Heel pain is the pain of the metatarsal surface of the heel (i.e., the heel) caused by a variety of chronic diseases, which is closely related to strain and degeneration, and the clinical manifestations are mainly pain, swelling and pressure on the metatarsal surface of the heel, aggravated by walking. The disease occurs mostly in obese people after middle age, with a high incidence in men and a simultaneous onset on one side or both. Causes of heel pain? 1, plantar plantar tendinitis: the most common cause of heel pain is a long-term, chronic, minor trauma caused by the accumulation of lesions, manifested by the rupture of fascial fibers and their repair process. There can be osteophytes in the vicinity of the inner fascia below the heel bone, forming a bone ridge. On lateral radiographs it appears as a bone spur. The latter is often thought to be the cause of heel pain, but clinical studies have demonstrated that its causal relationship with heel pain is difficult to establish with certainty, that metatarsal fasciitis is not always accompanied by bone spurs, and that people with heel spurs do not always have heel pain. Heel pain caused by metatarsal fasciitis can be cured naturally. Elevating the heel, reducing the tension of the Achilles tendon on the heel bone, and plantarflexing the forefoot to relieve the tension of the plantar fascia can all reduce symptoms. Plantar tendon membrane is the tendon tissue on the bottom of the foot to maintain normal arch, cushion shock and strengthen the role of bouncing force. Prolonged walking and excessive weight-bearing can cause strain on the plantar tendon membrane, leading to local aseptic inflammation and painful symptoms. 2, heel spurs: Most often seen in elderly patients, when there is heel pain, after taking X-rays, you can find the formation of bone spurs of different sizes at the heel nodes. Raised bone spurs, easy to make local tissue friction, strain, and produce aseptic inflammation, the degree of heel pain is related to the severity of the local inflammatory response, but not directly related to the size of the bone spurs. 3, plantar fat pad atrophy: heel pain in the elderly is more complex, in addition to the above two possible causes, in old age, the elasticity of the heel pad decreases, the plantar fat pad atrophy, its role in cushioning shock, preventing friction is weakened, the heel bone in the absence of padding to bear weight, in serious cases, scarring and calcium deposits can be formed, causing heel pain. Often occurring in the elderly, the heel pad is an elastic liner formed by the fibrous tissue below the heel bone as a spacer, with fatty tissue and elastic fibers. In youth, the heel pad is highly elastic and can absorb oscillations. In old age, the elasticity of the heel pad decreases, and the heel bone bears weight without a pad, which can lead to scarring and calcium deposits in severe cases, causing heel pain. Heel pad pain differs from metatarsal fasciitis in that there is pressure pain throughout the lower part of the heel. Treatment is by using sponge heel pads or local drug injections. 4. sub talar arthritis: It often occurs after heel fracture and is a kind of traumatic arthritis. anterior tarsal sinus on radiograph, pain is aggravated by weight bearing. Often occurs after a heel fracture and is a form of traumatic arthritis. anterior tarsal sinus on radiograph, pain worsens with weight bearing. If conservative treatment fails, heel talar fusion should be performed. Old heel fractures or, rarely, tumors or tuberculosis of the heel bone are also causes of heel pain. Disorders outside the heel that cause heel pain include rheumatoid spondylitis, lumbar disc herniation that compresses the sacral nerve roots, and tibial nerve extrusion that occurs in the lower leg. 5, heel osteoarthritis: often occurs in boys aged 8 to 12 years, the lesion is similar to the calf tibial tuberosity osteoarthritis, is in the development process, the unhealed epiphysis by the tendon pull caused by the symptoms, pain in the Achilles tendon attachment point below, can be bilateral at the same time. Running and toe standing can aggravate the symptoms. The symptoms disappear naturally after the epiphysis heals. Generally symptomatic treatment can reduce the activity of the child, and heel pads can also be used to reduce the pull of the Achilles tendon on the heel bone. 6, posterior heel bursitis: most likely to occur in the bursa between the Achilles tendon and the skin, caused by frictional damage from inappropriate high-heeled shoes. Bursa wall variable hypertrophy, the bursa is filled with synovial fluid, local swelling, and pressure pain. The treatment method is to improve the shoe type. If the swelling of the bursa does not subside, puncture and suction can be performed, and hydrocortisone can be injected. Differential diagnosis of heel pain: 1. Foot pain: common symptoms of ankylosing spondylitis include heel pain, foot pain, and intercostal muscle pain. 2. swelling and pain below the anterior aspect of the outer ankle: most acute ligament injuries of the ankle joint have a clear history of trauma. The patient can be found to have swelling and pain below the front of the ankle, localized pressure pain, subcutaneous petechiae, limited joint movement and claudication, etc. 3. Toe pain: Gouty toe pain mostly occurs in middle-aged men. It often starts acutely. Most of the patients have red, swollen and hot pain in the joints of toe and ankle. Prevention of heel pain should be noted? Avoid wearing soft, thin-soled shoes as much as possible. Second, the heel should be protected by thick soft pads, and hollow heel pain pads can also be applied to vacate the bone spur site to reduce local friction and injury. Third, often do plantar stirrups to enhance the tension of the metatarsal tendon membrane, strengthen its ability to resist strain and reduce local inflammation. Soaking feet in warm water, supplemented with physical therapy when available, can reduce local inflammation and relieve pain. Fifth, when there is persistent pain, some non-steroidal anti-inflammatory and analgesic drugs should be taken orally for treatment. Sixth, if the pain is severe and seriously affects walking, local closed treatment is the most effective treatment method. How to exercise for heel pain? What about heel pain? Doctors especially pointed out that patients with heel pain should avoid long-term standing and long-term walking, the heel should be protected by thick soft pads, avoid wearing thin-soled shoes, more warm water foot soak, supplemented by physical therapy when available. In addition, often do three movements can also relieve heel pain. 1, arch stretch: lie flat on the bed, lift and straighten the leg, wrap the front of the foot with a towel, then pull the towel with both hands, stretch the ball joint at the root of the big toe and the ankle until the knee is straight and the foot slowly points to the nose. This method can effectively stretch the heel fascia. 2, foot pedaling action: lying flat on the bed, feet straight, simulating the action of boarding a bicycle, this action can enhance the tension of the metatarsal tendon membrane, strengthen its ability to resist strain and reduce local inflammation. 3, toe pinch method: this exercise is specifically to stretch the muscle tissue groups under the plantar fascia, as long as the toes are simply bent to make as if to hold a pencil posture can be.