures of the heel bone, prevents the ossification of tendons and the progression of arthrosis and arthritis, normalizes the calcium-phosphorus balance and provides support to bones and joints in systemic metabolic diseases. One of the most effective and easy-to-use chondroprotectors is Artracam - glucosamine sulfate in sachet form. Artracam has maximum bioavailability for the body and begins to act after 2 weeks of administration. Also, for the treatment of heel pain when walking, doctors recommend Dona, Movex Active and others.

Chondroprotectors

have a cumulative effect, so they must be taken for at least 3-6 months. They help reduce pain, and with it the amount of medications taken for heel pain.

In case of mild disease, compresses with dimexide

,
novocaine
,
acetylsalicylic acid
.

Therapeutic massage is one of the ways to prevent heel pain

Classification of injury by severity

Depending on the severity, there are 4 degrees of bruise in the heel area:

1. I – minor injuries, usually expressed by scratches and abrasions on the skin, and healing without drug treatment.
2. II – the presence of a bruise and small lumps; in some cases, swelling forms in the injured area.
3. III – internal damage to the muscle structure is observed, accompanied by extensive hemorrhages. In a more severe situation, the integrity of the bone tissue is compromised.
4. IV – as a result of a bruise, a fracture of bone tissue occurs, resulting in serious internal injuries to the soft tissues of tendons and ligaments.

Note!

In case of a fracture, the victim requires immediate assistance from specialists, otherwise there is a high probability of disability.

Preventing heel pain when walking

If your job requires prolonged standing or walking, the following guidelines should be followed:

1. Give your legs a rest
   . If you have to stand a lot, place a low stool or a rolled-up towel at your feet. Periodically place your foot on an elevation so that the muscles have time to relax and tissue nutrition can be restored. After a while, change your leg.
2. Wear comfortable shoes with low heels
   . If necessary, use orthopedic insoles or shoes with orthopedic heels. Make sure your shoes don't put pressure on your feet or pinch blood vessels.
3. Watch your diet and try to lose excess weight
   . To relieve heel pain in the morning, consume as many natural vitamins and minerals as possible and as little simple carbohydrates as possible (sweet fruits, baked goods, fast food, sugary drinks).
4. If an orthopedist or rheumatologist has ruled out the inflammatory or traumatic nature of heel pain, it is advisable to alternate loads on the foot or periods of long immobility with therapeutic exercises
   . These include rotating the foot, stretching and pulling the toes (away from you and towards you), rolling a rolling pin or gymnastic stick with your foot, picking up pencils scattered on the floor with your toes and other warm-up methods.
5. Be sure to wear warm socks in cold and wet weather
   - hypothermia is dangerous for your joints and can worsen heel pain in the morning.
6. Do not develop chronic or infectious diseases; have your injuries treated promptly by a doctor
   .

Easy walking for you!

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Specialists of the direction

Victor Rybka

Specialist in foot surgery and kinesiotaping. Work experience 8 years

Oleg Loskutov

President of the Association of Foot Surgery, expert in the field of foot surgery and endoprosthetics. Work experience 14 years

Victor Rybka

Specialist in foot surgery and kinesiotaping. Work experience 8 years

Oleg Loskutov

President of the Association of Foot Surgery, expert in the field of foot surgery and endoprosthetics. Work experience 14 years

Use of ointments

Additionally, you need to use ointments and gels that quickly relieve swelling. These products are usually applied to clean, dry skin throughout the day. Experts recommend using the following drugs:

1. "Lioton" is an ointment that relieves swelling of the damaged area. The product normalizes blood circulation in the diseased area.
2. "Levomekol" is an antibiotic that destroys pathogenic bacteria. The product provides healing.
3. “Dolobene” is an ointment for bruises with combined action. The main component is considered to be dimethyl sulfoxide. The ointment eliminates pathogenic microorganisms. The drug gets rid of the tumor, but this will take several days.
4. "Indovazin" - an ointment for bruises created on the basis of troxerutin. The product restores tissue damaged by bruise. It reduces pain.

Ointments must be applied carefully. Light self-massage improves blood circulation in the damaged area. Non-steroidal anti-inflammatory drugs are used for pain relief.

Physiotherapy

If the bruise is severe, the doctor prescribes the following physical procedures:

1. Ultrasound therapy. A special feature of the procedure is that ultrasonic waves provide microvibration in the soft tissues of the heel. Thanks to this, hematomas are reduced and the severity of the tumor is reduced.
2. Magnetotherapy. The procedure affects the soft tissues of the heel, which quickly heal under the influence of a magnetic field. The magnetic field has an anti-inflammatory, antispasmodic effect. It activates tissue regeneration in the body.
3. Phonophoresis. The procedure is similar to ultrasound therapy with the only difference - to ensure high-quality transmission of ultrasound waves to the soft tissues of the heel, it is lubricated with a special ointment.

Exercise therapy

Foot strengthening exercises are a great way to recover. They will serve as pain prevention. Gymnastics must be performed in the morning and evening. Do the following exercises:

1. It is performed in a sitting position with legs extended. It is necessary to curl your fingers, gather them in a “handful”, and hold your feet in this position for 1–2 minutes. Relaxation required. The exercise is repeated 3 times. It normalizes muscle tone and strengthens ligaments.
2. Performed in a sitting position, legs positioned perpendicular to the floor. The foot is placed on a shady ball and rolled back and forth. The exercise is performed slowly, with each leg in turn. It strengthens the plantar fascia and relieves muscle spasms.
3. The exercise is done while sitting, one leg is bent and pulled towards the body. With one hand you need to hold the heel, and with the other, pull your thumb down and rotate it left and right, and then straighten it and do the same action. Each finger is developed in turn. Exercise restores joint mobility and normalizes blood circulation.

It is advisable to perform the complex every day to strengthen the feet. The procedures are useful for those people who, due to their profession, have to be on their feet for a long time.

Bruises after jumping are common. It is necessary to start treatment urgently to prevent complications. Effective preventive measures will prevent injury.

Massage

Massage helps with recovery - an excellent means of rehabilitation when the acute period has passed. The procedures relax muscles, relieve muscle tension, improve blood circulation and restore tissue nutrition. You can visit a professional massage therapist or perform the procedures yourself.

Until complete recovery, you should massage the heel 2 times a day. Massage should not be performed immediately after an injury or if there is bruising. The procedure is carried out as follows:

1. Massage oil is applied to clean, dry feet.
2. Using soft stroking movements, the entire foot is massaged, including the toes.
3. Warm up the heel using gentle circular movements.
4. A point technique is used - using your thumbs, apply a little pressure on the painful areas.
5. The massage ends with soft strokes.

ethnoscience

Treatment is not limited to traditional methods alone; there are also folk remedies. They are based on natural herbal ingredients that do not lead to side effects. But it is advisable to consult a doctor before use.

The following folk remedies are used:

1. Compress based on fresh cabbage juice. To perform the procedure, a cabbage leaf is ground until juice is formed. Using a bandage, the product is applied to the affected area in the form of a compress.
2. Infusion of wormwood or oak bark. Finely chopped pieces of wormwood or oak bark are poured with boiling water. The product should sit for 1-2 days. A bandage is moistened in the resulting solution and applied as a compress.