Causes
Mainly imbalances in the muscular system, ligament weakness in the ankle joints, deformations of the foot or systemic diseases of the locomotor system lead to pain above the heel. This leads to overloading or incorrect loading of the Achilles tendon, which becomes irritated and can become acutely inflamed. In extreme cases, the Achilles tendon can even tear.
Constant overloading of the Achilles tendon often leads to a chronic inflammation, a so-called tendinitis. The inflammation leads to tissue damage and the tendon becomes torn. The cause of the overloading of the Achilles tendon is often sports activities.
But structural changes in the heel can also lead to pain above the heel. For example, an overlying leg can develop on the heel bone, causing discomfort. In many cases, the inflammation of the Achilles tendon turns into bursitis, which causes additional pain. In addition, an upper or posterior heel spur can form. This is understood to be a bony extension at the transition from the tendon to the bone.
Therapy
The treatment of pain above the heel depends on the cause, localization, and duration and extent of the pain. If an acute inflammatory reaction is the trigger for the pain, it is recommended that the Achilles tendon be spared and not stressed for several weeks. Cold applications are perceived as pleasant and can be pain-relieving.
For example, a regular cold shower or bath of the affected area is helpful. The short-term intake of pain-relieving medication (e.g. paracetamol) is also a suitable method for severe pain. Light physiotherapeutic exercises are useful as long as they are performed in a controlled and instructed manner.
This keeps the ankle in motion and does not stiffen it by sparing it. The therapy for chronic inflammation in the heel area is different. Physiotherapeutic techniques such as connective tissue massages, foot and calf exercises, as well as orthopedic aids for the foot play a role here.
In particular, insoles and special shoe fittings such as heel elevations, which compensate for different leg lengths, can be simple aids to alleviate the complaints. In rare cases, surgical therapies are also used.Inflamed Achilles tendon tissue can be surgically removed or a torn tendon can be sutured together. Bony protrusions (e.g. a ganglion) can also be removed by a surgeon. However, in most cases, conservative measures should be exhausted in any case before surgical therapy is undertaken. If the inflammation and symptoms persist for several months after conservative treatment, surgical therapy should be considered.
