Microtraumas and support defects favor heel pain. In the acute phase, ice packs and anti-inflammatories are recommended. The use of surgery is rare
The heel pain it is a symptom as common as it is annoying, also because it often tends to become chronic. Precisely for this reason, it is better not to underestimate it.
What are the most frequent causes of heel pain?
«Inflammatory pathologies affecting theinsertion of the plantar fascia (a fibrous tissue that extends from the heel to the toes) or the
Achilles tendon in the heel
, are the most common causes of heel pain – stated Silvia De Martinis, orthopedist at the First Orthopedic Clinic Asst Gaetano Pini-CTO in Milan -. In the first case the pain is felt mainly in the most plantar part of the heel, while in Achilles tendinopathy the pain is localized in the back part of the heel, where the Achilles tendon inserts onto the heel. In both cases, inflammation can be favored by a series of factors, starting from mechanical overload and come on repeated microtraumaspossible accomplices foot support defectssuch as a flat, hollow or over-pronated foot, or one that falls inwards.”
How is it characterized?
«In the case of plantar fasciitis the pain tends to manifest themselves especially when starting the engine after a period of rest, for example in the morning as soon as you wake up, while in tendinopathy of the Achilles tendon it is typically felt with physical activity. These pathologies can present themselves with occasional episodes, but not infrequently, especially in the case of plantar fasciitis, there is a chronicity, generally because the pain is underestimated. Furthermore, the development of calcifications at the point of insertion of the plantar fascia or the Achilles tendon into the heel and sometimes of bursitis in the posterior part of the heel is frequent.”
How can it be counteracted?
“In acute phase young him ice packsThe anti-inflammatories and restHowever, if the pain persists, it is a good idea to have an orthopedic visit to trace the cause of the heel pain. The specialist can then suggest further investigations such as radiographyto exclude other pathologies, for example stress fractures (common in runners), and ultrasound to evaluate the plantar fascia and the state of the Achilles tendon.”
When is surgery needed?
“Lplantar fasciitis therapy it almost always is conservative and involves the correction of any biomechanical defect with specific insoles, stretching exercises and massage with a roller or tennis ball to relax the band. Additionally, we recommend a weight loss if you are overweight. «In both conditions, focal shock waves and possible infiltrative therapy with PRP (Platelet Rich Plasma), a concentrate of the patient’s own platelets, are useful. In the case of Achilles tendinopathy, other physical therapies such as tecartherapy. The use of surgery in plantar fasciitis is very rare, also because in most cases, in a more or less long time, it resolves with conservative treatment. The Achilles tendon, on the other hand, is more at risk of rupture, which is why scarification surgery to stimulate its repair is more common”
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December 10, 2023 (changed December 10, 2023 | 07:27)
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