Heel Pain, causes and treatment, plantar fasciitis diagnosis and treatment.
ฝัง
- เผยแพร่เมื่อ 16 ก.ย. 2024
- Dr. Ebraheim’s educational animated video describes different causes of heel pain. it also explains
diagnosis and treatment of heel pain including plantar fasciitis.
Heel pain is an extremely common complaint with several common causes.
1. Plantar fasciitis (the most common cause)
2. Baxters nerve compression (a rare cause)
3. Fat pad atrophy
4. Achilles tendonitis
5. Haglund's deformity
6. Stress fractures of the calcaneus
7. Tarsal tunnel syndrome
8. Lumbosacral spine radiculopathy
So it is difficult to determine the source of the pain and this makes diagnosis difficult or confusing. The most common cause is plantar fasciitis. Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot. This fascia can become inflamed and painful, making walking more difficult. Plantar fasciitis is most severe in the morning. The start up pain symptoms is more severe for the first out and persist with activity through the day. Pain symptoms will intensify with prolonged exercise or standing. There will be tenderness over the plantar medial heel with negative Tinel's sign. X-ray may show a plantar heel spur. Plantar fasciitis is usually associated with a tight heel cord.
The Baxters nerve. It is the first branch of the lateral plantar nerve. The Baxters nerve contributes to 20% of all heel pain cases in this nerve provides motor innervation to the abductor digiti minimi muscle. The nerve courses vertically between the abductor hallucis and the quadratus plantae muscles, then makes a 90 degree horizontal turn, coursing laterally beneath the calcaneus to innervate the abductor digiti minimi muscle. Involvement of the Baxters nerve may affect running athletes causing pain on the medial plantar aspect of the foot. Entrapment of the Baxters nerve is usually overlooked or misdiagnosed.
Fat pad atrophy. The fat pad cushions the calcaneus and in the condition of fat pad atrophy, the fact that cushions the calcaneus is thinned so the calcaneus loses its cushion. This condition is common in elderly people and can cause significant pain while walking. There is always a history of steroid injections. The injections are commonly used to treat plantar fasciitis and they can cause this heel pad atrophy. Patient will have pain when walking. The pain is deep, central, nonradiating plantar heel pain that is worsened when the patient is barefoot and resolves when the patient walks on her toes, with tenderness at the central aspect of the heel pad.
Achilles tendonitis
The patient will have ankle pain for several months (chronic condition).
The patient will complain of pain and swelling because the tendon is thickened with tenderness to palpation about the top of the calcaneus.
Haglund's deformity
The Haglund's deformity is an insertional calcification and exostosis at the insertion of the Achilles tendon. The patient is usually treated by physical therapy and noninflammatory medication. Do not injection through the tendon, rather inject around the tendon. If the symptoms persist beyond 6 months, then surgery may be needed with excision of the Haglund's exostosis and insertional calcification. If more than 50% of the Achilles tendon is detached to remove the posterosuperior calcaneus prominence, and the tendon becomes weak and should be secured to the bone of the calcaneus with suture anchors or tendon transfer to bridge the gap. The operation will be an Achilles tendon debridement, calcaneal exostectomy and FHL tendon transfer, especially if the tendon degeneration is greater than 50% of the width.
Stress fracture of the calcaneus
The stress fractures of the calcaneus can occur due to overuse injuries. The patient will complain of heel pain, severe weightbearing pain in the patient increases with walking and running. The pain associated with the calcaneal stress fracture does not improve throughout the day and each step is painful. The pain is more with medial to lateral compression of the calcaneal tuberosity.
Compression tests or squeeze test
X-ray can be normal. We may need to get an MRI to diagnose the stress fracture of the calcaneus.
Tarsal tunnel syndrome
Paresthesia and numbness in the plantar foot. Symptoms are worse with activity and the paresthesia may wake the patient up at night.
Ganglion cyst of the ankle (tarsal tunnel syndrome). - Known cause of tarsal tunnel syndrome. Check the MRI.
The patient will respond well and have a favorable outcome to excision of the ganglia and the patient may have resolution of the tarsal tunnel syndrome symptoms.
Lumbosacral spine radiculopathy
Pain on the lateral side of the foot can result from L5-S1 herniated disc (will cause radiculopathy). The S1 nerve root supplies the lateral aspect of the foot. Pain on the lateral side of the foot can result from L5-S1 herniated disc. The S1 nerve root involvement causes decreased sensation and pain on the lateral aspect of the foot.
![Retrocalcaneal Heel Bursitis [Pain in the back of the Heel TREATMENT!]](http://i.ytimg.com/vi/U1VFnNMKPtg/mqdefault.jpg)
![BEST Heel Nerve Pain Treatment [Baxters Nerve Entrapment Treatment]](http://i.ytimg.com/vi/1ZqubXExmc4/mqdefault.jpg)
I've seen a couple of "Foot Doctors" due to foot pain and both assumed it was plantar fasciitis. The first at least did an x-ray and put me in a boot to wear day and night which was a waste of time and money. The second made me feel like a statistic. He probed my foot for tenderness and there was none, yet he proceeded to treat it with a steroid injection and set me up an appointment for two weeks later.
I'll never forget the "know-it-all, self-ingratiating smirk" on his face when I went back two weeks later. The first thing he asked how I my foot was now in a self-congratulatory tone. His attitude did not sit well with me, and I honestly replied that there was no difference. Of course, that was not what he wanted to hear so he didn't offer to look any further and never offered a follow-up appointment or even tried to find out what was actually causing the pain.
I don't know where you live or practice but, in the USA, I have witnessed two types of experiences with doctors:
1- They give it their quickest best guess and if they're wrong, they don't want to take the time to figure it out; or
2-They want to run every test imaginable to make sure they get every dime of money they can before they offer any kind of treatment or relief for your pain.
Most of the time, after you've spent tens of thousands of dollars for all the tests they run, including CT scans,
x-ray's, blood & urine samples, and a host of other tests so they can report back to you that they see no cause for the pain so it must all be in your mind. Nothing wrong with you, just go home and suffer. So dammed frustrating especially when you stop and realize we are one of the few countries that has to pay out of pocket for any medical care we receive. Seems like they want to keep us running from one specialist to another for relief until we finally either run out of money or die...or both!!!!
You are 100% right. I'm suffering through the same condition. I got severe pain at the back of my heels since years. Can you please guide me if yours got sorted. Thank you
Comprehensive, yet brief. Best video that I watched recently on youtube.
Thank you Dr. Ebraheim for your simplified, concise yet dense overview for the differential diagnosis of heal pain. The symptoms and treatment reviewed is valuable information assisting those of us with pain to address the issue through lifestyle as well as in consultation with doctors. You are a blessing.
Thank you Professor for a great explanation. I get some ideas now about my foot pain. Foot pain is one of my struggle I face every day:-/
Great video with explicit explanations and visuals- thank you sir
This has to be the best medical-related video on the web! It provides a survey of conditions related to heel pain and their causes and treatment.
د نبيل أنت دآئما رآئع بشرحك وبالصور الذي تزودنا به ، ياريت فيديوهاتك تترجم الى العربية
Click on "CC" button, then click on "settings" button, select "subtitles/CC", then select "Auto-translate", then select "Arabic"
اضغط على زر "CC"
ثم اضغط على زر "settings" واختر "subtitles / CC" ثم اختر "Auto-translate" ثم اختر "Arabic".
Thank you Dr Ebreheim. Without any doubt, your video is the best regarding this heel pain subject. And trust me I have watched a lot. I am still struggling to find out what I have, almost during the last 2 months.
Excellent information. My Dr misdiagnosed me as plantar fasciitis and operated on me. The pain was getting worse, so I requested the MIR and turned out he was wrong all along. I am working on my Calf Muscle with a physical therapy and schedule to check lumb spine. I do believe I have boxer nerve entrapment. Scheduling to see a specialist on baxer.. Its been 12 month already. what a waste. I wish I watch this video before. This video give me the information and hope. thanks so much DR.
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Thank you doctor very well explained for all types of Heel pain'.
Thanks
I was diagnosed with chronic pain in both my heels after an injury (falling from height).
The pain was so bad, it felt like my feet were on fire, worn-out and throbbing.
By chance i found out the podiatrist has a pulse wave machine.
I go there every 6 weeks and get this pulse therapy on the inside of my heels.
I dont get the servere burning feeling anymore. After the treatment my heels feel great..but shortly after an itchyness comes back and some discomfort.
The best and crisp explanation one can give in shortest time.
Thank you for fantastic video.
Thank you very much; I appreciate that.
Thank you very much for this very instructive and enlightening video. I learnt a lot. Real value.
This is an excellent and detailed video. The best info I have found
Can I just trade my feet out for new ones?
Right 😂!!!
Lol ikr
Yeah I gotta pig who wants human feet. Let's swap nfo
excellent explanation. I have heel pain more than 3 months no matter how I stretch as the therapist shows. but where can I get diagnose? Family doctors just ignores my pain.
Thank you for sharing and precise explanation
Thank you very much. I have bad pain for years. Finally remove bone spurt. On left foot 🦶. But is hard to get a good podiatrist and have the insurance aprobé.
Gabriella Barera a ferjemnek ugyan ez volt a prolemaja Budapesten az Istvan korhazba egy alkalommal volt lezerrel szetbombaztak a kinott csontot teljesen fajdalommentes volt minden fajdalma elmult soha tobbe nem fajt a sarka a laba hogy ezt leirtam remelem segitettem Udv.Ovari Magdi
thank you sir you help to humanity
Thank you so much. I needed this. Currently going through this sort of pain. Underwent a few tests but none came out of it. You gave me a clear picture of what is happening. I am in that group where you get severe pain when you get up from the bed in the morning and place your feet on the floor as you tske yyour first step of the day. -- Preethi
Es muy importante su información, tengo fascitis plantar, será posible tener en español
Love your videos, thank you for sharing your knowledge without a paywall!
Thank you
Cảm ơn Bạn đã chia sẽ kinh nghiệm và những hình ảnh thực tế để cho mọi người xem và học hỏi. Thanks you very much.👍🙏😘❤️
Thank you professor!
I bought a scooter at Walmart to have some fun while I exercise every day. Big mistake. Now I have heel pain from "Plantar Fascitis." My sister had a pair of Black colored Flip Flops with a huge hump in the middle for the foot arch. I tried them on at her house and I got instant total relief. Also walking in grass gave me instant total relief. Also Walmart Avia Brand shoes with enduropro comfort inserts helped reduce the pain in my heels by 50%. So in conclusion, I would recommend 1. Avia shoes 2. Walk on grass. 3. Orthotic Flip Flops with Arch Support. - TAV ♥️🇺🇸🌎👍
Freeze a water bottle and roll it under your foot while standing.
@@boboso4705 Thank you. I will try that. - TAV
@@theodorevegh6030 tennis ball also can help
@@boboso4705 OK. Thank you.
Sounds like you’re a TH-cam add for Walmart! Lmao 🤣
The video is very helpful
No Dr had explained in such a detail
Excellent presentation prof
i have high uric acid and i am overweight too, and for most of the time, i have been having heel pain, and the doctors i visited were guessing it's a uric acid pain. But, my pain results from when i walk too much and continuously for days, and it pains around the heel. But after seeing this video, i think, i have the calcaneus stress. after 2-3 years of dealing with it, this is the first time my heel pain would be diagnosed properly.
Thank you for your thoughtful and thorough explanation.
Great explination sir..thankyou sir.
Fabulous video, I think I have identified my own heel problem and the treatment! Thank you so much
Best medical info video on heel pain. I had heel pain intermittently when walking some distance. Docs and physios could not nail down. Sometimes the pain at side of heel or at bottom of centre heel, not at constant location. From this video, it could be associated with nerve. I stopped long walking, occassional pain at centre of heel. Best walking shoes for me is Nike Maxi. I have spur at region of Hagland, but no archilles tendon pain at all. Physio advised regular archilles tendon exer for calf muscles which do help to stretch. Thanks very much Dr Ebraheim.
Very good explanation! Thank you doctor.
Thank you for an informative video. I have been having a lot of pain in my both feet, alternating at each time, which lasts for a few weeks. It gets better after some physio and accupuncture treatment s. Doctor s haven't been able to figure out the cause of pain and where it's coming from. It makes sense in your video that it might be coming from my L5 disc herniation.
That was a great indepth explanation. Thank you.
Excellent sir, best illustration and scientific information...whole topic cover by you in 8 minutes...👌👍🏼👍🏼
Very helpful ! Thank you so much !👍
Thanks sir! This video help me open my mind. It's amazing!
Very good information. Thanks. 👍 Dr's and physios diagnosed me wrongly. 🙄 My pain comes from the spine. I have had a herniated disc for 25 years!!! Heels never treated. So, there you go!! Still have to find the right specialists... 🙏
Beautifully explained in a good speed
This video is so precious and comfortable to listen
Very clear and in detail explanation helpful to understand what is happening to my feet. Thanks a lot
Hola muy buena si página pero podrían colocar subtítulos en castellano , soy de Venezuela y no hablo inglés. Pero si me interesan todos sus temass
Thanks Doc, this was so informative 👏
Good sharing 👍 good knowledge 👍
Hello sir please do a. Video about foot pain other than heel pain.
Iam suffering from foot pain for 2 years
Please check your complete blood count.. the pain is
Due to high content of uric acid
In the blood...
I was facing the same problem.
Now I m ok.
Thank you very much Dr. May God bless u
Sir please explain whole body parts, part by part. Just like heel pain
Great diagnosis this one
Hi, In the several problem of heel, I don't see Heel Bursitis problem!!!
I'm not a physician. and I just like the football and running.
about 5 month ago., my heel start to pain!!! and I did not notice to it! after 5 month of heel pain, I decided to stop any activity, and focusing on heel treatment ......
Thanks for the video
All of your videos are very well made and very well explained... Truely great work Professor
Wonderful presentation.
Thank you. 🙏
Thank you so much
My doctor never say anything it’s normal because of I stand long hours.
But I have pain for 3 years now for my knee to my foot
All you discuss I have it and
The pain is sharp.
Thank you
Thank you for putting up the anatomy chart Professor.
It was very helpful,thank you very much.
Excellent presentation, Dr Ebraheim! Thank you
This is realy helpful.
Thank you very much
Super thorough!
Very good and helpful video. Great doctor.
What are the symptoms for tarsal tunnel syndrome
Thank you so much.
good explanation
Thank you So much it’s was Real greet help full Jazakallah kheir 🤙😀❤️❤️
I'll become an orthopedic doctor watching Dr. NABIL
Thank you Doc as am always in pain
Thank you so much Dr Ebraheim,it's very useful information with great and clear explanation. 🙏🙏💐
Thank you, but you didn’t mention what the treatment for the Baxter ‘s nerve compression is!
I get pain on the left side of my left heel in the mornings and to the touch.
It happened after irritating my achilles while playing soccer, but has lingered longer than the achilles irritation.
I wish I could figure out how to get rid of it.
What thing cause you have that symptom?
@sabbairidaq8825
I went to a camp where we played sports all day every day for one week. On the last day I wore cleats and played soccer and that was the moment it began.
Explicas muy bien zolo falta que salga traducido en español
Thanks sir for detailed usefull information ❤
Pls give advise. For. Dvt problems.
What about flat foot, pes planeus?
Best video ever
Thank you it was helpful. My pain could be from my cyst or Baxter nerve thats where it feels the pain is.. I have suffered from planta fasciitis
I feel the bottom of both feet numb but chiropractor did sensation test and I sense the needle
Excellent video! Thank you.
Hi Dr. What about aneurysmal bone cyst?
Very helpful and to the point - thank you for such a comprehensive tutorial!
This doctor is very professional since 4 years I have a heel pain I take lot of medicine still not find finally I take painkiller only I don't know what to do😒😒😒
Check your cholesterol levels
I have pain around Achilles tendonitis at the joint of haglund it’s been months I have done all possible. I play soccer and it’s getting worse after training . Any help doc
nice information Doctor
Very good explanation. Thanks
Thanks for the information Dr. Nabil Ebraheim. 7 months ago my leg was cut off and only stitched by the clinic nurse. The part that was cut was the abductor hallucis muscle because I couldn't move my big toe to the side. Now when I tiptoe, it hurts a lot in the phalanges of the thumb. My question is whether the muscle can still be reattached as before so that the thumb can be moved back to the side again?
You took a lot of time to write this nonsense, bravo.....
Thanku so much sir.. It really helped me with the differential diagnosis.. Stay blessd
Saya senang dengan vidio ini,nambah ilmu buat saya di bidang alternatif...
Tapi saya belum mengerti bahasa asing.
Mau kah mengartikanya dengan bahasa indonesia
Thanks a lot Sir
Thanks.
Very helpful- thank you so much
Very helpful! Thank you.
Very informative presentation..tnx
Excellent explanation ☺️☺️☺️
Very good good information. Thanks
Extremely good.
Great video 👍👍 Thank you so much 💞🙏🏾💞
Excellent explanation Thank u 👍👍
Worth to learn this.
I am in Tanzania patient how can I get you l am sick of joints in my legs
My last three toes will start to pain after few hours of standing.I have no history of injury on my foot before.
May I know what causes it.
Thank you so much for this very detailed explanation. I suddenly developed severe heel pain and thumb joint pain. It seems my body is being attacked by some foreign entity like one doctor explained about a certain protein in the bloodstream.
Thanks