Apophysitis calcanei must be distinguished from other diseases that are associated with similar symptoms. To make a diagnosis, a detailed medical history is taken and the symptoms are examined. Decisive factors are the pain in the heel bone and the circumstances of the patient.
In addition, an X-ray image is helpful, which may show a fragmented apophysis of the calcaneus. This may also be the case in children without symptoms. The X-ray image is mainly used to exclude other diseases, e.g. joint problems, injuries of the Achilles tendon or rarely occurring tumour diseases.
If no clear diagnosis can be made after the medical history and the X-ray and further clarification of the cause of existing unclear pain is desired, an MRI examination can be performed. Bones and soft tissues (muscles, tendons) can be shown very precisely and possibly provide information. With the help of imaging, changes in the apophysis of the calcaneus, but also changes in the structure of the foot, which lead to incorrect loading, can be made visible. With the help of imaging, changes in the apophysis of the calcaneus, but also changes in the structure of the foot, which lead to incorrect loading, may become visible.
The treatment options for heel pain are very varied. First of all, it is recommended to take care of the affected foot/foot. The heel bone should be loaded as little as possible so that the irritated areas can recover.
Sporting activities should be paused or at least the feet, such as long runs etc. etc. , should be excluded.
Acute pain can be relieved with the help of painkillers, but these should only be taken for the duration of the acute pain and should not be used for the primary healing of the heel. In addition, anti-inflammatory ointments can be applied to the heel region to alleviate inflammatory symptoms. Ultrasound treatments can also contribute to healing in this case, as they stimulate the tissue to regenerate.
It is possible to wear a heel wedge or cushion in the shoe, so that the shoe is cushioned in painful areas (heel cushion/heel soft bed) on the one hand, but on the other hand also leads to a reduction of tension on the calf muscles. As a result, the Achilles tendon, which attaches to the heel bone, is less tense, the mechanical pull on the heel bone decreases and, as a consequence, the pain also decreases. In addition, cold applications with ice can lead to a reduction in pain.
If too much body weight is involved in the development of the disease, weight reduction should be worked on to prevent other long-term damage. Regular stretching of the calf muscles can also be helpful to prevent long-term shortening. Taping is a modern technique that involves applying elastic adhesive tapes to painful areas.
Taping is used for a wide range of complaints and is very popular because it is painless and has no side effects. In the area of the heel, the application of a tape can serve to relieve the Achilles tendon and to relax the calf muscles, thus supporting the healing process of the heel bone. A combination of a muscle-oriented and a ligament / tendon structure-oriented tape system is used.
Crucial for the effectiveness of the tape is the correct application of the adhesive tapes, which can usually be done by physiotherapists. Insoles for heel pain are used for two different reasons On the one hand, shoe cushions are used to cushion painful areas and make the shoe more comfortable to wear. On the other hand, there are specially shaped heel wedges which are intended as an insole in the shoe and relieve the Achilles tendon by elevating the heel.