Talalgia with plantar heel or in clinical term, is defined tallodinia inflammatory disease, painful heel, namely the region of the foot that corresponds to the back and bottom of the heel, also called the heel.
The causes of the disease vary depending on the affected areas, namely:
soft areas (tendon inflammation, fasciitis, bursitis, etc..)
areas bone (stress fractures, heel spurs, arthritis talus-calcaneus, tumors, etc.).
It is not uncommon that even the pain occurs due to postural alterations that somehow alter the structure and breech loading on this area. This can happen for various reasons such as overweight or obesity, unsuitable footwear, sporting activities.
The sports most at risk are running, soccer, volleyball, basketball, walking and all those disciplines that involve substantial efforts to heel region. Do not underestimate these shoes used for sports activities that need to be equipped with a special heel, called a shock absorber, capable of reducing vibration and impact stresses. Women who move from high-heeled shoes to flat shoes may suffer because the pressure on the heel bone and ligamentous structures of the heel increases with the decrease in height of the heel.
Several types of bead
The hooker may be located at the longitudinal arch, with or without concomitant pain in the heel, and in this case is called plantar fasciitis. Typically, the pain originates in the middle of the arch and by palpation of the nodules can also detect, in turn painful. The pain appears in the morning when you start to walk before moving on, although it may take suddenly during the course of the day.
One of the most frequent causes of plantar talalgia, however, is the heel spur, also called heel spur, a bony protrusion of the heel that may be of congenital origin or occur later. The heel spur is generated because, for various reasons that will be seen later, pronation, ie the support of the foot during gait is altered and this causes inflammation through a continuous traction of the plantar fascia at the insertion point on the heel.
There are various causes of this disease and between the main physical activity which increases the stress and repeated microtrauma possible - perhaps turning wrong shoe shod (narrow or hard edges) or moving on land not suitable - which increases the pressure and irritation causes bruising of the heel and plantar surface of the foot. Not to mention, the overweight or erroneous and distorted postures.
But, of course, the disease can also be caused by systemic and metabolic diseases including it should be noted:
rheumatoid arthritis
Gout
the collagen
rheumatic diseases, etc..
The calcaneus, where there is a secondary center of ossification of the tendon which inserts the heel (Achilles tendon), can be also exposed to osteochondrosis, a disease that is characterized by an alteration of the degenerative-necrotic ossification in the growth. It is striking, in fact, young people between 8 and 13 years, with localized pain in the back of the heel, especially after a long walk. Evolution is always benign and does not cause local deformity even if the duration of the condition can be quite long. In these cases, just an arch support that limits the rear shock, giving at times when the pain becomes more acute anti-inflammatory drugs.
In the elderly, the cause of the heel can find, however, the progressive atrophy of the fat pad infracalcaneare, due to the aging of tissues.
Haglund's deformity and bursitis.
Diagnosis
The heel spurs, also called Haglund's deformity, or "pump bump" consists of an exostosis, which is a congenital bone growths, which most often appears at the posteromedial side of the bone.
This form of bone change very frequently due to bursitis, or inflammation of the bursa anterior to the Achilles tendon and back of the heel, since it causes abnormal pressure on the point where it is and resulting in pain.
The doctor, having collected from the patient all the information needed to classify the disease, since the mode of onset, performs a physical examination of the party concerned, requesting the support of X-rays, ultrasound, magnetic resonance imaging, can show the presence of bone spurs or deformation.
The back of the Achilles tendon bursitis can be diagnosed either by X-ray investigations, which directly experiencing the painful part that usually has a diffuse swelling and the formation of a thick callus on the back surface of the calcaneus.
Possible therapies
Of course the treatment depends largely on the nature and extent of any damage talalgia the heel bone. Keep in mind that a mild disease heals within a few days. If the pain persists beyond two weeks is necessary to use a specialist.
The main piece of advice, especially if the patient is involved in physical activity continues, is to suspend it immediately, waiting to resume its normal function. The heel pain, in fact, should not be underestimated under any circumstances, but above all we must avoid the risk of possible deterioration that can occur if you do not suspend the motor activity, because of what are called compensatory paramorphisms. People who suffer from heel tend to limit the load on the foot sore, but by adopting a particular posture or incorrect change in an unnatural way of walking. Which, in the long run, can cause problems, even serious, pelvis, spine and knees.
The first intervention during the acute phase of illness is, as always, the application of a bag of ice on the painful area. In cases of plantar fasciitis can be effectively undergo stretching exercises that, in addition to the plantar fascia, involving the calf and the Achilles tendon. Later, you can resort to the use of orthotics, so-called "discharge", guardians night, knee-highs that promote walking and, in cases where the pain is particularly intense, it may be advisable the use of crutches. Profits are also physiotherapy, possibly also using crioultrasuoni, a therapy that has recently proven effective in many cases, and iontophoresis. It is clear that if the heel is not resolved within a period of two weeks, it is necessary to conduct further investigations and clinical examinations.
