Heel pain is a nagging, uncomfortable problem that can affect people of all ages. It can commence without a fall or trauma to the heel and yet progress in such away that it is either present constantly, or at different stages of the working day.
Heel pain caused by nerve compression
Pain into the sole of the heel that is sharp with possibly a tingling element in surrounding areas of the foot can be narrowed down to compression of the medial calcaneal branch of the tibial nerve which stems from the back of the knee joint. Excessive constant pressure applied to the local nerve branch that supplies sensation to the heel such as an excessive heel strike of the foot when walking may cause irritation of this nerve branch. An artrithic hip joint for example may be causing that prolonged heel strike, resulting in local nerve tenderness at the heel bone (calcaneous). The lower spine may also be the aggravating factor for this heel pain. The origin of the calcaneal branch stems from the tibial nerve, which is a branch of the sciatic nerve that stems from S1 vertebra of the lower back. Compression of the S1 nerve root in the lower spine can be the cause of this referral heel pain. This is especially so if pain radiates to the outside area of the foot sole and also if the patient experiences abnormal weakness in lifting their foot off the floor.
Heel pain caused by plantar fasciitis or heel spur
I have previously written about plantar fasciitis and its treatment protocol. It’s best diagnosed with heel pain when getting out of bed at morning time or when moving from a seated to a standing position. It commonly eases after a short walk. Chronic or long term plantar fasciitis can be more prolonged with no relief when walking. Plantar Fasciitis is often confused with a painful heel spur or boney growth that forms on the sole of the foot. It’s commonly aggravated by any walking or standing activities and relief is only attained through non-weight bearing rest.
Accurately diagnosing the cause of heel pain is important in order for treatment to be effective. The lower back, hip joint and foot mechanics should be assessed so as to address the origin of why the condition arose.
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