Heel pain
Very pain can be quite difficult to walk, stand and exercise. A well-known example is pain under the heel at first steps in the morning or after a period of rest. In others the pain occurs during or after long standing, walking or sports. The heel can feel sharp, stabbing or nagging and sometimes there is also stiffness, swelling or a burning sensation.
The cause may lie in overload of the tendon plate under the foot, Achilles tendon or other structures around the heel. Sometimes an injury or condition is involved.
Acupuncture and Chinese herbal medicine can be used to reduce pain and support recovery. The treatment is tailored to the cause, character and duration of your complaints and can be combined with for example exercises, physiotherapy, podotherapy or modifications in load and footwear.
Western disorders in which heel pain can occur
Very pain is a symptom and can have several causes. Common disorders are:
- plantary fasciitis: irritation of the tendon plate under the foot, often with pain under or on the inside of the heel;
- heel trail: a bone protrusion on the heel bone that occurs regularly together with fasciitis plantar, but does not always cause complaints;
- Achilles tendon complaints, including complaints regarding the attachment of the Achilles tendon to the heel leg;
- mucus exchange inflammation around the back of the heel;
- contusion, stress fracture or other injury;
- Gout or inflammatory rheumatism.
Not everyone with heel pain is diagnosed with a specific condition. Also overload of muscles, tendons and connective tissue around the foot and only can cause symptoms.
Possible causes
Overload is a common cause of the heel pain. The complaints can arise after a sudden increase in walking, running or sports, but also due to long standing or always the same load.
The position and mobility of the foot and ankle can also influence. Flat feet, a high arch, limited movement of the ankle, tense calf muscles and less suitable footwear can change the load on the heel.
In addition, age, body weight, previous injury and certain conditions such as diabetes, gout or inflammatory rheumatism may contribute to the onset or persistence of heel complaints.
How can acupuncture help with heel pain?
Acupuncture looks at the exact location and character of the pain, when it occurs and what loads or other factors are associated with it. Also the tension and motility of the foot, ankle and calf can be taken away. The treatment can be adjusted during recovery.
Acupuncture may include:
- reduce pain and tenderness around the heel;
- reduce tension in the foot and calf;
- reduce stiffness and support the mobility of foot and ankle;
- support the recovery after overload or injury;
- gradually improve foot capacity for activity;
- support prolonged or recurrent heel complaints.
For mechanical reasons, it is important to look at loads, footwear, footstands and exercises as well. Acupuncture can therefore be combined with physical therapy, podotherapy and a gradual build-up of sports or walking loads.
How can Chinese herbal medicine help with heel pain?
Chinese herbs can be used in addition to acupuncture, especially when heel pain is present for a long time, comes back regularly or is part of a broader grievance image. As herbs are taken daily, they can also provide support between acupuncture treatments.
Depending on the underlying pattern, Chinese herbal medicine may focus on:
- support the flow around the heel in case of sharp, local or persistent pain;
- treat pain and stiffness when cold or humid weather clearly worsens the symptoms;
- treat heat and swelling when an inflammatory image is in the foreground;
- supporting muscle and tendon recovery after overload or injury;
- to support general taxable capacity and recovery in the event of prolonged or recurrent complaints.
The composition is tailored to your complaints and general health and can be adjusted during the treatment course. Herbs are not required for every form of heel pain; in a mainly local or mechanical complaint, the emphasis may be on acupuncture, exercises and adjusting the load.
How does Chinese medicine view heel pain?
Within Western medicine, we look at the structure or condition that can explain the heel pain, such as fasciitis plantar, an Achilles tendon problem or injury. The traditional Chinese medicine (TCM) also looks at the nature of the pain and the circumstances that caused or continues to cause the complaint.
In case of pain problems, the meridians and the flow of Qi and Blood are particularly central. Meridians are seen within TCM as compounds through the body that circulates Qi and Blood. Around the heel are the Bladder and Niermeridian. Therefore, the precise location of the pain can help determine which meridians receive attention during treatment.
An important starting point within TCM is that pain occurs when the free flow in an area is obstructed. After overload, this disturbance can be relatively mild, while after injury or prolonged complaints a stronger local stagnation may occur. Cold and moisture can also impede movement around muscles, tendons and joints. A warm and swollen heel looks at a different pattern.
In case of prolonged heel complaints, the general support for tendons and bones can also be considered. Within TCM these functions are inter alia connected to the Liver and Renal Organ Systems. A TCM organ system is not only meant for the anatomical organ but a collection of functions and relationships within the body. These patterns are especially relevant when helping with, for example, reduced strength, weakness of knees or ankles or low back problems.
A recognizable combination of such characteristics is called a TCM pattern. Two people with the same Western diagnosis, e.g. fasciitis plantar, can be treated differently.
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns may occur at the same time. Not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall picture of your symptoms.
What's a meridian?
Most common TCM-patterns in heel pain
Qi- and Blood stagnation
At Qi- and Blood stagnation, the local flow around the heel has been hampered. This often occurs after overload or when walking, standing or exercising repeatedly provokes the same pain. If more stagnation occurs, the pain can become sharper and more persistent.
Common symptoms: clearly localised pain, tenderness to pressure, pain during or after stress and sometimes stiffness after rest. If more stagnation occurs, the pain may be sharp or stingy and may also remain at rest.
Examples of Western disorders: plantar fasciitis, Achilles tendon symptoms and other overload complaints around the heel.
Blood stasis
At Blood stasis the local stagnation is stronger and usually more persistent. This pattern can occur after a fall, bruising or other injury, but also when local heel pain lasts for a long time.
Common symptoms: sharp or stabbing pain, clearly defined pain spot, strong sensitivity to pressure and prolonged complaints after injury. The pain may also be present at rest or at night.
Examples of Western disorders: prolonged heel symptoms after trauma, bruising and chronic local pain after an earlier injury.
Wind-Cold-Dampness
According to TCM, cold and moisture can hinder the free movement around muscles, tendons and joints. This pattern fits especially with heel pain where temperature and weather conditions clearly influence the complaints.
Common symptoms: a cold, stiff or heavy heel, pain that gets worse due to cold or damp weather or cold feet and improvement by heat and quiet movement. Sometimes there is slight swelling.
Examples of Western disorders: prolonged muscle, tendon and joint complaints in which cold and stiffness play a clear role.
Damp-Heat
At Dampness-Heat is a warm and inflammatory image in the foreground. The heel can clearly be warm and swollen and the pain may feel burning or pounding.
Common symptoms: warmth or redness around the heel, swelling, burning pain and a heavy feeling in the foot. Heat can worsen the symptoms and cooling may feel pleasant.
Examples of Western disorders: some mucus fair infections, gout and inflammatory symptoms around the heel.
Liver and Kidney deficiency
Within TCM, the Liver and Renal Organ System are inter alia linked to support for tendons, bones and joints. This pattern is seen especially in long heel complaints where recovery and general capacity for activity are reduced. Local stagnation may be present simultaneously.
Common symptoms: chronic whining heel pain, symptoms that increase after prolonged standing, walking or exertion, weakness or stiffness of knees and ankles and sometimes low back discomfort. Rest often gives relief.
Examples of Western disorders: long-term fasciitis plantar, chronic Achilles tendon symptoms and other recurrent or degenerative complaints around the heel.
Outlook
How quickly heel pain improves depends on the cause, duration and severity of the complaints and the extent to which the heel is loaded daily. A recent overload or mild injury can recover relatively quickly, while fasciitis plantar, prolonged Achilles tendon symptoms or complaints that have been present for months usually require more time.
In the initial phase, it is often treated about once a week. For acute or severe symptoms, treatment may be more frequent temporarily. When pain decreases and strength improves, the frequency can usually be reduced. These are guidelines; the course of treatment is tailored to your situation.
In the case of overload complaints, it is important to look at footwear, foot and ankle mobility, exercises and the construction of standing, walking or sports. A gradual increase in the load can help to recover and help prevent complaints from returning.
When is medical research important?
Medical assessment is important for sudden severe heel pain, inability to bear weight normally, marked swelling or redness, a wound or signs of infection. Persistent unexplained pain or symptoms after a clear injury may also require further investigation.
Contact
Do you suffer from all the pain and want to know if acupuncture can do anything for you?
During a first consultation, we will discuss your complaints, medical history and any underlying factors. On the basis of this, a treatment plan will be drawn up that matches your situation.
You can make an appointment directly online or contact us for more information.