Heel pain or “talalgia” is pain related to inflammation of the plantar fascia, the thick fibrous membrane that connects the calcaneus (heel bone) to the phalanxes of the foot.
Causes of heel pain
Running
Talalgia can be caused by micro-traumas related to the inappropriate practice of physical activity,such as running and jumping. The heel on the ground receives shocks that can cause inflammation of the insertion of plantar apotheosis. “This is observed in people who are too intense and brutal in physical activity. It is necessary to go gradually!”stresses Dr. Loniewski.
Sever’s disease
Sever’s disease is osteochondrite of the foot, which usually occurs in adolescents. It corresponds to an abnormality in the growth of bone and cartilage.
Ankylosing Spondylitis
Heel pain is one of the symptoms of ankylosing spondylitis, an inflammatory disease of the spine. “Itis an autoimmune rheumatic disease that leads to joint inflammation,”says Xavier Loniewski. The pathology is explored in cases of painful symptoms specific to heels, as these pains can mark the onset of the disease.
Plantar aponévrositis
Apotheosis is a fibrous tissue of the foot located under the skin, in the middle of the arch and attached to the heel and the first phalanxes. It is the plantar aponeurosis that stretches the arch of the foot. It transmits the force needed to propel the foot from the rear forward. The plantar aponeurosis is also an actor of the stability of the plantar arch during walking. “Plantar aponévrositis is when inflammation is not only insertion but the entire fibrous layer.”
Calcaneal spine
“The spine is not a cause, but a consequence of talalgia: it is the ultimate evolution of tendonitis. The inflammation of plantar apotheosis will gradually create calcifying tendinitis,”explains orthopedic surgeon Xavier Loniewski. On the radio, this calcification takes on a similar aspect to that of a thorn. “This development is very common.”
Wearing unsuitable shoes can cause heel pain. “Shoes that are too flat or insoles that are too thin, for example, should not be allowed. On the other hand, contrary to what one might think, wearing heeled shoes does not increase the risk of talalgia – if at all that these heels are not too high.” Bad shoes can also cause Haglund’s disease, which is characterized by a bone defect. “There is a lump behind the heel related to the conflict between the shoe and the calcaneus.”
Other risk factors
Overweight (also in pregnant women) and obesity, flat or hollow feet can lead to talalgia.
Symptoms: How to recognize heel pain?
The pain is felt at the heel, the arch and can radiate up to the ankle (and up to the calf, but to a lesser extent). “These pains occur both actively and at rest, but mainly during walking,” adds Dr. Loniewski. Awakening is also a time for pain: “morning blurring can be painful, as in all inflammatory diseases.” Other possible symptoms include “swelling in the heel, palpation pain.”
Treatments: How to relieve heel pain?
To relieve talalgia, there is a simple and unavoidable remedy:”to pass an ice cube on the heel, which will deflate the area”. Drug treatments include anti-inflammatory creams and patches,as well as nonsteroidal anti-inflammatory drugs (NSAIDs). “Ifthis doesn’t work, silicone-based heels can be prescribed, which cushion the heel impact on the floor, or even custom orthopedic insoles,” explainsXavier Loniewski.
Shock waves are increasingly being used to relieve these ailments. A machine sends shocks to the heel, like a small hammer. “This shakes the heel and causes a vascularization that regenerates the insertion of the tendon. It also eliminates calcification. Eight times out of ten, I manage to cure my patients as well. So we avoid surgery.” Cortisone infiltrations or heel insertion level are also part of the therapeutic arsenal.
