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Heel and Foot pain

Most common cause of heel pain.

The plantar fascia is a band of tissue, called fascia, that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking. Inflammation of the band is PF.

Causes For Degeneration/ Inflammation
  • overuse
  • wrong Shoes/ Poor Support
  • high Arch/ Flat Feet
  • systemic Causes; Spondyloarthropathy, Obesity
Management
  • rest / immobilisation
  • ice / anti-inflammatory medicines
  • supportive shoes/ shoe inserts Exercise
  • for persistent chronic pain
    • usg guided steroid injections for pain relief
    • regenerative therapy

Baxter Nerve Entrapment

Baxter nerve entrapment can be found in up to 20% of cases with chronic heel pain Baxter’s Entrapment is an entrapment (or compression) of the Inferior Calcaneal Nerve just under the base of the arch of the foot. It is painful to feel along the arch on the bottom surface of the foot


Diagnosis: It is very difficult to identify the clinical indicators of inferior calcaneal nerve compression through physical examination, so this nerve compression is often missed unless an ultrasound guided local anesthetic diagnostic test or MRI is performed. A local anesthetic agent (such as lodocaine) is injected near the origin of the Medial Calcaneal Nerve using ultrasound guidance to increase accuracy. If the trial injection results in a significant decrease in pain, then this indicates that Baxter’s Entrapment is likely to be present.

Mpn Entrapment

The condition described happens when a nerve (Medial Plantar Nerve) near the knot of Henry gets trapped due to repetitive turning outward of the foot, often seen in runners, also known as "jogger's foot." This leads to pain on the inner side of the sole, spreading to the underside of the first three toes.


Irritation of the MPN can also result from problems with the tendons of the big toe (flexor hallucis) and the long toe (flexor digitorum longus). We can use ultrasound image guided procedure such as hydrodissection (with 5% dextrose) of the nerve and surrounding tendons can be performed for pain relief

Tarsal Tunnel Syndrome (Tts)

Tarsal tunnel syndrome (TTS) can cause pain, numbness and tingling in the feet. It results from inflammation in the posterior tibial nerve, which runs along the inside of the ankle and foot. The inflammation is due to nerve damage and compression


  • Sharp, shooting pain that radiates to the arch and sole of the foot
  • Tingling or burning sensations
  • Numbness on the sole of the foot
Management: Hydrodis section of the nerve will help in relieving the symptoms
ANKLE SPRAINS/LIGAMENT INJURIES AROUND THE ANKLE

Deltoid Ligament Injury

It has been reported that injuries to the deltoid ligament occur in about 15% of all cases involving ligaments. These injuries typically happen due to either excessive inward rolling (pronation) or outward rolling with rotation (supination-external rotation) of the ankle.
ANTERIOR TALOFIBULAR LIGAMENT In cases where the ankle rolls outward (common in ankle sprains), the ligaments on the outer side of the ankle may also be torn, which can result in instability of the ankle in multiple directions.
DELTOID LIGAMENT INJURY
ANTERIOR TALOFIBULAR LIGAMENT