Diagnosis
For a diagnosis that explains the heel pain, it is first of all very important to take a medical history. It is important that any risk factors and other current or past illnesses that could still affect the heel are assessed. An exact description of the symptoms (when, where, how often, how severe) should also be provided.
The doctor then carries out a physical examination, in which he first takes a close look at the entire body with a special focus on the legs (are there any malpositions? What is the posture like? How is the patient walking?)
and then checks muscle strength, sensitivity and reflexes. In addition, he should check where exactly the pain is located and whether it can be triggered by pressure, for example. Depending on what the doctor suspects after an initial examination, further diagnostic procedures are used in addition. For example, imaging procedures (X-ray, computed tomography, magnetic resonance imaging, scintigraphy), blood analyses or joint endoscopy (arthroscopy or tendoscopy) can be used to arrive at a final diagnosis.
Therapy
The therapy of heel pain naturally depends on its cause. Especially if the pain in the heel is caused by overstrain, it is often helpful to spare the heel for some time. If present, overweight should be reduced and stressful sports (e.g. jogging) should be avoided for a while.
For effective relief, it can be helpful to wear specially adapted shoes or insoles, at least temporarily, to reduce the pressure on the heel during running. Heel cushions and pads are also available for the same purpose. In worse cases, the patient should consider walking with crutches for a while.
Cooling the heel (with ice cubes or cooling pads) is also considered by many to be pain-relieving. For most forms of heel pain, appropriate physiotherapy can help. Here, certain stretching and gymnastic exercises are learned and performed as regularly as possible in order to relieve the strain on joints, tendons and muscles on the one hand and to strengthen them on the other.
Special connective tissue massages are also successfully used in physiotherapy to treat heel pain. Further possibilities are the transcutaneous electrical nerve stimulation (TENS; in this procedure electrical impulses are transmitted through the skin from outside, which are able to activate the pain-inhibiting system of the body. Homeopathy or osteopathy are also therapeutic options that provide relief for some patients.
Painkillers, preferably from the group of non-steroidal anti-inflammatory drugs (NSAIDs, for example ibuprofen or diclofenac), can of course be used to accompany severe pain. In the case of more extensive damage (for example, tears of the Achilles tendon or heel bone fractures), surgery is sometimes necessary. For example, tissue can be removed, a fracture reduced or a tendon transplanted as part of a surgical procedure. If there are underlying diseases (tumors, circulatory disorders, metabolic disorders, etc. ), these must of course be treated adequately in order to permanently relieve the pain in the heel.
