What will help get rid of heel pain in a child? The child's heel hurts (it hurts to step on): causes and treatment The boy's heels hurt what to do.

Enhanced immunity to diseases does not protect the child from danger, trips to surgeons and orthopedists. In adults and children, pathologies are different, since the structure of the body is different, and they turn to different doctors.

Often, when examined by a doctor, a disease is detected. Not terrible - which is treated, but a disease.

List of common diseases:

• Plantar fasciitis is an inflammation of the fascia, bands of connective tissue and skin on the sole. It becomes inflamed closer to the clutch with the heel tubercle, this place hurts. The reason is wearing uncomfortable shoes;
• Calcaneal apophysitis - inflammation occurs in the apophysis, the plate responsible for the growth of the foot. At 3-6 years old, the plate is weak, pressure causes pain. Pain also appears when walking, running, jumping, physical exertion, if the child is not used to it;
• Haglund-Schlinz disease - the apophysis becomes inflamed due to injury. If, after a strong blow or fall, the cartilage inside the heel is destroyed, blood circulation is disturbed. The cartilage begins to grow, the distance between the apophysis and the calcaneus increases, causing pain.
• Tendon overload - characterized when walking, trying to step on the heel. With flat feet, they wear medical insoles that reduce the friction of the sole with shoes;
• Flat feet are a common cause of heel pain. With flat feet, there is pressure on the foot when walking. Avoiding trouble, it is better to carefully monitor the shape of the child's foot, to prevent a possible deviation from the norm.
• Excess weight puts pressure on the legs and spine. The lower extremities have to bear the weight, the pressure on the heel is maximum. This is the reason to maintain a healthy lifestyle, to force the child to eat right.
• Curvature of the spine occurs when the child does not want to keep his back straight, hunches and stoops. The vertebrae are displaced, the hip muscles are loaded unevenly, affecting the condition of the limbs, on the heel. Muscle tension changes, heels hurt.
• Osteochondrosis - often the result of malnutrition, lack of vitamins in the body.
• Lack of calcium in the body - bones and joints lose strength, quality, strength. Contact with the external environment causes blisters, injuries.

The skin on the heel and the sole is thin, easily exposed to changes and damage. A crack, a callus are places where pain occurs. Closely monitor the child's condition. Finding the cause is the first step to curing the disease.

There are many more reasons for heel pain. An orthopedist or surgeon will help determine the child's illness. If a child has a genetic predisposition to a disease, the parents become the unwitting cause of the disease.

Do not blame yourself that the child has a heel pain: there are things that are beyond our control. Prevention of heel diseases depends on us, measures taken regardless of the age of the child.

Self-medication is not worth it. You need to see a doctor after the onset of symptoms.

How to get rid of heel pain? How is it treated?

Do not prescribe a course of treatment yourself. Contact doctors who specialize in working with children. If you can cope with such a pathology, remember that the child's body does not grow like an adult, it is necessary to take other drugs, carry out other procedures.

The treatment is complex: taking pills, preventive measures - physiotherapy, heel massage - sometimes plaster. Doctors recommend limiting physical activity, rest, and eating foods rich in calcium.

Doctors prefer to use conservative methods of treatment. Surgery scares children. Often there is no need for it: the operation is done when there is an incorrect fusion of bones in the foot, a purulent disease that passes to the lower leg, knee, gets to the pelvis, hips. In other cases - pills, physiotherapy, massage, warming up, proper nutrition. Doctors advise the use of folk remedies - herbal compresses, warming ointments, tinctures prepared at home. The use of traditional medicine is agreed with the attending physician.

Heel surgery is reserved for severe cases. If the child complains of discomfort, go to the doctor.

Prevention of heel diseases, rehabilitation after treatment

Measures to prevent heel pain:

• Buy loose shoes made of breathable fabric;
• Wear medical insoles if flat feet are diagnosed;
• Maintain a healthy lifestyle, eat right;
• Do exercises, physical exercises on the limbs, dosed, without overworking;
• If a parent has flat feet that was inherited by the child, wear special medical insoles.

It doesn’t matter why the heel hurts, if you get rid of the original cause in time. The body of the child grows, moreover, quickly. The missed pathology remains in the bones. Not all bone pathologies go away on their own - many require intervention - surgical, medicinal - it doesn’t matter. Pain is a sign of pathology in the body. It is important to understand the cause in advance, to do everything necessary for treatment.

As children grow, there is an increase in their physical activity. However, in addition to being useful for the body, this can provoke individual negative manifestations. For example, the fact that a child has a heel pain. Why is it important to have an idea that the foot can hurt due to, which are harmless, and sometimes quite serious, requiring an urgent trip to the doctor.

How to understand that a child's heel hurts

When the son is still small and does not know how to pronounce words, the parent cannot immediately understand why the child walks and is naughty. But having learned to pronounce the words, it becomes possible to make out that it hurts the child to step on the heel.

Often you can observe that the heel area begins to peel, swell. It is impossible to make a diagnosis on your own, as a result of which the heel begins to hurt. It is recommended to contact an orthopedist, to be examined and tested.

It happens that the heels are affected by strong pressure, so the patient complains of pain discomfort in them due to fatigue. If complaints of this kind are received, parents should reduce the activity of their child.

A fairly common disease that develops due to inflammation is. The little patient is unable to walk normally and tries to walk on his toes because the heels are sore.

Often, this pathology is formed in babies from eight to fourteen years old. When the heel hurts at 8 years old, this is characterized by the fact that at this time the development of the heel bone occurs.

Possible causes of heel pain in children

There are various factors that lead to pain in the heels. Almost all of the causes are considered dangerous, since bone formation is not yet completed.

It could be:

• Walking in uncomfortable shoes that constrain the limb, also when there are large heels.
• Powerful physical activity, injuries.
• The presence of clubfoot

Trauma can also be a factor. Children are characterized by hyperactivity, which leads to their suffering. Due to mobility, there is an uneven distribution of pressure on the soles, the heel is subject to injuries, bruises, sprains.

Very often, after a long summer vacation, one can observe that, having returned to the educational channel, the child’s heels hurt after training. Children athletes begin to train vigorously, do exercises, so the pain can be associated with a recent sports activity.

Often, parents observe allergic reactions in children. An allergy on the heels of a child can develop as a result of wearing shoes made of poor-quality material, synthetic tights.

Possible Allergy

Sometimes reveal dystrophic phenomena in the body. The factor that there is a seal on the heels, or a sudden pain syndrome associated with the disease appears.

Diseases are as follows:

• Osteochondropathy
• Fasciitis
• Achillodynia

Schinz-Haglund disease

This disease involves the presence of necrosis of the bone tissue of the calcaneal tuber. What is the cause of the pathology has not been fully identified, however, according to statistics, the disease often develops in girls at the age of about 10 years.

Schinz-Haglund deformity

Predisposing factors for the development of the disease include:

• Heredity
• completeness
• Heel injury
• powerful pressure

Heel tubercles can hurt for quite a long time, sometimes until the child's growth is completed. Heels often hurt in a child of 10 years old, if he is an athlete. It happens that the disease is observed in those who are less active.

Achilles tendon strain

Why does my child's heels hurt when walking? The factor may lie in stretching. In everyday life, tendon sprain is often observed due to subluxations, due to improper formation of the foot during a sudden movement with great physical onslaught.

This may include:

• Dropping a limb off a step
• blows
• sharp jumps
• Painful lateral flexion when walking in heels - the foot turns inward, and the ankle moves outward.

Such a disease is associated with the manifestation of soreness in the Achilles tendon, which connects the ankle and

The following factors contribute to the formation of inflammation of the Achilles tendon in a child:

• Flat feet, clubfoot.
• uncomfortable shoes
• Different limb lengths

With prolonged minor trauma, tendinitis may form. Inflammation can also develop with viral infections, rheumatic ailments. Such factors can provoke damage to the synovial bag, which reduces friction in the middle of the heel bone and tendon.

Calcaneal epiphysitis

At the age of 13, the heel bone consists of cartilage, which ossifies over the years. If the cartilage tissue is subjected to increased pressure, it leads to inflammation due to a number of factors.

1. Vitamin D deficiency.
2. Diseases of the arch of a congenital nature.
3. The tendon is shortened, so the foot is curved.

Apophysitis

The disease is associated with a change in the growth of the heel bone where it is combined with the Achilles tendon.

Apophysitis occurs as a result of powerful pressure on the sole. This includes uncontrolled physical pressure, hyperactivity, rapid bone growth.

Heel spur

One of these is shark oil ointment. It should be applied to the affected area, rub until the ointment is completely absorbed. In order for the cream to work well, it is advised to wrap the heel in warm material for half an hour. Treatment is carried out up to 3 times a day.

Ointment Shark Fat

To help with heel pain, it is recommended to use mustard, pouring it into socks. The effect of mustard, like mustard plasters, which are given to children, they have a warming effect. Mustard has a lot of essential oils that can irritate the skin and stimulate blood circulation. They put mustard in dry socks, so it will have a slow effect and the patient will not get burned.

But if you put mustard plasters on your heels, then they act immediately and when using them, the risk of burns will be maximum.

Which doctor to contact

The child's body reacts quite critically to the appearance of pain, so various complaints should not be missed.

If the patient has such manifestations, it is necessary to consult a doctor:

1. The patient is not able to lean on the foot due to the formation of an acute course of pain.
2. The heel tubercle is changed, and goes beyond the border of the posterior arch of the foot.
3. The temperature is rising.
4. The heel zone, ankle, swell, becomes an uncharacteristic shade for the skin.

An appeal to which doctor is needed will be prompted by the attending pediatrician, who can refer to a narrower specialist, based on the patient's symptoms.

• Orthopedist
• Neurologist
• Hematologist

Which doctor should I contact from the proposed list? The child will need to go through all the doctors, he will be assigned the necessary tests,. According to the results of the research, it will be revealed what was the factor in the manifestation of pain in the heels in the children's body. Recommendations will be given to the child and the parent, therapy will be prescribed.

With Shinz's disease, children of eight to nine years old need to reduce their physical activity. Also, children of 9 years old are undergoing physiotherapy, and. For severe pain, nonsteroidal medications, vitamins B 6 and 12 are prescribed.

Achillodynia is treated by reducing physical activity, resting the limb from pressure. It is recommended to visit the pool, carry out ankle massages, do simple exercises so that the flow of blood to the damaged area increases. If the situation is severe, the mucous bag is excised through a hole in the tendon.

For the treatment of plantar fasciitis, glucocorticosteroids are prescribed to reduce pain, which act locally on the center of pain. Elimination of puffiness, inflammation is carried out using NSAIDs. To eliminate pain, physiotherapy is carried out. To relieve tone, massage is done.

Therapy of apophysitis with pain discomfort in the heel area in young patients is carried out with the use of analgesics and non-steroidal anti-inflammatory drugs. In addition, vitamins are prescribed, containing a large amount of magnesium and calcium. The foot should be immobilized for a while, a light massage will bring the muscles into tone.

Prevention

It is important to pay attention to preventive measures than to wait until pain discomfort occurs in the heel area. In addition to buying new shoes for children, parents need to instruct them to exercise.

Unfortunately, professional sports do not promise excellent health, because sprains, injuries, bruises happen, but doing regular exercises will keep the body active.

1. Heavy load on the limb should be avoided.
2. When there are problems with the soles of the feet (flat feet), it should be used.
3. Watch your diet. It is required to eat regularly, including minerals, vitamins.

When heel pain appears, if the parent reacts instantly to the symptom, the child can be relieved of the problem quickly. Initially, this is a reduction in the load on the feet, let them rest a bit, and a therapeutic massage course that you can do yourself will also help.

And be sure, if the child has a heel pain, it is important to immediately contact the doctor and not start the problem.

Heel pain can occur with the following diseases:

• Haglund's deformity;
• tarsal tunnel syndrome;
• fissure of the calcaneus;
• heel spur;
• stretching of the Achilles tendon;
• heel injury;
• gout;
• diabetic angiopathy;
• epiphysitis of the calcaneus;
• bursitis;
• reactive arthritis;
• tuberculosis of the calcaneus;
• osteomyelitis of the calcaneus.

Haglund deformity

Haglund's deformity is a disease in which a bone growth occurs in the region of the posterior surface of the calcaneus ( ledge), which can be detected by feeling the heel ( behind and above). This growth is usually located slightly above where the Achilles tendon attaches to the calcaneal tuberosity. Therefore, during movements in the ankle joint ( e.g. walking, running) the Achilles tendon constantly rubs against it. Due to this constant friction, mechanical damage to the fibers of the Achilles tendon and retrocalcaneal bag occurs ( ), which is then accompanied by their inflammation. The reason for the appearance of Haglund's deformity is still not exactly established. However, it is known that it is most often observed in females aged 20 to 30 years, who spend a large amount of time in high-heeled shoes. Pain in the heel in this pathology is caused by Achilles bursitis ( inflammation of the retrocalcaneal bursa) and tendonitis ( inflammation) Achilles tendon.

Tarsal tunnel syndrome

Tarsal tunnel syndrome is a pathology that occurs as a result of mechanical compression of the branches of the tibial nerve in the tarsal canal ( medial ankle canal), which is localized behind the medial ( inner side) ankles. This canal is formed by closely spaced bones in relation to each other ( calcaneus and talus) and flexor retinaculum ( retinaculum mm. flexorum inferius). In addition to the tibial nerve, the tendons of the posterior tibial muscle, the long and common flexor fingers, and the tibial artery also pass through this canal. The main causes of tarsal tunnel syndrome are mechanical injuries of the posteromedial ( rear inner) of the foot, the presence of volumetric formations inside the tarsal canal ( bone exostoses, lipomas, tendon ganglia) or congenital or acquired deformities of the foot. Heel pain in this syndrome is caused precisely by mechanical damage to the tibial nerve.

Heel fracture

A fissure is an incomplete, closed fracture of a bone, in which there is no displacement of its processes at the site of injury. A calcaneus fracture usually occurs as a result of a person falling on their heels from a certain height. A little less often, such a pathology can be found with direct and strong blows ( for example, as a result of an explosion) in the heel area. There are many types of heel fractures. These types are mainly classified depending on the location of the cracks ( extra-articular or intra-articular fissures of the calcaneus) and their number ( single or multiple). Calcaneus fractures can often coexist with other types of calcaneus fractures and ankle injuries ( dislocation, bruise, sprain, etc.). If the patient has an extra-articular fracture, then this type of fracture is classified as a mild injury. An intraarticular fissure is a fracture of moderate severity. Pain in the heel with a fissure of the calcaneus is most often caused by crushing of the subcutaneous fat located in the heel region, as well as damage to the periosteum of the calcaneus.

Heel spur

Heel spur ( plantar fasciitis) is a disease in which aseptic ( non-infectious) inflammation of the plantar aponeurosis ( plantar fascia) together with its attachment to the calcaneal tuberosity of the calcaneus. The cause of this inflammation is the constant traumatization of the plantar part of the foot ( Where is the plantar fascia located?), resulting from excessive physical exertion, obesity, and various structural and deformation pathologies of the foot ( flat feet, hyperpronation syndrome, hollow foot, etc.). Inflammatory processes in the area of ​​​​attachment of the plantar fascia to the heel tuber often lead to the appearance of bone outgrowths - osteophytes, which are heel spurs. These spurs can be seen on x-ray and cannot be felt. These formations are not the cause of heel pain. Pain in plantar fasciitis, as a rule, appears as a result of the presence of inflammatory processes in the plantar fascia.

Achilles tendon strain

Achilles tendon strain is one of the most common types of injury. It can occur as a result of significant and / or sudden physical exertion, poor warm-up before training, the use of low-quality shoes, when running on hard surfaces, deformities, mechanical injuries of the foot, falls on the foot from a great height, etc. When stretched, microtraumatization and partial rupture occur. fibers of the Achilles tendon, as a result of which inflammatory processes occur in it, which serve as the main cause of pain. The most common injury to the Achilles tendon is where it attaches to the posterior surface of the calcaneus ( calcaneal tuberosity). Therefore, pain in such an injury is usually localized in the back of the heel. Pain may also be felt along most of the Achilles tendon. Pain in this injury, as a rule, increases when moving the foot on the toe, running, jumping, walking.

Achilles tendon strain is the mildest type of injury. A more serious injury to the Achilles tendon is its partial or complete rupture, in which a person cannot move ( e.g. walking, running) with the help of an injured leg and feels severe pain in the heel and in the area where the Achilles tendon is located. In such cases, the supporting function of the lower limb is completely preserved, since this tendon is not involved in maintaining the static position of the leg.

Ankle sprain

The ankle joint is strengthened by a large number of ligaments ( medial ligament, anterior talofibular ligament, posterior talofibular ligament, etc.). Most of these ligaments insert near the calcaneus ( to the talus or to the scaphoid) or directly to it ( calcaneofibular ligament), therefore, if they are damaged ( e.g. stretching or tearing) the patient often feels pain in the heel region. One of the most common injuries of the ankle joint is sprain of its lateral ligaments ( ligaments that connect the fibula to the bones of the foot), which is observed with a sharp tucking of the foot inward, which is often found when walking, running, jumping. These injuries usually damage the calcaneofibular ( ligamentum calcaneofibulare) and anterior talofibular ( ligamentum talofibulare anterius) links. Due to the partial destruction of the fibers of these ligaments, inflammation occurs in the places of their rupture, due to which pain, swelling and redness appear. All three of these symptoms are localized on the outer lateral surface of the foot, just below the outer ankle and closer to the heel ( its outer side surface).

Heel bruise

A heel bruise can occur when it hits any hard surface. This can often be observed when falling on the heel area, when running, jumping, walking barefoot ( on an uneven surface). Also, such a bruise can occur if any heavy object has fallen on the heel area. Less commonly, a heel bruise can be caused by one or more direct, directed blows to the heel region with a blunt object. With this type of injury, the soft tissues of the heel are most severely affected - skin, subcutaneous tissue, muscles, ligaments of the arch of the foot, blood vessels and nerves. Damage to these anatomical structures and tissues leads to the development of inflammation in the heel, the appearance of swelling, bruising ( due to rupture of small blood vessels), redness and pain ( due to mechanical damage to the nerves). A heel bruise is a type of closed tissue injury. It can often be associated with other types of open ( wounds, open fractures) or closed ( dislocation, closed fracture, sprain, inflammation of synovial bags, etc.) traumatic injuries. Therefore, the pain that occurs when a heel bruise may also indicate that the patient has any additional injuries in the foot.

Gout

Gout is a disease associated with metabolic disorders. With this pathology in the blood of patients, an increase in the concentration of uric acid is observed ( formed as a result of the breakdown of purine bases - adenine and guanine). An increased amount of this metabolite ( product of exchange) in the body leads to the deposition of uric acid salts in various tissues ( articular, periarticular, renal, etc.), resulting in gout-specific symptoms.

One of the main symptoms is monoarthritis ( inflammation of one joint) or polyarthritis ( inflammation of multiple joints). Gout can affect various joints ( ankle, elbow, hip, knee, etc.), however, most often the joints of the foot are involved in the pathological process with it ( intertarsal, metatarsophalangeal, tarsal-metatarsal joints). Inflammation of the intertarsal joints ( calcaneocuboid, subtalar, talocalcaneal-navicular etc.) with gout leads to pain in the heel.

The causes of this disease may be congenital defects in the enzymes responsible for the utilization of uric acid in the body ( for example, a defect in hypoxanthine-guanine phosphoribosyltransferase or adenine phosphoribosyl pyrophosphate synthetase), kidney pathology ( chronic renal failure, kidney cancer, polycystic disease, etc.), blood ( paraproteinemia, leukemia, polycythemia, etc.), consumption of large amounts of meat, alcohol, physical inactivity ( sedentary lifestyle) and etc.

Diabetic angiopathy

With diabetes ( endocrine disease associated with absolute or relative insufficiency of the hormone insulin) due to the constant presence of a high level of glucose in the blood, systemic diabetic angiopathy develops ( vascular damage). The blood vessels of the kidneys are especially seriously affected in diabetes ( diabetic nephropathy), retina ( diabetic retinopathy), heart and lower extremities. Damaged blood vessels in diabetes mellitus narrow and sclerosis ( replaced by connective tissue), due to which the blood supply to the tissues that they nourish is disrupted. Therefore, with the development of diabetic angiopathy of the lower extremities, trophic ulcers gradually appear on the patient's legs ( due to tissue death).

Such ulcers are localized more often on the foot, toes, heel, ankle zones. With this pathology, there is also a decrease in local immunity, which is why leg ulcers are constantly infected and heal for a very long time, so diabetic angiopathy is often complicated by osteomyelitis ( purulent inflammation of the bones) and gangrene ( tissue necrosis) feet. Such complications are observed in patients constantly, since damage to nerve endings occurs in diabetic angiopathy ( diabetic polyneuropathy), which is accompanied by a violation of the sensitivity of the tissues of the leg.

Epiphysitis of the calcaneus

The calcaneus consists of the body of the calcaneus and the tubercle of the calcaneus. The tubercle of the calcaneus is located behind and slightly below the body of the calcaneus. It is due to this bone process that the bone support for the heel region is formed. Most human bones are formed due to endochondral ossification, that is, due to the ossification of cartilage tissue, which serves as their primary rudiment during prenatal development. After birth in children, the heel bone contains predominantly cartilaginous tissue, which will have to ossify during its growth period. Such ossification begins from foci of ossification, which are called ossification points. Such points provide not only ossification of bones, but also their growth and development.

The first ossification point appears in the body of the calcaneus at 5-6 months. Ossification ( ossification) bones in the region of this point begins at the moment when the child is born into the world. Approximately at 8-9 years old, the child has a second ossification point in the apophysis ( process of a bone, near its end) of the calcaneus, from which the tubercle of the calcaneus is formed. After its appearance, both points gradually begin to coalesce with each other. Their complete fusion ends when the child turns 16-18 years old.

Epiphysitis of the calcaneus ( Sever's disease) is a pathology in which inflammation of the calcaneus occurs as a result of partial separation of the apophysis ( bone process, from which the calcaneal tubercle will subsequently arise) from her body, due to the incomplete process of fusion and ossification. This pathology is observed mainly in children 9-14 years old ( since the first and second ossification points are completely fused by the age of 16-18).

Various factors contribute to the development of this disease ( excessive physical activity, permanent injuries, anomalies in the development of the foot, deficiency of calcium, vitamin D), which cause damage to the cartilaginous tissue in the calcaneus and a partial rupture of its connective tissue fibers, which disrupts the normal fusion of both ossification points and ossification ( ossification) of the entire bone as a whole. Pain in the heel with epiphysitis of the calcaneus is projected onto its lateral sides and occurs due to inflammatory processes inside the calcaneus.

Osteochondropathy of the calcaneal tuber

Osteochondropathy of the calcaneal tuberosity ( Haglund-Schinz disease) is a pathology in which aseptic ( non-infectious) inflammation. This disease is most often observed in girls aged 10-16 who are actively involved in sports. However, sometimes it can also appear in boys. The probable cause of the development of this pathology is a disorder of the heel bone blood supply, which is facilitated by hormonal changes in the body at this age and constant pressure loads on the not yet fully formed heel bone.

Such loads cause mechanical damage to the vessels of the heel region, as a result of which they narrow, and microcirculation is disturbed in them. The lack of blood flow to the tissues of the calcaneus provokes the development of dystrophic and necrotic changes in it, due to which it becomes inflamed. Haglund-Shinz disease is characterized by the appearance of diffuse pain in the heel zone ( in the area of ​​the calcaneal tubercle), which increase with physical activity and extension of the foot. Particularly severe pain is usually projected at the junction of the Achilles tendon with the calcaneal tubercle. They can be easily identified by palpation palpation with fingers).

Bursitis

Bursitis is an inflammation of the synovial sac cavity anatomical formation, consisting of connective tissue and preventing friction between various tissues near the joints). There are two types of bursitis in the heel area - Achilles bursitis and posterior calcaneal bursitis. Achilles bursitis ( Albert's disease) inflammation of the retrocalcaneal synovial bursa occurs, located between the Achilles tendon and the posterior surface of the calcaneus. With posterior calcaneal bursitis, inflammation of the superficial bag of the Achilles tendon, delimiting it from the skin, is observed. Pain in the heel with both types of bursitis is localized in the area of ​​​​the back surface of the heel, in the place where the Achilles tendon is woven into the calcaneal tubercle with its lower end. The causes of Achilles bursitis and posterior calcaneal bursitis can be mechanical injuries of the back surface of the heel, the patient wearing tight shoes with a hard back ( trailing edge), excessive physical exertion on the ankle joint, the presence of Haglund's deformity ( ) or systemic autoimmune diseases ( systemic lupus erythematosus, rheumatoid arthritis, etc.).

Reactive arthritis

Reactive arthritis is a pathology in which inflammation of one or more joints develops during or some time after an infectious disease ( intestinal or urogenital infection). This pathology has an autoimmune origin and occurs as a result of a malfunction of the immune system. There are two main forms of reactive arthritis ( postenterocolitic and urogenital). Heel pain is most commonly seen in urogenital reactive arthritis. This type of arthritis usually appears 1 to 6 weeks after a urogenital infection and is characterized by the development of inflammatory processes in various joints of the lower extremities ( knee, ankle). The joints of the foot in the region of the tarsus, metatarsus, and phalanges of the fingers may also be affected.

One of the main features of urogenital reactive arthritis is the occurrence of pain in the heel region. Their appearance is associated with the defeat of various types of connective tissue structures located in the heel zone. Achilles tendon enthesitis is the most common with this type of arthritis ( inflammation of the tendon attachment to the calcaneus), tendinitis ( inflammation) Achilles tendon, plantar aponeurosis enthesitis ( inflammation of the site of attachment of the plantar aponeurosis to the calcaneus). Localization of pain always depends on which structure is affected and inflamed. So, for example, with enthesitis or tendonitis of the Achilles tendon, pain is felt on the back of the heel, with enthesitis of the plantar aponeurosis, the patient experiences pain in the region of the underside of the heel.

Tuberculosis of the calcaneus

Tuberculosis is an infectious disease that occurs as a result of human infection with Mycobacterium tuberculosis. Most often, this pathology affects the lungs ( pulmonary tuberculosis). However, there are times when these mycobacteria can invade the bones of the foot ( with blood flow). It was then that calcaneal tuberculosis occurs. This form of tuberculosis is extremely rare and occurs predominantly in children ( 9 – 15 years old) with weakened immune systems. Quite often, with it, along with the calcaneus, the talocalcaneal joint is damaged. With tuberculosis of the calcaneus, various tissues that belong both to itself become inflamed ( bone tissue, periosteum, bone marrow, etc.), and those that surround the calcaneus ( ligaments, muscles, blood vessels, skin, subcutaneous tissue, etc.), as a result of which the heel swells significantly, increases in size and turns red. The patient with this pathology cannot step on the heel due to the presence of significant pain in it. Pain in the heel is usually diffuse. Pain in the heel increases sharply with pressure from any side of it.

Osteomyelitis of the calcaneus

Osteomyelitis is a pathology in which purulent inflammation occurs in the bone. Osteomyelitis of the calcaneus is quite common in diabetic foot ( one of the complications of diabetes mellitus, in which trophic ulcers appear on the skin on the foot, often in the heel area) and fractures of the calcaneus, accompanied by infection of the soft tissues of the calcaneus. In some cases, this pathology occurs when a harmful infection is introduced by the hematogenous route ( by blood) from infectious purulent foci that appear in the body with bacterial endocarditis ( inflammation of the inner lining of the heart), pneumonia ( pneumonia), pyelonephritis ( kidney inflammation), liver abscess, caries, after joint prosthetics, etc. In all these cases, pyogenic microbes penetrate the heel bone and begin to multiply there, as a result of which purulent inflammation occurs in it. This is what causes heel pain. The most common osteomyelitis of the calcaneal tuber, much less often - osteomyelitis of the body of the calcaneus. Pain in the heel with this pathology is diffuse, they do not have an exact localization.

Diagnosing the causes of heel pain

Diagnosis of most pathologies that cause heel pain is based on taking into account the results of a clinical examination of the patient ( history taking, calcaneal palpation) and information obtained in the course of radiological studies ( ultrasound, X-ray examination, computed tomography, magnetic resonance imaging). Also, such patients are often prescribed the passage of some laboratory tests ( complete blood count, biochemical blood test, immunological blood test, etc.).

Haglund deformity

With Haglund's deformity, a dense bump-like protrusion appears on the posterior-upper surface of the heel. The skin over this formation is always edematous and hyperemic ( of red color), sometimes there is hyperkeratosis ( increased peeling). Pain in the heel is mainly aching in nature and is projected around the bone growth and the place of attachment of the Achilles tendon to the calcaneal tuber of the calcaneus. It should be noted that the appearance of swelling behind the heel is not always a symptom of Haglund's deformity. This symptom may also occur with isolated superficial bursitis ( inflammation of the synovium) Achilles tendon, calcaneal exostosis, etc.

Palpation of the posterior surface of the heel in this disease can reveal an abnormal bone growth, swelling of the tissues adjacent to it, and severe local pain. To confirm the presence of the Haglund's deformity in the patient, he needs to do an X-ray examination of the heel region. Sometimes such a patient may also be ordered to undergo an ultrasound examination ( ultrasound), which is necessary for visualization and assessment of the condition of the Achilles tendon and retrocalcaneal bag ( synovial bursa located between the Achilles tendon and the calcaneus).

Tarsal tunnel syndrome

Tarsal tunnel syndrome is characterized by burning pain and tingling in the heel. Pain may radiate spread) along the entire sole to the toes, as well as in the opposite direction - from the heel to the gluteal region. Pain in the heel and in the sole, as a rule, increases with the extension of the foot. In addition, with this syndrome, there may be a partial or complete violation of the sensitivity of the skin of the sole and difficulty in the mobility of the muscles of the foot ( for example, the muscles of the abductor hallux, flexor digitorum brevis, flexor hallucis brevis, etc.), which is explained by damage to the sensory ( sensitive) and muscle fibers of the tibial nerve. Such patients quite often find it difficult to walk "on tiptoe" ( on socks).

An important diagnostic sign of tarsal tunnel syndrome is Tinel's symptom ( the appearance of pain and numbness in the areas of innervation of the tibial nerve when tapping with fingers in the region of the tarsal canal). Palpation of the posterior surface of the entire leg can often reveal local pain. An electroneuromyogram is used to confirm whether a patient has a tibial nerve injury. In order to identify the cause of tarsal tunnel syndrome, patients are prescribed radiation research methods ( radiography, computed tomography, magnetic resonance imaging).

Heel fracture

With a crack in the calcaneus, pain in the heel appears, the damaged area of ​​​​the foot swells and turns red. There may be bruising at the site of the fracture. Such patients usually do not lose the ability to move, however, the transfer of weight on the injured leg gives them unpleasant, painful sensations in the heel. Palpation of the heel zone can reveal local pain and swelling on the sides of the calcaneus and from the side of the sole. With a calcaneus fracture, active articular movements in the ankle joint are sharply limited, and in the subtalar joint ( connection between calcaneus and talus) are impossible. This type of injury most often occurs when falling on your feet from a height, so this fact is an important diagnostic criterion, which the doctor must ask the patient about in the process of taking an anamnesis. Confirmation of the diagnosis of a fissure of the calcaneus ( more precisely - an incomplete fracture of the calcaneus) is carried out by assigning a patient an x-ray examination of the calcaneus in two projections - standard lateral ( showing the side of the foot from heel to toe) and axial ( dorsal plantar).

Heel spur

Patients with heel spurs complain of pain in the heel ( from the side of the sole) that appear when walking and running. Sometimes such pain may be present even at rest. The intensity of pain in the heel varies, but most often it is pronounced and haunts patients. Such patients usually cannot wear flat shoes and walk with heels or socks. The pain syndrome is quite pronounced in the morning, when patients just get out of bed, and decreases slightly during the day and at night. This is due to the fact that during sleep, the damaged plantar fascia heals a little ( as the patient's leg is resting). When getting out of bed, the load on it suddenly increases ( due to the fact that in the vertical position of the human body, about half of its mass presses on it), it is damaged again and inflammatory processes intensify in it.

When feeling ( palpation) of the calcaneal region, it is possible to detect an increase in pain in the area of ​​localization of the calcaneal tubercle - the place of attachment of the plantar fascia to it. In addition to clinical examinations, such patients may also be prescribed an X-ray examination of the heel in two mutually perpendicular projections. This study helps not only to establish the exact localization of inflammation and the presence of osteophytes ( heel spurs) in the area of ​​the calcaneal tuber, but also to exclude other possible pathologies ( e.g. calcaneal tumors, osteomyelitis, calcaneus fracture, etc.).

Achilles tendon strain

When the Achilles tendon is stretched, pain appears in the back of the heel. In this area, swelling and redness of the skin may also appear. The pain syndrome with such an injury, as a rule, increases when moving the foot on the toe, jumping, running or walking. Soreness can often be felt along the course of the Achilles tendon itself and intensify when it is probed with fingers. With significant stretching of the Achilles tendon, mobility in the ankle joint is sharply hampered. The slightest bend ( bringing the toes to the anterior surface of the lower leg) or extension ( abduction of the toes from the anterior surface of the lower leg) of the foot causes pain in the heel. With a rupture of the Achilles tendon, as a rule, there is severe pain in the heel region, severe swelling and hyperemia ( redness) skin at the site of injury. Active flexion or extension of the leg in the ankle joint is not possible.

For the diagnosis of stretching of the Achilles tendon, it is very important to clarify the patient's events and circumstances in which pain in the heel appeared, since, in most cases, such an injury occurs during physical exertion, mechanical injuries of the leg, falling from a height, poor warm-up before training etc. Therefore, anamnestic data are a very important criterion for diagnosing an Achilles tendon sprain. In addition to clarifying the patient's complaints and taking an anamnesis, he should also be assigned an ultrasound examination, computed tomography, and magnetic resonance imaging. Using these methods, it is possible to quickly identify damage to the Achilles tendon and exclude other possible pathologies ( ). X-ray examination in such cases is not effective, since radiographs ( pictures taken from x-rays) sprains usually cannot be recognized.

Ankle sprain

When the lateral ligaments of the ankle joint are stretched, the patient experiences pain in the heel ( on its outer side), external ankle and ankle joint. These pain sensations are always aggravated by active movements in the ankle joint, as well as when trying to actively or passively supinate ( inward rotation) of the foot or its adduction. On palpation, local pain is felt below and / or in front of the outer ankle, as well as in the projection zones of the lateral surfaces of the talus and calcaneus. The skin over these areas is edematous and hyperemic ( of red color). Ankle sprains most often occur during sports ( running, walking), when a person accidentally steps on the lateral ( outer side) surface of the foot. This should be taken into account when collecting history data. To exclude fractures of the bones of the foot and lower leg, which have similar symptoms, the patient is prescribed an X-ray examination.

Heel bruise

A bruise forms at the site of injury on the heel ( bruise), swelling and redness of the skin. The maximum soreness is felt by the patient right in the middle of the injury site. Also, open injuries, abrasions, wounds can be found at the site of the injury. It all depends on the characteristics of the traumatic factor. Closed damage ( e.g. calcaneus fracture) can be recognized by radiography or computed tomography of the heel region.

Gout

The diagnosis of gout is made on the basis of clinical, laboratory and instrumental research methods. The main clinical sign of gout is the sudden onset of pain in one or more joints ( most often the joints of the foot). Pain in the heel ( which develop if there is a lesion of the intertarsal joints), as a rule, occur at night, their intensity increases sharply by morning. Pain is always associated with redness and swelling of the skin over the affected joint. The duration of such an attack varies and ranges from one day to several weeks. The occurrence of such an attack is most often associated with certain provoking factors ( for example, visiting a sauna by a patient, drinking excessive amounts of alcohol, meat food, medicines, the patient being in stressful situations, etc.). In a general blood test in such patients, leukocytosis can be detected ( an increase in the number of leukocytes) and an increase in the erythrocyte sedimentation rate ( ESR) . In a biochemical blood test for gout, the amount of uric acid is increased. X-ray of the heel region can reveal intraosseous cystic formations ( tophi), filled with uric acid crystals, as well as subchondral ( subchondral) osteolysis ( bone destruction) tarsal bones.

Diabetic angiopathy

Since diabetic angiopathy of the lower extremities is a complication of diabetes mellitus, in order to make such a diagnosis, it is necessary to establish the very fact of the presence of this endocrine disease. To detect diabetes in a patient, the level of glucose in the blood is examined, a glucose tolerance test is prescribed, laboratory tests for glycated hemoglobin, fructosamine, they are asked about the presence of symptoms of polyuria specific to diabetes ( frequent going to the toilet "on a small scale"), polyphagy ( frequent meals), polydipsia ( constant thirst), weight loss, etc.

If a patient has diabetes mellitus, then he is assigned consultations with doctors of the appropriate profile, who can establish and confirm the presence of one or another complication in him. For example, an ophthalmologist may diagnose diabetic retinopathy ( retinal damage due to diabetes), a general practitioner may identify a patient with diabetic nephropathy ( kidney damage due to diabetes), the surgeon usually diagnoses diabetic angiopathy of the lower extremities.

With diabetic angiopathy of the lower extremities on the leg ( or legs) in a patient, most often in the area of ​​\u200b\u200bthe foot, ulcers are visible against the background of dry, atrophied skin that has a pale or cyanotic color. The skin is often cracked and flaky. Pain in the heel region always has a different intensity, which is not related to the area and depth of ulcerative defects. This is due to the presence of diabetic polyneuropathy ( nerve damage), in which there is a noticeable decrease in skin sensitivity. Occasionally, these patients present with intermittent claudication ( that is, when walking, they cannot normally step on their feet due to pain syndrome). To assess the peripheral blood supply ( which is significantly impaired in this pathology) different methods are used ( ultrasound, radiopaque angiography, magnetic resonance angiography, etc.).

Epiphysitis of the calcaneus

Epiphysitis of the calcaneus is characterized by the appearance of pain on the sides of the heel, its slight swelling and redness. Pain in this pathology, as a rule, increases with pressure on the heel with fingers ( especially from her sides), as well as when running, jumping, moving the foot to the toe. Most often, epiphysitis of the calcaneal bone develops in children aged 9–14 years who go in for sports daily and wear shoes with thin and flat soles ( boots, sneakers, running shoes, etc.). Sometimes this pathology can be observed in children who consume little calcium in food and are not exposed to enough sun ( the sun's rays stimulate the formation of vitamin D in the body, which is involved in the processes of bone ossification). The diagnosis of epiphysitis of the calcaneus is confirmed on the basis of the results of radiological studies ( computed tomography and magnetic resonance imaging).

Osteochondropathy of the calcaneal tuber

Osteochondropathy of the calcaneal tuberosity is accompanied by diffuse pain in the heel after exercise ( running, walking, jumping, etc.) or foot extension. These pains can occur in both heels at the same time. Pain, as a rule, occurs when a person is in an upright position and subsides during sleep or rest. The heel with this disease swells, becomes red. The skin in this area has increased tactile sensitivity. As the disease progresses, heel pain becomes unbearable, so when walking, patients will mix the load on the forefoot ( walk on socks) and/or using crutches. When feeling the heel, there is pronounced local pain in the area of ​​​​attachment of the Achilles tendon to the calcaneal tuberosity. The diagnosis of osteochondropathy of the calcaneal tuber is confirmed on the basis of X-ray data of the calcaneal region. This study helps to identify compaction and fragmentation of the calcaneal tubercle, its roughness, areas of aseptic ( non-infectious) necrosis ( tissue death) and etc.

Bursitis

Pain in Achilles bursitis and posterior calcaneal bursitis occurs in the back of the heel. There you can also find a slight swelling and redness of the skin. Achilles bursitis ( inflammation of the retrocalcaneal bursa) this swelling is usually located on both sides of the Achilles tendon, between it and the calcaneus. This type of bursitis most often occurs with injuries to the posterior surface of the heel, excessive physical exertion on the ankle joint, or the presence of Haglund's deformity ( the appearance of a bone growth near the retrocalcaneal synovial bag).

With posterior calcaneal bursitis ( inflammation of the superficial Achilles tendon bursa) swelling is more distinct ( in the form of a knot) and is located on the posterior surface of the Achilles tendon. This type of bursitis occurs in people who periodically wear tight, hard-toed shoes ( trailing edge). X-ray methods of research can help in establishing the final diagnosis to the doctor ( ultrasound, radiography, computed tomography). These studies can accurately identify signs of bursitis - an increase in the size of the synovial bag, hypertrophy ( thickening) its shell, the appearance of pathological contents inside it.

Reactive arthritis

With reactive arthritis, pain in the heel appears mainly on its lower or back surface. Pain can occur both at rest and during physical exertion. Heel pain in this pathology is almost always associated with pain in the knee, ankle or hip joints. Often they can be accompanied by balanitis ( inflammation of the skin of the glans penis), conjunctivitis ( inflammation of the mucous membrane of the eye), uveitis ( inflammation of the choroid of the eye), glossitis ( inflammation of the tongue), fever, swollen lymph nodes, weight loss. When taking anamnesis in such patients, it is important to find out whether he was ill ( or sick at the moment) urogenital infection. Since this is one of the key diagnostic signs, since reactive arthritis is not an infectious disease, but occurs as a result of hyperimmune ( excessive immune) response to a past urogenital infection.

Important diagnostic signs of reactive arthritis are also the results of some laboratory tests. Immunological typing is performed in patients with suspected this disease ( study) for the presence of the HLA-B27 antigen ( a molecule on the surface of white blood cells that predisposes a patient to developing reactive arthritis), serological tests and PCR ( polymerase chain reaction) for the presence of antigens in his blood ( particles) harmful microbes ( that have caused genitourinary infections in the past), as well as microbiological examination of smears from the urethra, cervical canal, conjunctiva of the eyes ( to detect chlamydia).

Tuberculosis of the calcaneus

With tuberculosis of the calcaneus, the patient develops diffuse pain in the heel area. Most often they are associated with the load of the foot during physical exercises ( walking, running, jumping). Because of this, the patient often shifts weight on the forefoot and limps noticeably. Heel pain can also occur at rest. If this pathology occurs in a child at an early age, then, in most cases, it is accompanied by deformation and underdevelopment of the foot ( as in tuberculosis, the destruction of the bone under the influence of bacteria). In addition to pain in the tubercle of the calcaneus, significant swelling of the calcaneal region and redness of the heel can be detected. The diagnosis of this disease is confirmed by X-ray or computed tomography, which can detect a focus of dead bone tissue in the thickness of the calcaneus ( in the form of enlightenment). Zones of osteoporosis are visible around the focus ( bone demineralization). If infection spreads from the heel bone to the talocalcaneal joint, then arthritis develops ( joint inflammation), which can also be seen on radiographs ( pictures taken with x-rays).

Osteomyelitis of the calcaneus

With osteomyelitis, there is a sharp and severe pain in the calcaneus, which is quite well detected by palpation. Pain in the heel with this pathology, as a rule, is accompanied by chills and fever. The heel itself in such cases swells, becomes red. Since osteomyelitis of the calcaneus occurs most often secondary ( against the background of diabetes mellitus, fractures of the calcaneus, injuries of the calcaneal zone, etc.), it is important to establish the presence of its cause. What the doctor does during the collection of anamnesis and examination of the patient. In a general blood test in a patient with osteomyelitis, leukocytosis can be detected ( an increase in the number of leukocytes), an increase in the erythrocyte sedimentation rate ( ESR). With the help of radiography and computed tomography, it is possible to detect the presence of destruction zones in the calcaneus ( destruction), sites of osteoporosis ( softening of the bone tissue), thickening of its periosteum.

How to treat when the heel hurts?

In the treatment of diseases of the heel zone, various groups of medications are prescribed ( antibiotics, anti-inflammatory, analgesic, antiseptic, anti-gout agents, glucocorticoids, etc.), physiotherapy, wearing various orthopedic insoles, shoes, bandages or plaster casts. In the absence of positive results during conservative treatment, the patient is prescribed surgical treatment. Such treatment may be the main one. As a basic surgical treatment, it is used for some pathologies of the heel zone ( e.g. tuberculosis or osteomyelitis of the calcaneus, tarsal tunnel syndrome).

Haglund deformity

In mild cases of Haglund's deformity, patients are prescribed non-steroidal anti-inflammatory drugs, physiotherapy treatment ( electrophoresis, massage, ultra-high frequency therapy, ultra-high frequency therapy, ultrasound therapy, etc.), wearing shoes without a back ( trailing edge) and special orthopedic insoles that reduce the load on the calcaneus. In such cases, it is also recommended to avoid excessive physical exertion and give the sore leg more rest. In more severe cases, when no significant changes in the clinical course of the disease are observed with conservative treatment, the patient is prescribed surgical treatment. It consists in endoscopic removal of the bone outgrowth from the surface of the calcaneal tuber, bursectomy ( removal of the retrocalcaneal bursa) and mechanical restoration of the function of the Achilles tendon.

Tarsal tunnel syndrome

Treatment for tarsal tunnel syndrome depends on the underlying cause. In the presence of volumetric pathological formations in the tarsal canal ( as well as with congenital or acquired deformities of the foot) the patient needs surgical intervention, through which these formations are removed and the normal patency of this canal is restored. In some cases ( this is especially true for congenital or acquired deformities of the foot) such patients are prescribed orthopedic correction ( wearing special orthopedic shoes) to normalize the biomechanics of the foot. In case of foot injuries, temporary immobilization is performed ( joint immobilization), prescribe painkillers and anti-inflammatory drugs and physiotherapy measures ( gymnastics, massage, electrophoresis, etc.).

Heel fracture

After a person falls from a height and he has severe pain in the heel, it is advisable to immediately call an ambulance. If this is not possible, then you should immobilize ( immobilize) the injured leg with the help of spikes and transport the victim to the traumatology department. Immobilization of the leg is necessary in order not to cause displacement of the bone fragments that appeared with a crack in the calcaneus. With a crack in the calcaneus, conservative treatment is prescribed. It consists in applying a plaster cast to the injured limb. Gypsum is applied from the foot to the knee joint for 8 to 10 weeks.

In the first 7-10 days, the patient needs to walk with crutches, while leaning on a cast leg is not allowed. After this period, you can start a full-fledged walking, gradually increasing the load on the damaged heel zone. Full working capacity of the patient is restored after 3-4 months. Such a long period of rehabilitation is explained by the fact that the calcaneus serves as the main supporting structure when a person walks. When standing upright, the entire weight of the human body presses on this bone, so it is very important that the patient endure the entire period of immobilization of the leg in order to completely heal the fracture and prevent various complications ( for example, displacement of bone fragments, increase in the size of the crack, etc.).

Heel spur

Patients with heel spurs are prescribed non-steroidal anti-inflammatory drugs ( ibuprofen, indomethacin, diclofenac, etc.). For severe pain, local corticosteroids are sometimes administered ( hormonal anti-inflammatory drugs). In addition to drugs, they are prescribed night orthoses ( special orthopedic shoes), which are worn during sleep to stretch the plantar aponeurosis and fix the foot in one position, as well as carrying out special physiotherapy procedures ( gymnastics, cryotherapy, shock wave therapy, ultrasound therapy, massage, electrophoresis, etc.). The effectiveness of such treatment always varies and depends on each individual case. If conservative treatment does not help such patients, then they are prescribed surgical treatment ( plantar fasciotomy, heel spur removal, radiofrequency tenotomy, etc.). The choice of the type of surgical treatment is selected individually.

Achilles tendon strain

A sprained Achilles tendon is treated conservatively. If you feel pain in the back of the heel, you should immediately apply cold to the sore spot ( ice bag). Cold compresses are effective only in the first 1 - 3 days from the moment of stretching. Cold does not need to be kept at the site of injury all day long, it is enough to apply it periodically for 20 to 30 minutes if there is pain in the heel area. The injured leg must be immobilized ( immobilize) with a tight bandage wrapped around and stabilizing the ankle joint. It is not recommended to carry out any movements in this joint ( this is especially true for sharp, impulsive, flexion and extensor movements). It is necessary for some time to give up physical activity, sports.

If the patient has severe pain in the back of the heel, in addition to cold compresses, he needs to take anti-inflammatory nonsteroidal drugs ( ibuprofen, baralgin, diclofenac, etc.). It should be remembered that severe pain in the back of the heel can also appear with other pathologies ( for example, with a rupture of the Achilles tendon, a fracture of the calcaneus, etc.), therefore, before self-treating an Achilles tendon sprain, it is recommended that you first consult with your doctor. Also, with this stretching, physiotherapy procedures help well ( cryotherapy, electrophoresis, ultra-high-frequency therapy, ultra-high-frequency therapy, low-frequency magnetotherapy, massage, therapeutic exercises, etc.), which significantly reduce the rehabilitation period, which takes quite significant periods of time for such patients ( on average, from 2 weeks to 2 - 3 months).

Ankle sprain

With this type of injury, an 8-shaped bandage is applied ( Suitable for both elastic and non-elastic bandage) on the ankle joint, thereby immobilizing the leg. The patient must wear such a bandage for 5 to 14 days. If the pain syndrome is quite pronounced, then you can drink non-steroidal anti-inflammatory drugs ( ibuprofen, indomethacin, diclofenac, etc.), which have analgesic and anti-inflammatory effects. On top of the dressing in the first 1 - 2 days, you can also apply cold compresses. From 3 to 4 days, the patient is further prescribed thermal compresses and physiotherapy for accelerated healing of damaged ligaments.

Heel bruise

Immediately after a heel bruise, it is necessary to attach an ice bag to it and drink an anesthetic ( ibuprofen, analgin, indomethacin, diclofenac, etc.). Cold compresses should be applied only on the first day ( 1 - 2 day) and as needed ( until swelling subsides and pain in the heel decreases). Painkillers are also sold in ointments and have almost the same names as their tablet counterparts. If there are abrasions or wounds at the site of the foot injury, then they must be lubricated with some kind of antiseptic ( brilliant green, iodine, hydrogen peroxide, etc.) and apply a sterile bandage on top. Local anesthetics ( ointments, gels) in the presence of open lesions on the heel should not be used, as this can lead to additional infection in the skin of the foot. After a foot injury, it is advisable to consult a traumatologist. This needs to be done immediately immediately), because heel bruises are often complicated by a fissure of the calcaneus, damage to the Achilles tendon and ligaments of the ankle joint.

Gout

Anti-gout medications are prescribed to treat gout. colchicine), non-steroidal anti-inflammatory drugs, uricosuric ( accelerate the excretion of uric acid from the body) and uricostatic ( reduce the formation of uric acid in tissues) drugs. The last two groups of drugs ( uricosuric and uricostatic agents) should only be taken after an attack of pain, as they affect the concentration of uric acid in the blood and thus may contribute to an increase in the duration of an attack of gout. Also, with gout, a special diet is prescribed, which completely excludes the use of various products by the patient ( sardines, red meat, anchovies, alcohol, spinach, liver, etc.), affecting the level of uric acid in the blood.

Diabetic angiopathy

In case of diabetic angiopathy of the lower extremities, complex treatment is prescribed. In order to correct carbohydrate metabolism, the patient is prescribed a diet that includes the consumption of a certain amount of carbohydrates per day, as well as insulin therapy ( administration of insulin to lower blood glucose levels). To normalize microcirculation in the foot area, analogues of prostaglandin E1 are prescribed ( angioprotectors), anticoagulants and antiplatelet agents ( prevent thrombus formation in blood vessels). To get rid of the infection in the area of ​​​​ulcers, patients are prescribed various antibacterial drugs and antiseptics. Antiseptics most often use a place in the form of compresses. Ulcerative defects themselves are treated surgically ( remove dead tissue in the area of ​​ulcers). Such patients are also recommended to prescribe special unloading shoes, unloading bandages to reduce the risk of new foot ulcers and accelerate the healing of existing ones.

Epiphysitis of the calcaneus

Epiphysitis of the calcaneus is not a serious pathology. It is treated fairly quickly and only in a conservative way. Such patients are advised to give full rest to the sore leg, to avoid physical exertion. It is better for them to change the sport for a while. These patients should definitely wear a heel pad - an orthopedic device that is installed between the heel and the sole in the shoe. It helps reduce stress on the heel area and reduces traction on the Achilles tendon during leg movement. With intense pain, cold can be applied to the heel ( ice bag). With epiphysitis of the calcaneus, physiotherapy treatment helps very well, therefore, physiotherapy is often prescribed for such patients ( electrophoresis, massage, mud baths, ultra-high frequency therapy, microwave therapy, ultrasound therapy, etc.).

In very rare cases ( for example, when pain in the heel is unbearable The doctor may prescribe non-steroidal anti-inflammatory drugs to the patient. These drugs reduce inflammation in the tissues and relieve pain in the heel. However, these funds should not be abused, since the disease is not so serious and dangerous. Pain in the heel during treatment will not go away immediately, sometimes they can last more than one week ( sometimes up to 1-3 months). It all depends on the speed of fusion between the partially separated sections of the calcaneus. If a calcium or vitamin D deficiency is detected in a child, he is prescribed appropriate drugs. In severe clinical situations ( which is quite rare) in such patients, a plaster cast may be put on the leg to completely immobilize the injured limb.

Osteochondropathy of the calcaneal tuber

With significant pain in the heel, non-steroidal anti-inflammatory drugs are prescribed. It is recommended that the sick leg be given complete rest or significantly reduce the static load on it. The latter can be realized with the help of special orthopedic insoles ( heel pads), made of gel and placed under the heel when wearing shoes. In rare cases, the doctor may make the patient temporarily immobilize the limb by applying a plaster splint to the lower limb. To accelerate tissue healing in osteochondropathy of the calcaneal tuber, all patients are usually prescribed multivitamin preparations and undergoing various physiotherapeutic procedures ( electrophoresis, ultra-high frequency therapy, microwave therapy, ultrasound therapy, etc.). With timely access to a specialist doctor, the prognosis of treatment, in most cases, is favorable.

Bursitis

With Achilles bursitis and posterior calcaneal bursitis, comfortable shoes with or without a soft back edge should be worn. Patients with these pathologies are prescribed various local anti-inflammatory drugs based on NSAIDs ( non-steroidal anti-inflammatory drugs) or glucocorticoids in combination with anesthetics ( painkillers). In some cases, the doctor has to puncture an oversized synovial sac to remove the accumulated exudate in it ( pathological fluid). In addition to drug treatment for Achilles bursitis and posterior calcaneal bursitis, physiotherapy is also prescribed ( electrophoresis, ultra-high frequency therapy, microwave therapy, ultrasound therapy, etc.), which quite well helps to reduce inflammation in the affected synovial bags. If conservative treatment fails, the patient is scheduled for bursectomy ( surgical removal of the synovium).

Reactive arthritis

Reactive arthritis is treated with anti-inflammatory drugs ( diclofenac, naproxen, ibuprofen, ketoprofen, etc.), immunosuppressants ( Plaquenil, azathioprine, delagil, methotrexate, etc.) and antibiotics ( ciprofloxacin, rondomycin, spiramycin, tetracycline, etc.). Antibiotics are used to destroy the remnants of the infection ( most common urogenital chlamydial infection) in the patient. Immunosuppressants ( suppress the activity of the immune system) and anti-inflammatory drugs help well to stop pain in the joints and in the heel region.

Tuberculosis of the calcaneus

The choice of treatment for calcaneal tuberculosis depends on its severity, the presence of complications, and the prevalence of the destructive process. In the initial stages of the disease, when the pathological focus in the calcaneus is small, they resort to conservative treatment, which consists in massive antibiotic therapy, including several types of antibiotics prescribed by a doctor according to special therapeutic regimens. In the later stages of the disease, and also when conservative therapy was found to be ineffective, the patient is prescribed surgical treatment, consisting of mechanical removal of dead tissues of the calcaneus and disinfection of the cavity formed inside it.

Osteomyelitis of the calcaneus

A patient with osteomyelitis of the calcaneus is prescribed antibiotics, immunomodulators ( increase immunity), vitamins, detoxifying agents. In addition to drugs, he is shown surgical treatment, which consists in opening a purulent focus in the calcaneus, cleansing it of pus and dead tissues, and thoroughly disinfecting the site of purulent inflammation. After surgical treatment, the patient is recommended to undergo a course of physiotherapy ( electrophoresis, ultrahigh-frequency therapy, etc.), which includes methods aimed at reducing inflammation and destroying the remaining infection in the calcaneus. It should be noted that osteomyelitis is a rather dangerous pathology that requires specialized medical care, so all stages of its treatment the patient must undergo in a hospital ( hospital).

Why do heels hurt in the morning?

Many diseases of the heel zone ( heel contusion, osteochondropathy of the calcaneal tuber, reactive arthritis, gout, diabetic angiopathy of the lower extremities) begin to manifest themselves in the morning. This is explained by an increase in physical load on the heel area. When the patient gets out of bed, most of his weight while walking is pressing on the damaged and inflamed anatomical heel structures ( calcaneus, talocalcaneal joint, subcutaneous tissue, skin, Achilles tendon, ankle ligaments, etc.), as a result of which he has pain in the heels, and the heels themselves often swell and become red. Pain in the heels with these pathologies can disturb the patient at rest, but their intensity will be much lower ( especially if the patient has previously taken an anesthetic) than when it begins to move in space. In diabetic angiopathy of the lower extremities, the disappearance of pain at rest, as a rule, is associated with the presence of diabetic polyneuropathy in the patient ( nerve damage due to diabetes), in which there is a noticeable decrease in sensitivity in the tissues of the foot.

Why does the back of the heel hurt?

The appearance of pain in the posterior surface of the heel indicates the presence in this area of ​​the pathology of the calcaneal tuber of the calcaneus ( e.g. cracks or Haglund deformations) or stretching of the Achilles tendon, or the appearance of bursitis ( inflammation of the synovium). All these diseases usually occur due to various injuries of the heel zone ( when falling from a height onto the foot, running on uneven surfaces, direct blows to the heel, excessive physical exertion), the use of uncomfortable shoes, the lack of a full warm-up before exercise.

Why does the inside of the heel hurt?

Localized pain on the inside of the heel refers to the heel area, which is located just below the inner ankle) most often occur as a result of her injury, sprain of the medial ligaments of the ankle joint, cracks in the calcaneal tuber of the calcaneus. Much less often, such pains appear due to epiphysitis of the calcaneus. All these pathologies have a traumatic genesis ( origin) and do not represent anything serious ( except for a fissure of the calcaneal tuberosity of the calcaneus). For pain in this area, you should consult with a traumatologist.

Which doctor should I contact if my heels hurt?

If you have pain in the heels, you should consult a traumatologist. With most pathologies of the heel region ( Haglund deformity, tarsal tunnel syndrome, calcaneal fissure, calcaneal spur, Achilles tendon sprain, ankle sprain, heel contusion, osteochondropathy of the calcaneal tuber, calcaneal osteomyelitis, bursitis, calcaneal epiphysitis) it is this doctor who is able to fully help the patient.

If such pains are simultaneously associated with pains in other joints, it is better to go for a consultation with a rheumatologist, since the defeat of several joints at once most likely indicates that the patient has an autoimmune or metabolic disease ( e.g. reactive arthritis, gout, systemic lupus erythematosus, rheumatoid arthritis, etc.). If, with pain in the heels, ulcers appear on the skin of the heel region and the patient has the main symptoms of diabetes mellitus ( increased desire to consume food and water, weight loss, frequent going to the toilet), then he should definitely go to an endocrinologist.

What ointment can be used when the heel hurts?

It is advisable not to use ointment for pain in the heel until their cause is established. This is due to the fact that with some pathologies of the heel zone, local remedies ( ointments, gels, sprays, etc.) may turn out to be either completely ineffective ( calcaneal tuberculosis, calcaneal osteomyelitis, diabetic angiopathy, tarsal tunnel syndrome, gout, reactive arthritis), or insufficiently effective ( calcaneal fissure, osteochondropathy of the calcaneal tuber, calcaneal epiphysitis). For many of these pathologies, it is necessary to take drugs in tablet form.

For other diseases ( e.g. heel contusion, Achilles tendon sprain, ankle sprain, heel spur, Haglund's deformity, bursitis) heel zone ointments help quite well, which is why they are prescribed to the patient in most cases. In addition, local remedies do not have such a toxic effect on the body as tablets do. Local remedies act much faster, as a result of which they are preferred for injuries of the heel zone and if the patient has a superficial inflammatory process.

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually prescribed for heel pain ( NSAIDs), painkillers and local irritants. NSAIDs ( diclofenac, indomethacin, ketoprofen, etc.) reduce pain, swelling and redness at the site of injury. An ointment based on non-steroidal anti-inflammatory drugs is recommended to be applied immediately after the injury. Also on the first day, you can use an ointment that includes an anesthetic ( anesthetic), for example, menovazine. A few days later, after the swelling at the site of injury subsides, the patient should apply locally irritating ointments to the painful area ( finalgon, viprosal, gevkamen, nikoflex, etc.). It should be remembered that locally irritating ointments should not be used on the first day after injury, as they contribute to increased swelling.

Why does the heel hurt and it hurts to step on?

Pain in the heel when stepping on it occurs in the vast majority of pathologies of the heel zone ( osteochondropathy of the calcaneal tuber, Haglund's deformity, calcaneal fissure, calcaneal spur, Achilles tendon sprain, heel bruise, calcaneal osteomyelitis, bursitis, calcaneal epiphysitis, calcaneal tuberculosis, etc.). This happens because when walking, the main part of the body weight falls on the calcaneus, resulting in compression of the inflamed tissues ( skin, subcutaneous tissue, periosteum, tendons, ligaments, etc.) in the heel, equipped with a large number of nerve endings. Therefore, it is quite difficult to say which pathology causes pain in the heel when stepping on it. To clarify the diagnosis in such cases, it is necessary to take into account the localization of pain, other symptoms ( for example, the patient has a temperature, pain in other joints, the presence of ulcers on the skin of the heel surface, etc.), as well as conduct the necessary research ( blood tests, x-rays, computed tomography, etc.).

Why does the heel hurt on the side?

The most common cause of lateral pain ( outside) heel is a stretching of the lateral ligaments ( calcaneofibular and anterior talofibular ligaments) of the ankle joint, which occurs when the foot is accidentally turned inward ( stepping on the outer lateral surface of the foot), which is often observed when walking, running. Pain during stretching of the lateral ligaments of the ankle joint is associated with damage to the structure of their connective tissue fibers. Pain on the side of the heel can also be caused by a fissure of the calcaneus or epiphysitis of the calcaneus. The symptoms of both of these pathologies can be quite similar to sprains of the lateral ligaments of the ankle joint. In addition, it is extremely difficult to recognize these pathologies only by symptoms, therefore, in these cases, the patient is assigned to undergo an x-ray examination of the heel region. Pain in the heel with epiphysitis and a fissure of the calcaneus is usually caused by inflammatory processes inside it.

Why does the sole of the heel hurt?

Sole pain is most often associated with plantar fasciitis ( heel spur), in which there is inflammation of the plantar aponeurosis. Slightly less often, the cause of their occurrence can be tarsal tunnel syndrome, which is a consequence of mechanical compression of the tibial nerve in the tarsal canal ( medial ankle canal), located behind the medial ( inner side) ankles. With this syndrome, pain can radiate ( spread) on the rest of the sole or rise up to the gluteal zone. Sole pain can also be a sign that the patient has a heel injury, in which the tubercle of the calcaneus is often damaged and its crack occurs. Such pains can appear with diabetic angiopathy of the lower extremities, tuberculosis and osteomyelitis of the calcaneus.

What folk remedies can be used when the heels hurt?

Folk remedies are rarely used in the treatment of diseases of the heel zone, due to their low effectiveness. Some of these diseases are generally not recommended to try to treat with folk remedies. First of all, this applies to such pathologies as calcaneal fissure, tarsal tunnel syndrome, Haglund's deformity, gout, diabetic angiopathy of the lower extremities, reactive arthritis, calcaneal tuberculosis, calcaneal osteomyelitis, calcaneal epiphysitis, osteochondropathy of the calcaneal tuber. In the presence of these diseases, the patient needs qualified medical care.

Folk remedies can usually be used for mechanical injuries of the foot - bruises of the heel, sprain of the ankle joint or Achilles tendon, bursitis. Sometimes they help with plantar fasciitis ( heel spur). It should be remembered that before self-medication, you must first consult with your doctor.

Folk remedies that can be used for heel pain are as follows:

• Tincture of white acacia flowers. This tincture is used for heel spurs. For its preparation, white acacia flowers are taken and mixed with vodka in a ratio of 1/3. Tincture of white acacia flowers should be lubricated with the sole of the foot several times a day.
• Tincture from marsh cinquefoil. Take and mix the roots of marsh cinquefoil with vodka in a ratio of 1/3. After that, this mixture must be insisted for a day. This tincture is recommended to use 2 tablespoons 3 times a day. Marsh cinquefoil tincture is usually indicated for patients with plantar fasciitis.
• Potato compress. Potato compresses are often applied to the site of injury with a bruised heel, sprained ankle or Achilles tendon, as well as various types of bursitis. To make such a compress, you need to take a few raw potatoes and chop them on a grater. After that, a gauze compress should be made from the resulting slurry, which should be applied to the injury site several times a day.
• Compress from plantain leaves. Take one tablespoon of dry, crushed plantain leaves and mix them with finely chopped onion ( 1 small onion). After that, an equal amount of honey should be added to this mixture. All this must then be placed in a boiling water bath and well placed. The resulting aqueous solution then needs to be insisted and filtered. Compresses can be made from it, which are applied to sore spots on the heel that have arisen from a heel bruise, sprain of the ankle joint or Achilles tendon.
• Horsetail infusion. To prepare it, you need to place 50-60 grams of dry horsetail grass in 500 ml of boiling water. The resulting mixture must be insisted for 30 - 60 minutes. After this, the tincture must be filtered and made into a gauze compress, which should then be applied to the sore heel 2-3 times a day.

What causes a child's heel pain?

Heel pain in a child is most often caused by various types of traumatic injuries ( calcaneal epiphysitis, heel contusion, ankle sprain, Achilles tendon sprain, calcaneal fissure, osteochondropathy of the calcaneal tuberosity), in which tissue inflammation is noted ( bones, tendons, ligaments, subcutaneous tissue, etc.) of the heel zone. Heel injuries are common in children. Their appearance is associated with high physical stresses that their body is exposed to in various sections, on the street, on various hiking trips, etc. Despite the fact that these loads have a favorable development for the growth and development of the child, in some cases they can be a little harm their health. The fact is that in children at an early age, the entire bone-articular-ligamentous apparatus is not yet fully formed, so excessive physical activity can adversely affect its condition. Equally important in this case is the hereditary predisposition of the child to various injuries.

If the child began to complain that it hurts to step on the heel, the first thing to check is whether he has any mechanical damage. The activity of children often leads to injuries and sprains, causing parents to worry. A mild bruise goes away in a couple of days, and in more serious cases, you can not do without the help of a doctor. If you cannot independently determine why the child has pain, it is better to show it to a specialist.

If a child complains of pain in the heel for no apparent reason, it is necessary to consult with the attending physician

Causes of heel pain in children

The most common causes of heel pain include:

Pathology	Reason for the appearance	Treatment tactics
Apophysitis	Inflammatory process in the bone caused by trauma. Usually occurs in active children (during dancing, sports, etc.).	Reduce the load on the injured area, in case of severe pain - taking analgesics. The doctor may also prescribe anti-inflammatory drugs, warm herbal baths and exercise therapy.
Osteochondropathy	Local vascular disorders.	Bed rest, physical therapy.
Achilles bursitis	Swelling of the heel bag caused by improperly fitting shoes.	Bandaging, heating, compresses, rest.
Achillodynia	Inflammation of the Achilles tendon caused by exercise or uncomfortable shoes.	SWT, in advanced cases - surgical intervention.
Epiphysitis	Damage to cartilage or bone attachments caused by an overly active lifestyle	Physiotherapy, restriction of physical activity, if necessary - vitamin complexes.
Schnitz's disease (we recommend reading:)	Inflammation of the synovial bag, which leads to pain in the heel.	Anti-inflammatory drugs and physiotherapy.
Tendinitis	Inflammation of tendon tissue	Anti-inflammatory drugs, analgesics.
plantar fasciitis	Inflammatory-degenerative changes in the plantar fascia.	Orthopedic devices, as needed - painkillers.
Sprain	Sudden movements that exceed the normal amplitude of the joint.	Bandaging, the first time - bed rest.
bruises	Mechanical injury to the leg without damaging its skin.	Depending on the severity. Light bruises go away on their own in 5-6 days. In severe conditions, painkillers may be taken.
Fracture in the heel	Swipe. Often - a fall from a great height.	Plaster, bed rest.

The cause of the pain may be a fracture in the heel region, in which case the child will be required to put a cast

To what doctor to address, what researches are carried out?

If your child has a heel pain, you should make an appointment with the pediatrician. He is a general practitioner and will be able to quickly determine what it could be. In complex cases that require specific diagnosis and treatment, the pediatrician will give a referral to narrow specialists - a traumatologist, neurologist or rheumatologist (depending on the alleged pathogenesis of pain).

Classical diagnosis includes the study of anamnesis and x-rays. The latter is performed only in the presence of severe pain in order to exclude a fracture. To exclude inflammatory diseases, you will need to donate blood for the presence of leukocytes and the determination of ESR. As a rule, examination and superficial palpation are sufficient for a specialist. The diagnosis will take no more than 9-10 minutes.

First aid for acute pain

In the vast majority of children under 7 years old, the heels hurt due to mechanical damage, so the first thing to do is to lay the child down. If it is clear that the cause of the symptom is an injury, examine the leg for swelling. Ice may be applied to relieve pain.

Self-administration of medications is not recommended for children under 10 years of age, as inappropriate use of pills can lead to health problems.

Types of therapy

Treatment, regardless of the diagnosis, will be complex. The doctor prescribes a list of drugs, taking into account the age of the patient, the type of disease and the severity of the condition. Another important event is physiotherapy. Foot baths, therapeutic exercises can be used, frequent exposure to fresh air is recommended. The need for certain actions is determined by the doctor.

Medical therapy

Pills in childhood should not be abused - this does not affect the growing body in the most favorable way. Before giving a medicine to a child, carefully study its composition to prevent allergies to any of the components and the occurrence of other adverse reactions. It is also necessary to pay attention to the minimum age limit from which the drug can be used.

Approximate treatment regimens for each pathology were described in the table above, so it is worth dwelling on specific drugs. Tablets are used taking into account the pathogenesis of the disease and are allowed only with an accurate diagnosis. If the cause of pain is nonspecific, analgesics are allowed (Nemisulide, Paracetamol), if infectious - antibiotics (Azithromycin, Amoxiclav). In inflammatory diseases, non-steroidal drugs (Ibuprofen) are prescribed.

Special orthopedic shoes

An equally important component of the treatment of heel pain is wearing the right shoes. Flat soles must be avoided, as they create additional stress on the heel due to pressure. Additionally, special orthopedic insoles are used. These devices help to redistribute the load on the longitudinal arches of the feet, and the leg is held in the correct position.

Physiotherapy

If at first rest and bed rest are the main assistants in recovery, then later a special exercise therapy may be prescribed. The set of exercises is individual for each case. The correctness of the performance of certain actions should be monitored by a specialist, since any amateur activity is dangerous. It is the attending physician who decides at what stage of the disease it is necessary to prescribe gymnastics.

What else can you do to help a child?

Additional ways to alleviate the course of the disease:

• ice compresses, which help reduce swelling by reducing blood supply
• application of a tourniquet in cases where there is severe blood loss;
• dressings that facilitate gait by eliminating possible overload of the heel;
• foot baths with the addition of anti-inflammatory preparations (chamomile, thyme, lemon balm);
• wearing instep supports helps to form the correct position of the leg and speedy recovery.

When it appears in a child, it puts parents at a loss. Small children do not receive intense stress on the lower limbs, so pain in the legs is the first sign of serious disorders in the body.

The child complains that he is worried about discomfort during and after walking. Rarely, pain occurs at rest. The correct actions of adults after such complaints will significantly reduce the risks of future health problems for the baby.

How to understand that the heel hurts?

While the child is not talking, it is difficult for parents to understand the reason for evening whims. When he has already learned to speak, the child complains that there is heaviness in the legs.

Often there is a slight swelling, induration, it is painful for the baby to step on the heel. It is impossible to independently diagnose the reasons for the loss of the ability to walk. It is recommended to visit the consultation of an orthopedic doctor, undergo diagnostics, take tests.

Sometimes the legs are exposed to an unbearable load, because the child may complain of pain due to ordinary fatigue. Often, when such complaints are received, parents should reconsider the motor activity of their crumbs.

Causes of discomfort

There are many reasons why a child has heel pain. Almost all of them pose a danger to a rapidly growing organism, because the bones have not fully formed.

Baby's feet can hurt for a number of reasons. :

It happens that dystrophic processes in the body are diagnosed. The reason that a seal has appeared on the heel or a sharp pain is disturbing is diseases: fasciitis, apophysitis, osteochondropathy, achillodynia, Schinz's disease.

The provoking factors are:

• flat feet;
• infectious lesions;
• scoliosis;
• congenital anomalies;
• lack of vitamin D, minerals.

It is necessary to evaluate the clinical picture of the disease, to collect a complete anamnesis of the child's life. Then the doctor will make a final diagnosis.

Possible consequences

When a child has, the consequences can be quite serious, and sometimes irreversible. Such a symptom, if not properly treated, can cause problems with the baby's bone skeleton, provoke various joint and fascial inflammations, and become the cause of chronic diseases of the internal organs.

Attention!

Parents need to remember that the skeleton is the support of the human body. If it is disturbed, the whole body suffers.

Which doctor should I contact?

When a child has sore heels when walking, a visit to the doctor should be scheduled for the next date of admission. Consultation should not be postponed until worse times.

Which doctors treat heel diseases:

• pediatrician;
• orthopedist;
• neurologist;
• hematologist.

A small patient must visit all the doctors, pass the appropriate tests, and undergo an X-ray examination. As a result, a conclusion will be issued, the specialist will give recommendations, prescribe treatment.

Video

Video - Causes of joint pain in children

Treatment

Heel pain should be treated with symptomatic remedies if children complain that it hurts. But it is much more important to influence the root cause of this symptomatology. As a rule, after the exclusion of all presupposing factors from the life of a child, the child becomes easier, he quickly recovers.

What is included in the therapy:

• medicines;
• physiotherapy (exposure to current, light, ultrasound);
• wearing specialized shoes;
• physiotherapy exercises;
• compliance with the rules of ergonomics.

Of course, with severe pain, medications, injections, droppers for emergency therapy are prescribed. When the child began to complain of pain in the legs, it is recommended to replace the shoes by choosing an orthopedic option.

Medicines

Medicines are prescribed by a specialist for serious forms of the disease.

1. Infectious manifestations require the use of antibiotics.
2. Unpleasant sensations, pain and swelling are eliminated with the help of an ointment with a cooling or warming effect.
3. Vitaminized complexes replenish the lack of substances.

Synthetic vitamins can be replaced by the establishment of a diet, the composition of which will be rich in the presence of all the necessary substances required by a growing body.

Parents should not independently decide on the advisability of using medicines, it is better to entrust this matter to a competent doctor. Foot baths are helpful. In warm water, it is recommended to add sea salt, soda, 50-100 gr. for 3 liters of liquid.

Orthopedic shoes

A kid who complains of heel pain should definitely wear orthopedic shoes. Well, if it is made according to the individual measurements of the foot, it is also allowed to use ready-made options.

Orthopedic shoes have a pronounced arch support, as well as a well-reinforced heel counter, which distinguishes them from ordinary shoes. The foot is tightly fixed, the insole repeats the natural curve of the foot. This pleasure is quite expensive, but it is not worth saving on children and their health.

Physical exercises

Competently built physical education classes are therapeutic, help to eliminate diseases.

Useful sports:

You can do exercises for foot therapy by visiting specialized institutions or at home. If parents decide to give preference to training at home, you should still visit a couple of classes with a trainer. He will evaluate the physical abilities of the child, then make the most suitable workout based on these data.

Sports stores sell special mats for such activities. They have many different irregularities, which allows you to massage the legs when the child walks barefoot on them.

The Importance of Ergonomics

The circumstances that the baby is exposed to daily also affect his health. The formation of the skeletal system is influenced by a number of factors, sometimes completely unrelated to the legs.

What else can be done for the health of the crumbs:

1. Buy an ergonomic mattress and pillow that follows the curves of the child's spine and other parts of the body.
2. For classes, it is recommended to select a table and chair, based on the proportions of the child, his height.
3. You should also protect the child from carrying heavy loads, especially on a regular basis.
4. Watch how the baby holds his back. Problems with the spine always cause diseases of the legs.

The future health of a small person directly depends on the implementation of the rules of ergonomics. The importance of suitable household items that the baby uses daily should be assessed.

Prevention

It is always much easier to pay attention to prevention than to the subsequent treatment of diseases. This statement is about the health of the feet. In addition to buying new shoes, parents should instill in their son or daughter a love of physical activity.

Unfortunately, professional sports are not a guarantee of health, but regular exercise manages to keep the body in good shape.

What else to do:

• You have to take care of nutrition. It should be balanced, regular, contain all the necessary trace elements, vitamins, minerals. For help in building a diet, you should contact a nutritionist.
• Walk barefoot on sand, gravel, rocks, and other uneven surfaces. Such impromptu workouts strengthen the muscles and joints of the foot.

Pain is not the norm for a child's body, so the timely reaction of parents to such complaints can be decisive for the future health of their own child.