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Heel spur

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Heel spur The heel spur (plantar fasciitis) is a chronic disease resulting from a microtrauma of the plantar ligament (fascia). The resulting bone growth (osteophyte) causes painful pain - a pointed spike up to 12 mm long, which squeezes the surrounding soft tissues. The neoplasm may not be visible externally, but to determine its location simply by pressing on the areas of the heel.



Heel Spur Development Mechanism

Plantar fascia - fibrous tissue, ligament connecting the calcaneus with the heads of the metatarsal bones. It supports the longitudinal arch of the foot. During walking, jogging, plantar fascia tissues experience the greatest tension just at the site of its attachment to the calcaneal tubercle. Normal microtrauma of the plantar ligament overgrow, recover independently. But permanent injury to the fascia often becomes the cause of the restructuring of the periosteum, the very bone tissue.

The mechanism of planar fasciitis can be associated with:

  • myctrotam ligaments at the site of its attachment;
  • development of aseptic (germ-free) inflammation in the injury zone;
  • irritation with loads of periosteum of the calcaneus.

Calcium salts are deposited in zones of inflammation, forming an osteophyte (heel spur). According to X-ray studies and studies using magnetic resonance diagnostics, doctors have found that 40% of the “thorns” are located in the plane of the fascia, and 50% above it. Structures "perpetrators" of their formation are the flexor muscles of the toes.

Spurs can form on one or both heels.

Causes of heel spurs

Each year, more than 2 million people are forced to seek treatment for heel spurs, with 70-80% of them being women, most often urban residents over the age of 40. Doctors highlighted several major causes of the disease:

  • flat feet - is the cause of the formation and growth of osteophyte in 90% of all cases;
  • age-related changes - abnormalities in the blood supply system of the lower extremities, reduced regenerating ability of tissues;
  • pregnancy;
  • overweight - increased load on the human foot when walking;
  • injuries, pathologies or diseases of tissues, nerves, vessels of the lower extremities - gout , diabetes, rheumatoid arthritis , etc.

In young people, intense sports training, wearing “wrong” shoes, such as high-heeled shoes and shale, can cause the heel spur.

Symptoms of heel spurs

The formation and development of an osteophyte may be asymptomatic, for example, if the cause was not of a permanent nature. In some cases, the heel spur is found by chance during an X-ray examination for other indications.

initial stage

The first symptom is a feeling of discomfort or “nail” in the heel when walking. This symptom is associated with the pressure of bone formation (osteophyte) on soft tissue. Although growths in the form of "nail" almost never occur. At one time in medicine there was an opinion that the neoplasm is a “continuation” of the calcaneus.

The intensity of the pain depends more on the location of the growth than on its size. Pain is stronger if the "spur" is formed close to the nerve endings. At the initial stage of the formation of growth of pain can disappear for a while, then resume again.

Initially, pain can only be at the first "starting" steps - when getting up in the morning or after any other long break in movement. But after the first 5-6 steps the pain disappears. In the future, on the contrary, the pain increases with increasing loads.

If untreated, pain also occurs at rest. Gradually, insoluble calcium compounds accumulate in the area of ​​injury. By irritating the mucous membranes of the articular bags surrounding the soft tissues, they also cause pain. The pain is acute, cramping or aching. It can also strengthen and pass gradually or suddenly.

The period from the first symptom to severe pain can range from 2 weeks to several months.

First effects

The second symptom is a consequence of the first - a change in gait. If discomfort appears in the heel area, the patient involuntarily tries to unload it. According to medical statistics, gait disturbances occur in 93% of cases. The improper distribution of the body’s severity to the anterior sections and the outer edge of the foot not only changes the gait, but also provokes the development of transverse flatfoot. It is especially difficult for people with heel spurs on both legs.

"Singing string"

Athletes determine the symptoms of precursors to inflammation of the plantar fascia with the “singing string” test. In the standing position of the athlete, the doctor bends the thumb as much as possible (upwards) and jerks it along the “stretched string” (fascia) up and down. With inflammation, the athlete feels sore and withdraws his leg. The appearance of the heels may remain unchanged.

Diagnosis of heel spurs

Heel spur symptoms It is impossible to diagnose only on the basis of an external examination and descriptions of pain. Pain in the heel area may also indicate other diseases:

  • ankylosing spondylitis;
  • gout;
  • rheumatoid arthritis;
  • osteomyelitis ;
  • bone tuberculosis ;
  • injuries - tendon sprains, bruises;
  • inflammation of the foot or various infections, including intestinal, urogenital.

In addition to collecting anamnesis, the doctor prescribes a number of laboratory and instrumental examinations:

  • blood test - general, biochemical;
  • Analysis of urine;
  • MRI of the foot;
  • X-ray examination of the foot.

The purpose of the events is not just to make a diagnosis, but also to identify the cause of the disease, its severity. In the presence of concomitant diseases, the doctor may recommend consulting other specialists.

Heel Spur Treatment

The method of treatment of the calcaneal spur is selected individually. Attempts to self-treatment can only aggravate the situation - burns, soft tissue damage, partial loss of mobility (movement with crutches).

Modern medicine offers several methods of treating a disease:

  • medications;
  • physiotherapy complex;
  • shock wave therapy;
  • ultrasound;
  • laser exposure;
  • surgical removal of the spike.

Medications

Methods of conservative treatment, primarily aimed at removing inflammation in the affected tissues of the foot. The selection of the drug is carried out by an orthopedic surgeon individually.

These are various gels, ointments, creams, infusions - more effective in the initial stage of the disease.

Another method is the injection of painkillers and anti-inflammatory drugs into the calcaneus. The effectiveness of injections is higher, but it is quite a painful and painful procedure. In addition, a single injection is not enough. Injections are carried out only by a surgeon. What matters is the dosage of the selected drug, the depth and accuracy of its introduction. Errors are fraught with the development of inflammation, osteoporosis, and suppuration. Frequent injections can damage or destroy fascia tissue.

Plasters containing painkillers, antiseptics, natural ingredients are most convenient to use.

Analgesics are not a cure - it is only one of the means to relieve pain. Minus painkillers - the likelihood of addiction and the occurrence of dependence on them.

Contraindications - individual intolerance to the components that make up the drugs.

Physiotherapy complex

The complex of gymnastic exercises, massage, mud and mineral baths, ultrasound therapy can reduce exacerbation.

To improve the medication effects on the areas of affected tissues are used:

  • electrophoresis - drugs penetrate deep into the soft tissues under the influence of galvanic current (low-voltage electrical impulses);
  • Sonophoresis - the penetration of drugs by using ultrasonic waves.

The physiotherapy complex may also include injections of corticosteroids — anti-inflammatory steroid drugs in admixture with an anesthetic are injected into the sole or heel area.

A wide range of activities allows you to choose the means for almost any patient.

Shock wave therapy

Under the influence of ultrasonic pulses, calcium deposits are “broken up” into tiny particles that are removed from the patient’s body through the bloodstream.

At the same time, shock-wave therapy activates the process of soft tissue regeneration, reducing inflammation, swelling.

The use of shock-wave therapy at the initial stage allows you to remove the heel spur completely. The use of the technique in advanced cases relieves inflammation, inhibits or completely stops the growth of calcium growth.

The technique has contraindications:

  • low blood pressure;
  • pregnancy;
  • bleeding disorders;
  • heart rhythm disorders;
  • intoxication, for example, due to intestinal poisoning, medication;
  • nervous system disorders;
  • malignant neoplasms;
  • thrombophlebitis in the area of ​​the affected area.

Also, the method is contraindicated in the presence of acute infections of any nature.

Heel Spur Treatment Exposure to ultrasound

Ultrasonic waves relieve pain, reduce inflammation due to deep warming of tissues. Penetrating into the damaged fascia, ultrasound accelerates its healing at the cellular level. Muscles relax, blood flow to the ligaments and tendons increases, swelling decreases.

Laser

A beam of light is sent to the damaged area. A positive effect is observed after 2-6 sessions, depending on the characteristics of the disease, the characteristics of the patient. Penetrating to a greater depth, the laser stimulates metabolic processes in damaged tissues, accelerates their regeneration.

Surgical method

The purpose of the previous techniques is to reduce inflammation, prevent and inhibit the growth of bone growth, and regenerate soft tissues. Surgical intervention allows you to completely get rid of the growth, but does not guarantee its re-emergence, so the doctors turn to this method only in extreme cases.

The amount of surgery depends on the nature of the disease. During the operation, the plantar fascia is partially or completely cut with simultaneous removal of the spur itself and the damaged tissues. But with complete (disconnecting) fasciotomy, the anatomy of the foot is disrupted. As a result, a change in gait becomes a cause of disability.

Minimally invasiveness is characterized by radiofrequency microtenomy (burning). Under the influence of high-frequency electromagnetic radiation, damaged tissues and nerve fibers are destroyed, which allows to remove pain syndrome completely.

The effectiveness of any technique depends on the timeliness of diagnosis of the disease and the implementation of a complex of preventive measures to prevent its development. Do not use the many "popular" means, even if they helped friends. At best, they will simply be ineffective.

Preventing heel spurs

Preventive measures for the prevention and development of the disease can be summarized by the abbreviation HLS (healthy lifestyle). There are several areas of prevention of heel spurs:

  • body weight control;
  • prevention of premature aging of the osteo-articular apparatus;
  • prevention of injuries, wear of the osteo-articular apparatus;
  • timely diagnosis and qualified treatment of diseases of the musculoskeletal system.

Corns, ingrown nails, bruises often cause changes in the position of the foot and create conditions for injury to the plantar ligaments. In the presence of discomfort, pain in the heel area, you should immediately consult a doctor and begin treatment.

Body weight control

Overweight does not only increase the load on the longitudinal arch of the foot. At the same time, a lot of weight can be evidence of metabolic disorders, various diseases that can directly or indirectly affect the condition of the plantar fascia, stimulate the formation of the heel spur.

Prevention of aging of the osteo-articular apparatus

An active lifestyle, proper nutrition, control over the state of your health will allow you to avoid premature aging of the joints and bones. Particular attention should be paid to the state of bone tissue after 40 years - the risk of osteoporosis. Medicine offers a variety of mineral-vitamin complexes to support the health of the musculoskeletal system.

Prevention of injury and wear

Wearing the wrong shoes, intense loads during sports training are also a common cause of heel spurs.

Shoes with high heels should be worn no more than 3-4 hours a day. Orthopedists do not recommend flip-flops, sandals and other types of shoes without a backdrop for constant wear. Shoes should be with a small heel - 3-4 cm and firmly on his feet.

For flat feet, you must purchase orthopedic shoes or use corrective insoles.

According to medical statistics, almost 25% of jogging people experience heel pain. The reason is non-professional approach to training. Sports are useful only with proper exercise. During races, jumps, athletic walking, it is required to monitor the position of the foot, gradually increasing the load. In the case of injuries, sprains, professionals advise to reduce the intensity of training or abandon them until full recovery. Renew interrupted classes need gradually.

Timely diagnosis

The effectiveness of therapeutic measures largely depends on the timeliness of diagnosis of the disease. Seeing a doctor at the first signs of the heel spur will help to avoid its complications. People who are in the “risk group” - with flat-footedness, pathologies and diseases of the joint and bone apparatus, undergo regular physical examination. Self-medication, folk remedies is unacceptable! The use of medical equipment should be carried out only on the recommendation of a doctor and under his supervision.

Diet with heel spur

One of the most important places in the treatment of heel spurs is diet. Osteophyte is formed from uric acid salts. Therefore, the main goal of the diet is to normalize acid-base balance, excretion of salts and reduce the risk of inflammatory processes in the body. Starvation can provoke an exacerbation of the disease, therefore it is completely excluded.

General recommendations:

  • reduced consumption of fish, meat, cereal, low-fat dairy products;
  • regular consumption of vegetables, fruits, fatty dairy products;
  • plentiful drink - up to 3 liters per day: alkaline mineral waters, decoctions and dogrose, coriander, nettle, chicory infusions; reducing the consumption of easily digestible carbohydrates - sugar, honey, candy, chocolate, etc.
  • rejection of mayonnaise, ketchup, hot spices;
  • rejection of alcoholic beverages, including beer;
  • to give up smoking.

The exact diet is selected by the attending physician for the health reasons of the patient. Observing such a diet helps to improve overall health.

Heel spur in children

The reasons for the formation of heel spurs in children are in many respects similar to “adults”:

  • flat feet;
  • overweight;
  • injuries;
  • diseases and pathologies of the musculoskeletal system;
  • infections.

Up to 18 years, children's foot has good elasticity and therefore is easily deformed.

Treatment and prevention of heel spurs in children

Treatment methods are also similar to adults and are selected depending on the age of the child, the severity of the disease. More often, in treating heel spurs in children, only conservative treatment methods are sufficient.

More difficult with symptoms. A sign of the formation of heel spurs in a child may be complaints of pain, change in gait, posture, decrease in motor activity. Be sure to pay attention to the state of children's feet. Corns, ingrown nails, bruises force the child to put the leg incorrectly, which can cause deformity of the foot and injury to the fascia.

Footwear

For a child, shoes, sandals, sneakers are not just shoes, but also a “form” for his feet. Therefore, it should be selected according to the age of the child. Booties with a soft sole fit only “sliders”, only occasionally standing on the legs. Babies taking the first steps should choose shoes with a leather sole on a small heel - about 1 cm and with a good fixation on the leg.

If adult slippers are not recommended, slates are not recommended, then they are prohibited for children! The presence of such shoes on store shelves is not a confirmation of its “usefulness”.

Ballet shoes, sneakers are not suitable for everyday wear. It is also not recommended to put children in second-hand shoes. Each child tramples the insole, wears out the sole in its own way.

Heel spur in pregnant women

In addition to common causes, the risk of heel spur formation in pregnant women is due to physiological changes - softening of ligaments during pregnancy. Diagnosis and treatment of the future mother is difficult because of the limitations of using certain methods and medications. Therefore, preventive measures are especially important:

  • daily foot massage (not for edema);
  • adherence to diet;
  • refusal of bad habits - alcohol, smoking;
  • wearing comfortable shoes with 2-4 cm heel lift;
  • use of prophylactic insoles instep supports.

Pregnant women (especially in the third trimester) can not stand still for a long time - queues, stops, but quiet walks are useful.

In the case of the formation of the heel spur during pregnancy, treatment is usually limited to sparing painkillers - ointments, patches, less often injections, so as not to harm the health of the baby.


| 5 December 2014 | | 10 351 | Uncategorized
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