Heel pain! What's going on

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Definition of technical terms Chinese name: heel pain English name: Heelpain Definition: Pain in one or both heels increases when standing or walking. Applied discipline: traditional Chinese medicine (first-class discipline); Diagnostics (two disciplines); Diagnostic Methods (two disciplines) The above contents were examined and published by the National Committee for the Examination and Approval of Scientific and Technical Terminology.

Encyclopedia business card heel pain One or both sides of the heel pain, no redness, inconvenient to walk. Also known as heel pain. It is a disease caused by the pathological changes of the bones, joints, synovial sac and fascia of the heel. Common is plantar fasciitis, which often occurs in workers standing or walking, and is caused by long-term chronic minor injuries. It is characterized by fracture and repair of plantar fascia fiber, hyperosteogeny and tenderness at the attachment of medial lower fascia of calcaneus, and lateral X-ray shows calcaneal spur. But bone spurs don't need heel pain, and bone spurs don't need plantar fasciitis. Chinese medicine believes that heel pain is mostly caused by yin deficiency of liver and kidney, phlegm-dampness and blood heat. Liver dominates muscle, kidney dominates bone, liver and kidney deficiency, muscle dystrophy, cold, wet or chronic strain will all lead to meridian obstruction, blocked blood circulation and muscle dystrophy. View wonderful pictures

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Introduction to the disease heel pain is pain on one or both sides of the heel, which is not red or swollen and inconvenient to walk, also known as heel pain. It is a disease caused by the pathological changes of bones, joints, synovial bursa and painful fascia of heel. Common is plantar fasciitis, which often occurs in workers standing or walking, and is caused by long-term chronic minor injuries. It is characterized by the fracture and repair of plantar fascia fibers, bone hyperplasia and tenderness near the medial fascia below the calcaneus, and lateral X-ray shows calcaneal spur. The clinical manifestations of heel pain are mainly unilateral or bilateral heel or foot bottom pain or needle-like pain, and difficulty in walking. Most of them are caused by traumatic inflammation of plantar fascia, periarthritis of achilles tendon, calcaneal bursitis, calcaneal spur and injury of fat pad under heel, and most of them are related to chronic strain. Clinically, there are: (1) periarthritis of achilles tendon; (2) calcaneal spur; (3) Calcaneal periostitis; (4) Subcalcaneal fat pad injury; (5) calcaneal fracture; (6) Subcutaneous bursitis of calcaneus; (7) Soft tissue strain of tarsal sinus; (8) calcaneal tuberculosis, tumor, etc. The most common causes of this disease are plantar fasciitis and heel pain, which are caused by long-term, chronic and slight trauma accumulation, and are manifested in the fracture of fascia fibers and their repair process. There may be bone hyperplasia near the medial fascia below the calcaneus, forming a bone ridge. On the lateral X-ray photograph, it shows a bone spur. The latter is often regarded as the cause of heel pain, but clinical studies have proved that the causal relationship between it and heel pain is difficult to determine. Plantar fasciitis is not necessarily accompanied by bone spurs, and people with calcaneal bone spurs do not necessarily have heel pain. Heel pain caused by plantar fasciitis can be cured naturally. Cushioning the heel, reducing the tension of achilles tendon on calcaneus, plantar flexion of forefoot and reducing the tension of plantar fascia can all relieve symptoms. Drug injection can be given once a week at the local tenderness point inside the foot root, and most patients can recover within two weeks after injection. Heel pad pain often occurs in the elderly. Heel pad is an elastic pad formed by adipose tissue under calcaneus and elastic fibers separated by fibrous tissue. In youth, the heel pad is elastic and can absorb shock. In old age, the elasticity of heel pad decreases, and the calcaneus bears the weight without pad. In severe cases, scars and calcium deposits will be formed, causing heel pain. Unlike foot pain and plantar fasciitis, there is tenderness under the whole heel. The treatment is to use sponge heel pad or local drug injection. Posterior calcaneal bursitis is most likely to occur in the capsule between achilles tendon and skin, which is caused by improper high-heeled shoes friction injury. The wall of synovial capsule can be thickened, the capsule is filled with synovial fluid, and it is swollen and tender locally. The treatment should be to improve the shoe shape. If the swelling of bursa of fabricius does not disappear, puncture and aspiration can be performed and hydrocortisone can be injected. Calcaneal neuritis is common in boys aged 8 ~ 12. Its pathological changes are similar to osteopontin in tibial tubercle of calf. It is a symptom caused by the tendon pulling the unhealed epiphysis during development. Pain is below the achilles tendon attachment point and can occur on both sides at the same time. Running and tiptoeing can aggravate symptoms. Symptoms disappeared naturally after epiphysis healed. General symptomatic treatment can reduce children's activities, and heel pad can also be used to reduce the tension of achilles tendon on calcaneus. Subtalar arthritis often occurs after calcaneal fracture, which is a kind of traumatic arthritis. On the X-ray photograph, the pain in the anterior tarsal sinus is aggravated when carrying weight. If conservative treatment fails, calcaneal arthrodesis should be performed. Old calcaneal fractures or rare calcaneal tumors or tuberculosis are also causes of heel pain. Diseases other than heel cause heel pain, such as rheumatoid spondylitis, lumbar disc herniation compressing sacral nerve root, calf tibial nerve compression, etc. How to distinguish the causes of heel pain in clinic? Generally speaking, in addition to X-ray and other corresponding auxiliary examinations, after clinical physical examination, it can basically be diagnosed by professional podiatrists. It can also be distinguished by treatment, such as heel pain caused by atrophy of plantar fat pad in the elderly, and local blocking treatment is ineffective. Clinical manifestations Pseudoheel Pain Heel pain is often manifested in the first and second steps of getting up and landing in the morning, and can be gradually relieved after a few steps. There are two kinds of heel pain: one is true heel pain, which is diagnosed by X-ray and has concentrated pain points; The other is false heel pain. X-ray showed no hyperosteogeny, persistent heel pain and severe leg fatigue. There is no correlation between these two kinds of pain. From the perspective of traditional Chinese medicine, heel pain is a kind of bone arthralgia, which is mostly caused by yin deficiency of liver and kidney and cold evil. Heel pain is a common disease in the elderly, but now the incidence among young women is increasing year by year, especially white-collar workers, who wear fashionable sandals and slippers to work and their heels are exposed for a long time, so they are vulnerable to cold evil in air-conditioned rooms. After work, they are busy shopping and doing aerobics, and their feet are not well rested. Due to long-term heel compression, excessive exercise and cold, aseptic inflammation of heel fat fiber pad is caused, and finally pain is induced. False heel pain can be prevented. Usually, keep your heels warm to avoid excessive walking or standing. You can soak your feet with warm water before going to bed, or apply hot compress to your feet. Try to wear soft-soled shoes at ordinary times. As for flat feet, you should pay more attention to avoid excessive exercise, and you'd better put on corrective shoes. The cause of postpartum heel pain in the second month, the maternal qi and blood deficiency, easy to suffer from cold and cold. Especially the feet, including the heels, once caught cold, will be painful in the later days. Postpartum heel pain is virtual, not caused by trauma or bone spur. This postpartum disease is mainly caused by kidney deficiency. Wearing high heels and barefoot slippers and sandals are often important incentives. Kidney is the foundation of vitality, and kidney governs reproduction and bone. According to the route of meridian circulation, heel belongs to the range of kidney meridian circulation Postpartum kidney qi is weak, chong and ren are damaged, pulse is deficient, and both qi and blood are deficient. If you often show your heels barefoot again, or often wear high-heeled shoes with hard soles and large bending degrees, the already weak foot muscles can't rest after delivery, and it is easy to cause heel pain because of warm nourishment and poor qi and blood. If it is not treated in time and does not heal for a long time, it will fall into the "root cause". Countermeasures for relieving pain 1. Be sure to keep your feet warm after delivery, and wear socks and shoes to protect your toes and heels. Don't wear high heels and hard-soled shoes for three months after delivery. Wearing sandals and slippers is best to wear socks. 2. Apply hot compress or other physical therapy to the painful part. 3. If you have the above symptoms, please seek the guidance of Chinese medicine and use the medicine correctly. Analysis of TCM treatment of heel pain is a common disease, which is characterized by heel swelling, numbness and pain, local tenderness and difficulty in walking. Heel pain is also called calcaneal spur or calcaneal hyperosteogeny. In traditional Chinese medicine, it belongs to the category of "bone arthralgia", and its etiology is mostly related to kidney deficiency, strain, trauma and cold and dampness in the elderly. For chronic or early heel pain, choose a variety of traditional Chinese medicines with the functions of expelling wind and removing dampness, warming channels and dispelling cold, softening hard mass and reducing swelling, promoting blood circulation and relieving pain, which will not damage the skin and have no side effects. Traditional Chinese medicine has been studying the symptoms of heel pain for a long time. Chao, a famous medical scientist in Sui Dynasty, called heel pain "foot root degeneration". Just as the book says: "People whose feet are degenerating suddenly have a pain in their heels, so they can't catch it. Secular call it foot root degradation. " Zhu Danxi, one of the four famous doctors in Jin and Yuan Dynasties, called it "heel pain" in "Danxi Heart Therapy", so we must use Guifu ointment. Plaster is a wonderful flower of traditional Chinese medicine. In ancient times, there was a saying that "the theory of external treatment is the theory of internal treatment, and the medicine of external treatment is the medicine of internal treatment, respectively, ear". "Plaster can be used to treat heel pain with Chinese medicine, and there is no special decoction, so it can be used correctly, and its sound should stand." Xu Lingtai, a famous doctor in the Qing Dynasty, said: "Plasters are used today, and the ancients called them thin ointments. ..... people who treat internal diseases, such as expelling cold, harmonizing qi and blood, eliminating phlegm and swelling, or strengthening tendons and bones, have very effective prescriptions, and the drugs should be added and subtracted according to the disease. Its ointment should be thick and lasting. " 1. Qi stagnation and blood stasis type: various reasons lead to slow local blood circulation, blood stasis block and vein obstruction, so blood circulation is not smooth, pain, pain is limited, pain refuses to stop, and walking is limited. Second, liver and kidney deficiency type: liver and kidney and their branches are located in the heel, the liver dominates the muscle, the kidney dominates the bone, the essence and the marrow. For the elderly, liver and kidney deficiency, deficiency of essence and blood, and poor meridians lead to tendon dystrophy, bone loss and weakness, so when standing or walking, the heel is sore, dull pain and fatigue, and the pain is easy to press, but the pain is reduced when touching it. Three, cold blood stasis type: qi and blood run slowly, but also feel cold evil, cold dominates stagnation, leading to meridian obstruction, qi and blood stagnation, pain, refusal to press, like heat and fear of cold. The needle can be closed, with quick effect and relatively low cost. Give an injection at the pain point first, and after half a month, you can strengthen an injection to see the pain. However, sealing the needle cannot guarantee a complete solution to the problem. Young women should use it with caution. It is a hormone drug, which can cause irregular menstruation for 2-3 cycles. It is best not to get pregnant within six months. "Closing the needle is to inject the drug into the painful part to achieve the purpose of diminishing inflammation and relieving pain, which has the effect of relieving local muscle tension. The long ones can be managed for more than a few years, and the short ones can be managed for several weeks, depending on the severity of the disease. This is symptomatic treatment and has a good effect on eliminating local pain symptoms. Treatment based on syndrome differentiation of traditional Chinese medicine 1. Typing therapy 1. Kidney-yin deficiency type: foot-shin fever, heel pain, Liuwei pill plus tortoise plastron and cinnamon. 2. Kidney-yang deficiency type: unable to stand for a long time, heel pain. Use bawei pills. 3. Wet type: severe swelling, with bone-setting pills and stone pot medicinal liquor. 4. Wet phlegm type: add papaya, rhizoma Dioscoreae Septemlobae, and radix Stephaniae Tetrandrae, and match with Huatan decoction. 5. Deficiency of both qi and blood: Buzhong Yiqi Decoction and Shiquan Dabu Decoction are used. 6. Blood-heat type: Siwutang plus Rhizoma Anemarrhenae, Cortex Phellodendri and Radix Achyranthis Bidentatae (see Medicine Guide: beriberi). The medicine composition: 20g of Ligusticum Chuanxiong, 20g of Radix Aconiti, 30g of Radix Cyathulae, 30g of Radix Dipsaci, 20g of Fructus Zanthoxyli, 30g of Radix Clematidis, 20g of Fructus Chaenomelis, 30g of Caulis Spatholobi, 20g of Rhizoma Corydalis, 20g of Olibanum, 20g of Myrrha, 50g of Natrii Sulfas (subpackaged) and 250ml of vinegar. Formula: Radix Aconiti, Fructus Zanthoxyli, Radix Clematidis, Caulis Spatholobi, dispelling wind and cold, dredging channels and activating collaterals; Rhizoma corydalis, Rhizoma Chuanxiong, Olibanum, and Myrrha have effects in promoting blood circulation, removing blood stasis, promoting qi circulation and relaxing muscles and tendons; Papaya, Radix Dipsaci and Radix Cyathulae nourish liver and kidney and strengthen bones and muscles; Glauber's salt softens lumps, reduces swelling and relieves pain; Vinegar contains vinegar ions, which has a strong osmotic effect, and is helpful for promoting blood circulation, removing blood stasis, softening and resolving hard mass. The medicine is decocted and smoked, and the medicine acts locally, penetrates the skin and reaches the affected part directly, so as to promote the circulation of qi and blood, improve local blood circulation, soften bone spurs, and promote the absorption of inflammation, thereby alleviating or eliminating symptoms. Usage: First, add 3000ml of cold water to 12, soak12h, boil for 30-40min, pour into a basin, add mirabilite and vinegar, and stir well. First fumigate the affected area with hot air, and soak and clean the affected area when the water temperature is not too hot. When the water temperature drops, it can be reheated, and the fumigation time is not less than 1 hour each time, 1 time in the morning and evening. 1 It can be used for two days. Western medicine surgical treatment ① Heel spur resection. For intractable calcaneal pain, if X-ray confirms that there is a bone spur, make an incision inside the calcaneus and file off all the bone spurs in the calcaneus treated by surgery. ② calcaneal drilling: It is suitable for patients with high calcaneal pressure, aiming at reducing the increased calcaneal pressure and treating intractable calcaneal pain without spur. After reaching the calcaneus, 7 ~ 10 calcaneus holes were drilled, and the effect was 90%. ③ Calcaneal nerve amputation: This method can be used for intractable heel pain without cause, but cutting the posterior tibial nerve branch and sural nerve branch of calcaneus is a destructive operation. ④ Calcaneal capsule resection: it is to remove calcaneal tubercle capsule and calcaneal inferior capsule. ⑤ Calcaneal osteotomy for the treatment of flatfoot: The purpose is to enlarge the calcaneal angle through calcaneal osteotomy, straighten the everted calcaneus, and make the calcaneus have a good biological scaffold. Other processing 1. Physical therapy; 2. Oral nonsteroidal anti-inflammatory drugs and analgesics; Inject prednisolone into the tenderness point once a week, often 2 ~ 3 times to cure it. Posterior heel bursitis often occurs between the achilles tendon and the skin, which is caused by friction injury and is characterized by effusion, swelling and tenderness in the capsule. Avoiding friction and intracapsular injection of prednisolone acetate are effective. Family remedial treatment 1. Elimination of heel pain: stand with your hands behind your head, then squat down and get up again immediately, which is 1 time. Do it 200 times a day, twice a day, and it will work for 3 months. 2. Treatment of heel pain by drug soaking: Take 30g of sappan wood, Rhizoma Typhonii, Herba Ephedrae, Radix Angelicae Sinensis and Rhizoma Chuanxiong, soak them in water to wash their feet, and rub their heels with their hands at the same time, so as to facilitate the liquid medicine to penetrate into the skin. 15 minutes each time, twice a day. 3. Treating heel pain with urine stains: Take a large piece of granite, put it on the ground after calcination, and immediately put the heel on the stone with urine stains of children, so that the steam can evaporate, and don't burn your feet. No granite can be replaced by iron. It is also effective to replace children's urine with saturated solution of mirabilite and liquor. 4. Acupoint massage to cure the cold pain in both heels: press the palm root of the other hand (slightly to the thumb side) with the fingertip of one thumb, and the operator will shake hands with the other four fingers as a support, and try to exert as much force as possible if the patient can accept it. After kneading for 3 minutes, it becomes a relaxed, pressurized, regular and rhythmic acupoint, 36 times, which is 1 time. Continue to knead for 5 minutes after lifting. Treat the disease in this way: pain in the right heel, pressing the left hand; My left heel hurts. Press my right hand. For heel pain, you can press the acupoints of both hands successively. After 5 days of general treatment, the condition recovered. Note: (This method has little effect on hyperosteogeny heel pain). 5. Folium Artemisiae Argyi and Mume can cure heel pain: Take 60g of Folium Artemisiae Argyi and Mume 10g, decoct them in water, then pour them into a box, then put the burnt bricks into a liquid medicine basin, put the affected feet on steam for fumigation and washing, and cover them with clothes. After the medicine is cooled to a proper temperature, put the bottom of the affected heel on the brick and press it for several minutes (the liquid medicine can be used repeatedly). 6. Treatment of heel pain with ebony vinegar: Take an appropriate amount of ebony, remove the core, add a little vinegar, mash it, add a little salt, stir it evenly, apply it to the affected foot, cover it with gauze and fix it with adhesive tape. Apply/kloc-0 once a day for a period of time, which is effective. 7. Treating heel pain with Chuanxiong: Take 45 grams of Chuanxiong and grind it into fine powder, divide it into 3 parts, put it into a small cloth bag and sew it. Put the medicine bag into the shoe and directly contact the painful part of the foot. Use L bags each time, and use 3 bags alternately. Put the medicine bag back and dry it. 8. Treatment of heel pain with fresh Xanthium sibiricum leaves: take appropriate amount of fresh Xanthium sibiricum leaves, mash them and apply them to the affected area, and fix them with plastic film covering tape. After drying, change the medicine any number of times. If there are blisters, you can treat them as burns and continue to use them after recovery. Note: generally, it takes 5-6 days to take effect, the pain disappears, and hyperosteogeny exists but does not develop. 9. Prunella vulgaris for the treatment of heel pain: Take 50 grams of Prunella vulgaris, soak it in 1000 ml vinegar for 2-4 hours, then boil it for 15 minutes, and smoke it for 30 minutes, 1 ~ 3 times a day/dose, which can last for 2 days. Medicinal material 10, cactus for treating heel pain: take a proper amount of cactus, scrape off the burrs on both sides, then cut it in half, stick the cut side on the painful part of the foot, and fix it externally with adhesive tape. 12 hours later, change half a piece. In winter, the wound is heated and then applied to the affected area. It is usually applied at night. During the treatment, it is advisable to wear cloth shoes and exercise moderately, so that the qi and blood meridians are unobstructed. 1 1. Treatment of heel pain with fresh neem leaves: take 30-60g of fresh neem leaves, add appropriate amount of brown sugar, mash them into paste, apply them externally to the affected heel, and replace them after 24 hours. Generally, the pain will disappear after 2-3 times of medication. Dietotherapy can choose dietotherapy: 90g chicken, 6g Sichuan bird, 60g black bean and jujube 12g by medicated diet. After washing, put it in a casserole, add appropriate amount of water, cook it with slow fire for 2-3 hours, and drink it as needed. It is suitable for people with foot obstruction due to wind, cold and dampness. You can also use 90g (cut into pieces) of mutton, 9g of epimedium and 0/5g of citric acid/kloc, wash them together, put them in a casserole, add a proper amount of water, and cook them with slow fire for 2 hours until the mutton is cooked and rotten. Suitable for people with cold and wet heel pain. Nutrition prevention and dietotherapy 1. Vitamin B6 supplementation can help the absorption of calcium and prevent the formation of bone spurs. 2. supplement vitamin C. Eat more foods containing calcium. 4. Eat more foods containing magnesium, such as vegetables, cereals, meat, beans and bean products. 5. Avoid alcohol, coffee and sugary foods, prevent obstacles in the recovery process and protect the mineral balance in the body. 6. Chuanxiong Angelica Pig's Foot Soup: Chuanxiong Angelica each 15g, one pig's foot. Stew pig's trotters and two kinds of Chinese medicines for an hour, and eat meat with soup. Dredging channels and activating blood, nourishing channels and collaterals. Nutritional recipe Miren root red bean juice [Ingredients] 30g of raw rice root and adzuki bean, 0g of Achyranthes bidentata12g, 9g of papaya and 9g of peony bark. [Production] The above raw materials were decocted in water. 【 Efficacy 】 Relaxing tendons and activating collaterals can be used for foot and eye pain. Grape root drink [ingredients] 60 grams of fresh grape roots. [Making] The grape roots were boiled with water. 【 Efficacy 】 Eliminating dampness and relieving pain and supplementing trace elements. Disease prevention 1. Adolescent calcaneal epiphysis is mostly caused by calcaneal trauma and long-term running and jumping, so patients with calcaneal epiphysis should avoid running and jumping at this stage, especially jumping from a height. Pay attention to this at the beginning of symptoms. 2. Senile heel pain is mostly caused by strain, plantar aponeurosis, calcaneal tubercle bursitis and fatty pad degeneration. Standing and walking for a long time should be avoided during this period, and raising the heel can reduce the heel load. Wear a soft sole and a soft pad at the heel. The center of the round pad is sunken, and the height is about 2 ~ 3 cm, which makes the center of gravity of the whole body move forward, reducing heel pressure and weight. 3. The heel pain caused by flat feet is due to the narrowing or disappearance of the arch of the foot and the inclination of the heel bone, so it will cause pain when walking for a long time. Therefore, the center of the sole should be padded with a soft pad, the height is 2 ~ 3 cm, the inner side is high and the outer side is low, and the front and rear sides of the center gradually flatten out in a slope shape. 3. Rheumatoid calcaneus inflammation should be controlled by drugs first, and the shoes should be padded. 4. Traumatic heel pain is mostly due to improper fixation of plaster. When making plaster, the sole of the foot forcibly squeezes the wet plaster to the center of the foot, so as to prevent the arch of the foot from disappearing due to long-term fixation of the plaster as a flat bottom. At the same time, as far as possible to reduce bed time, walking exercise as soon as possible. Avoid fat pad atrophy. Precautions 1. Try to avoid wearing soft thin-soled shoes; Second, the heel should be protected with a thick pad, or a hollow heel pain pad should be used to make the spur part empty to reduce local friction and injury; Third, often do foot pedal action to enhance the tension of plantar aponeurosis, strengthen its anti-strain ability and reduce local inflammation; Fourth, warm water soaking feet, supplemented by physical therapy when conditions permit, can reduce local inflammation and relieve pain; Fifth, when persistent pain occurs, some non-steroidal anti-inflammatory and analgesic drugs should be taken orally; Six, if the pain is severe, seriously affecting walking, local blocking treatment is the fastest treatment.