Every 8 people complain of heel pain in the morning or after rest, most often women. They cannot get out of bed and immediately begin to actively move, they have to walk slowly until the pain passes. To avoid serious consequences, do not attribute the painful sensations in the heels to simple fatigue of the legs. It is necessary to find out the reason for their appearance and eliminate it, because a progressive disease can end in complete disability.
Of the 26 bones of the foot, the calcaneus is the largest and most loaded, it experiences the pressure of the entire body weight. Many blood vessels and nerve fibers pass through it. Pain can occur both in a limited area and cover the entire foot, be general and diffuse. The main reasons for its appearance are associated with overstrain of the foot when too much pressure is applied to its middle, which can cause the following:
- long walking, running, or standing for a long time;
- excess weight;
- dancing or athletics;
- enhanced training on leg muscle simulators;
- uncomfortable shoes that taper downward or do not provide adequate cushioning.
In older people, pain may appear due to the thinning of the fat pad on the heel or with the development of flat feet, when the arch of the foot drops, and the tissues connecting it to the heel are stretched and microcracks appear in them. Such problems most often arise in those who have a high arch of the foot from birth.
In children, the heels can hurt when there is a lack of calcium and magnesium in the body.
The main cause of pain in diseases of the musculoskeletal system is an inflammatory syndrome. It hurts to step on the heels in the morning after sleep, most often due to inflammation of the fascia of the tough connective tissue that runs along the foot and connects the heel bone with other bones.
This pathology is called plantar (or plantar) fasciitis. It is difficult for the patient not only to take the first steps in the morning but also to walk after a long sitting, climb stairs. The pain is localized in area 3-4 cm from the front of the heel, this place is soft to the touch.
During the night, during sleep and rest, the fascia is shortened due to the accretion of damaged areas, but at the first steps, the tissues begin to stretch and break again until the fascia lengthens. This causes pain, which can be mild, relieving after a minute of walking, or sharp and exhausting when the heel cannot be stepped on. Most often, the pain subsides during the day, and in the morning it repeats.
If fasciitis is left untreated, constant tears of bone tissue are allowed, they grow and form heel spurs or bone osteophyte. The growth on the heel has the shape of a thorn or hook 0.5–1 cm in size, which constantly presses on the soft fibers, causing their inflammation, coarsening of the skin and sharp pain, the peak of which occurs in the morning when you have to get out of bed after rest. Heels on both limbs can hurt.
The same symptoms are typical for the initial stage of the following diseases:
- ankylosing spondylitis;
- spine (lumbar) injuries;
- inflammatory process in the Achilles tendon;
- reactive arthritis.
Treatment of all of these conditions is prescribed by a doctor. With fasciitis, conservative therapy can last 6-12 months. The patient is treated at home. To recover, you need to do the following:
- Exercise regularly to stretch the Achilles tendon, several times a day.
- Wear a splint on the foot at night to prevent the contraction of the fascia. In severe cases, a cast is applied to the legs or an orthosis is put on.
- Use a heel pad while walking to relieve stress on the heels.
To alleviate the condition, pain relievers with anti-inflammatory effects are used, for example, Advil or Ibuprofen. If the pain persists, steroid shots are given, but these injections have many side effects, which can lead to rupture of the plantar fascia and unrecoverable flat feet.
If there is a direct threat of a ligament rupture in case of irreversible dystrophic changes in the tissues of the ankle, the patient is offered fasciotomy – removal of a part of the altered fascia tissue so that it does not pull the bone when walking, and the bone outgrowth itself. The operation can cause complications, including injury or rupture of adjacent nerves, so it is prescribed in extreme cases.
Surgery is increasingly receding into the background; treatment of heels is carried out by hardware methods. A special place among them is occupied by extracorporeal shock wave therapy (SWT), which acts directly on bone and cartilage tissue, calcium deposits. Shock waves penetrate deep into the fibers of the heel and activate the processes of cell renewal and renewal, improve metabolism.
After 5–7 procedures, the bone growths on the heels disintegrate, microvessels begin to grow in the treated area, the tissues receive nutrition, inflammation, and edema subside. For some patients, the sessions are too painful, therefore, before starting treatment, you should discuss with your doctor all the potential benefits and risks. Simultaneously with the UHT, a specialist can prescribe the following physiotherapeutic agents:
- Ultrasonic phonophoresis. Medicine is applied to the painful area of the heel, and then it is exposed to an ultrasonic emitter for 2–5 minutes. The treatment does not correct the bone build-up.
- Laser (quantum) therapy. The beam penetrates deep into the heel tissue, cells are activated, blood flow improves, spurs dissolve, and pain is eliminated. During the procedure, the patient feels only pleasant warmth. The laser is used in courses.
- Magnetotherapy. Exposure to constant and variable low-frequency magnetic fields improves the nutrition of the heel tissues. The method is most suitable for elderly and debilitated people with an initial stage of fasciitis or for its prevention.
The use of non-traditional means must be agreed upon with the attending physician. Traditional methods help relieve inflammation and pain in the heel in the morning in the following ways:
- Compresses. They are put on the heel at night and wrapped around the leg. Cabbage leaves with honey, warm clay, grated raw potatoes, or bischofite diluted in water (1: 1) are used. The number of procedures is 10-14.
- Footbaths. Epsom salt or oils such as eucalyptus, rosemary, and juniper to promote relaxation. The procedure lasts 15020 minutes.
- Contrasting baths.
- Massage. You can do it yourself by rubbing anti-inflammatory ointment into your feet in a circular motion. Then they put on warm socks. The procedure will be most beneficial before bedtime.
- Kneading the heels with a rolling pin, door sill, or other objects.
It is not recommended to knock on the sore spot, as this further injures the soft tissues. Do not recklessly use products that can harm your legs, for example, vinegar essence, since it can burn the skin.
It is useful to wear special orthopedic insoles. The best ones are those that are made individually from a cast. The pad should adhere to the foot over the entire area – only then will it restore the height of the arch.
Elderly people often refuse to treat the heels, considering pain in them a natural companion of age. If nothing is done, in 6–10 months it can go away on its own, but then it will return. It is imperative to treat fasciitis using several methods at the same time.
First of all, you need to get rid of the reasons leading to foot overload: lose weight, choose comfortable shoes with heels no higher than 3-4 cm, and those who have to be on their feet all day are advised to visit the pool.
A simple preventive measure for heel pain is a massage mat. Its rubber spikes of different heights act on the foot so that its muscles contract and at the same time the entire ankle joint is strengthened, trains tendons and improves blood circulation. The thorns massage biologically active points on the foot, thereby increasing the tone of the whole organism.
To stretch the muscles of the feet, it is useful to do the following exercises:
- Sitting on a chair, bend and unbend your feet for 1-2 minutes.
- Pick up scattered small objects with your toes and put them in a box.
- In a sitting or standing position, with your hands or with a tape, pull your foot towards you to maximum flexion and hold in this position for 15 seconds.
- Walk on toes and on the inner and outer edges of the foot for 5-20 minutes a day.
- Rotate the feet 10 times in each direction.
Before doing the exercises, do a warm-up, stretching and warming up the area of the calf muscles. Remedial gymnastics does not take a lot of time and effort, and it can help when done regularly.
Performing some kind of work, you cannot stay in one position for a long time, since this can also provoke discomfort in the joints of the legs. Treatment of heels with increased loads is slow, so you should reduce activity. However, it is important not to abandon it altogether.
For those who are involved in jogging, experts recommend changing sports shoes after 600-800 km of run, and during training, in order to prevent relapse, do not step on uneven surfaces. If the shoe has hard heels, for better fixation, silicone liners are placed under the heels to increase walking comfort.
So that your legs do not fail to a ripe old age, you need to take care of them. And if there is a pain in the heel in the morning, do not hope that it will go away on its own – seek qualified help.
As a result of self-treatment of fasciitis, the patient may get the following complications:
- increased pain in the heels during the first steps after sleep;
- swelling of the ankle;
- arthritis or arthrosis of the thumb joint.
The first results of treatment are noticeable within a month. But if your health has not improved after 1.5 months of therapy, the doctor will select other methods. For success, you need to start the course as early as possible, follow the recommendations and be patient.