What Causes Heel Pain?
Differential diagnosis
Detailed Answer:
Hi Kolava, thanks for asking from HCM.
I can understand your concern. You are having complaint of pain in plantar aspect of feet. It could be due to multiple reasons
- nerve involvement - painful sensations can occur due to sensory nerve damage. It can be due to
Diabets
B12 deficiency
L5-S1 central disc herniation
Neuritis
Symmetrical sensory polyneuropathy
- Plantar fasciitis - It occurs due to prolonged standing, lifting weight. In it, pain occurs more on standing and relief on lying down.
- Peripheral vascular disease like atherosclerosis/Burger's disease/vasculitis- Pain occurs more on walking, doing exercise. Skin becomes pale, hair loss.
These are the probable reasons. Kindly give me details of your complaint to suspect some diagnosis.
What is the duration?
What is condition of feet, skin?
Is there any history of alcohol, diabetes, smoking?
Is there any history of prolonged standing, lifting heavy weights?
Is there any other chronic illness?
Hope it will help you. If any doubt, do let me know.
Thanks. Take care.
Painful neuropathy or reflex sympathetic dystrophy
Detailed Answer:
Hi Kolava, welcome back.
Thank you for providing me the detailed history and answers. Your history is suggesting you are having extremely sensitive extremities, redness, burning pain. There is history of injury. Such kind of sensitivity following injury can be due to
- Painful sensory neuropathy
- Reflex sympathetic dystrophy
In neuropathy, there is no swelling or redness. So it is more likely reflex sympathetic dystrophy. In it, there is pain, tenderness, burning sensations, redness, flushing, discolouration, shiny skin.
It is also known as complex regional pain syndrome.
For diagnosis, you need to consult doctor. It is diagnosed based on the clinical features described previously. Blood tests are not abnormal because of it, though the associated triggering events mentioned previously may lead to abnormalities in laboratory testing. Plain film X-ray testing and MRI scanning can show patchy thinning or significant osteoporosis. Nuclear bone scanning can show characteristic uptake patterns.
The treatment is greater in the earlier stages of the condition than in the later stages.
- Cool, moist applications to the affected areas can provide some relief of burning symptoms.
- Gradual exercise can help prevent contractures.
- Medications for pain and inflammation can also reduce symptoms.
For persisting symptoms, high doses of prednisone (cortisone) may be used for periods of weeks, depending on the response, and then gradually reduced.
- Other medications that may be of benefit include amitriptyline, pregabalin and clonidine.
You can discuss it with your doctor. Please let me know what was the examination findings and investigations?
If any doubt, do let me know.
Thanks. Take care.