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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

Frequently Asked Questions

What are the common causes of heel and foot pain?

Region of Pain

Common Cause

Typical Features

Bottom of heel

Plantar fasciitis

Morning first-step heel pain

Back of heel

Achilles tendinitis

Pain/stiffness behind heel after activity

Ball of foot

Metatarsalgia

Pain while walking, worse with pressure

Between toes

Morton’s neuroma

Burning pain or “pebble in shoe” sensation

Inner arch/foot

Posterior tibial tendon dysfunction

Arch pain with flattening of foot

Apart from these causes, referred pain from the lower back can also be felt in the heel or great toe depending upon the nerve involvement due to disc prolapse causing sciatica. Visit Absolute Vital Health for all heel and foot related pain.

Is heel pain always a sign of Plantar Fasciitis?

Common causes of pain in the heel include, Plantar fasciitis — most common, Heel fat pad syndrome, Calcaneal stress fracture, Baxter’s nerve entrapment (inferior calcaneal nerve) or a Heel spur. It could also be a referred pain like sciatica. If you have heel pain then do not delay to find out what is causing the pain. Book an appointment with Dr.Ayshvarya Ramalingam. 

What are the best treatments for chronic heel pain?

  1. A. PRP (Platelet-Rich Plasma) Chronic fasciitis/tendinosis Regenerative option for tissue healing

B. Corticosteroid injection Severe inflammatory pain Short-term relief; repeated use avoided

C. Ultrasound-guided nerve blocks Baxter’s nerve entrapment, neuropathic pain Diagnostic and therapeutic

D. Weight reduction & gait correction Pressure-related heel pain Reduces recurrent stress

          In Absolute Vital Health, Aikiya Healthcare we offer all the above treatments for chronic heel pain.

Why does my foot swell along with pain?

Flare ups in Inflammatory arthritis like Psoriatic arthritis, rheumatoid arthritis could be an important cause for foot pain with swelling, they may be associated with multiple joint swelling, associated with stiffness. Gout could be another reason for sudden severe pain mostly in the big toe. Other causes can be due to injury such as ligament strain, ankle sprain, stress fracture of metatarsal bones or infections. If you have foot swelling with pain, book an appointment with Dr.Ayshvarya Ramalingam to get the right treatment.

Can standing for long hours cause foot pain?

Yes , standing for long hours can cause foot pain, due to continuous load from the body, causing stress on the arch straining the plantar fascia, fat pad compression, stress on the joints and tendons causing inflammation, poor blood flow and venous pooling (due to absence of calf muscle pumping action). The patients with flat feet, high arches and tight achilles are more susceptible to developing such pain. Does your job require you to stand for long hours, then book an appointment with Dr.Ayshvarya Ramalingam for foot pain treatment in chennai.