Achalasia is caused by long-term standing and walking, strenuous activities, resulting in fat pad, bursa, tendon membrane and ligament of the heel being strained and injured, local congestion and edema, aseptic inflammation, scarring, contracture, local stress changes, causing calcification and ossification at the attachment point of the heel bone, forming bone spurs. This disease was first seen in the Qing Dynasty in Liu Hengduan’s “Experiencing Miscellaneous Treatise on the pains”, which is mostly considered by Chinese medicine to be caused by old age and lack of liver and kidney. The onset of the disease is insidious, and the course of the disease is long, so it is called “heel paralysis” in Chinese medicine. Diagnosis】 Usually no history of trauma, slow onset, may have a history of several months or years, pain occurs in one or both sides. The patient complains that the pain is burning, and the pain gradually increases with the course of the disease, especially after climbing with weight or running or jumping. 1, mostly in middle-aged and elderly people, mostly in obese people, more common in men. 2, pain on the bottom surface of the heel, aggravated in the early morning when standing or walking, alleviated after a few moments of walking, and aggravated after walking for too long. 3, heel fat pad inflammation or atrophy, the pressure point in the heel weight-bearing area of the medial side, pressure pain is obvious, sometimes can be touched subcutaneous fat pad fiber block. In severe cases, the local skin becomes soft and feels allergic. 4, metatarsal fasciitis, the pressure pain point is limited to the heel metatarsal fascia attachment, especially the medial side, and can be significantly reduced or disappeared after closure. 5, heel bone spur, when the pressure point and x-ray radiographs show the location of the bone spur has some significance, but the bone spur caused pain is only a minority, only the oblique forward and downward bone spur in the clinical may cause symptoms. 6. X-ray radiographs may show bone spurs of different sizes in the heel bone, especially at the beginning of the metatarsal fascia. Etiology and pathogenesis] Heel pain mostly occurs in middle-aged and elderly obese people aged 40 to 60 years old, mostly due to deficiency of liver and kidney or long-standing disease, weakness of qi and blood, and slackness of meridians, combined with obesity, weight gain, and overloading of the skin, subcutaneous fat and metatarsal fascia at the bottom caused by long walking and standing. The heel bone is composed of spongy cancellous bone, with large venous sinuses in the medullary cavity, and the heel bone is at the lowest part of the body, which is affected by gravity, making arterial injection easy and venous reflux difficult⋯1; with increasing age, endocrine disorders in the body, the heel blood circulation is damaged, leading to stasis or congestion in the heel bone, which increases internal pressure and causes heel pain. The repetitive stress of walking through the inelastic plantar fascia on the medial tuberosity, resulting in repeated tearing of the medial heel tuberosity and repeated fatigue injury to the plantar fascia and intrinsic foot muscle itself, resulting in aseptic inflammation, and chronic injury inflammation caused by repeated stretching of the plantar tendon membrane and plantar muscle at its attachment, and inflammatory stimulation leading to the formation of bone spurs. The main points of evidence】 Heel pain belongs to the category of heel paralysis in Chinese medicine. In addition to kidney deficiency, blood stasis should also be taken into account, because it is not painful to pass, but painful not to pass, and the foot is the lowest part of the body, which is moistened by the continuous flow of qi and blood. In addition, people with kidney deficiency are susceptible to wind, cold and dampness, and wind, cold and dampness invade the tendons and bones, resulting in stagnation of the bones and veins and pain if they do not pass. Therefore, in the clinical treatment of TCM, TCM treatment should be based on the nature of pain, such as dull pain, stabbing pain, thin pain, combined with the accompanying symptoms and tongue and pulse. For those with liver and kidney deficiency and meridian obstruction, nourish the liver and kidney to relieve pain; for those with qi stagnation and blood stasis, treat with qi and blood activation to relieve pain; for those with cold and damp stagnation, treat with herbs to warm the meridian and disperse cold, dispel wind and remove dampness. The main symptoms: pain is fixed, stabbing, obvious when the foot follows the ground in the morning, and can be mildly relieved after walking, and can be significantly alleviated or completely relieved after resting again. Pathogenesis: Long-standing disease, the disease enters the ligaments for a long time, the Qi and blood do not run smoothly and stasis, the stagnant blood is blocked internally, and the pain has a fixed location. Stasis is often seen around the periphery, with dark tongue or petechiae, and astringent pulse is a sign of stasis. Treatment: Regulating Qi, invigorating Blood, resolving blood stasis and relieving pain. The tongue is light and fat, with white greasy coating and smooth pulse. Pathogenesis: The evil of cold and dampness stays, paralyzing the tendons and collaterals, and the qi and blood are not smooth, because the cold nature attracts and the dampness is heavy, the two evils are combined, so the pain is diffuse. Cold and dampness are stagnant, the spleen and Yang are not invigorated, there is a lack of healthy transportation and insufficient source of transformation, therefore, there is coldness in the limbs, poor appetite and weakness. The tongue is pale and fat, the coating is white and greasy, and the pulse is stringent and slippery. Treatment: Warming the meridians and dispersing cold, dispelling wind and removing dampness. Pathogenesis: Due to old age and physical weakness, prolonged illness and kidney, and the kidney is the main bone and marrow producer, so the essence deficiency is kidney deficiency, the waist loses nourishment, so the waist and knees are thin and weak, kidney deficiency is not solid bone, breeding bone spurs, the tongue is light, there are petechiae on the edge of the tongue, the moss is thin and white, the pulse is sunken and thin and astringent is a sign of liver and kidney deficiency. Treatment: Nourish the liver and kidney, promote the circulation and relieve pain. By relaxing the whole foot and all reflex zones and taking medium and heavy strength to treat the heel pain points, together with vinegar compress, it can make the bone spur and keratin layer play a softening role. 2.Needle knife therapy The local bleeding or congestion caused artificially during the operation of small needle knife relaxation, instead, has the effect of improving local blood supply, promoting metabolism and accelerating the absorption of inflammation. Targeted access to the lesion site, cutting, peeling and loosening of the adhesions, release of high tension continuous traction, elimination of muscle and fascia tension spasm, reduction of local soft tissue tension, and restoration of biomechanical equilibrium. 3.Classic food therapy, swelling and pain relief drink 1, composition: 30 grams of raw rice kernel root, 30 grams of adzuki beans, 9 grams of papaya. How to use: Wash raw rice kernel root, adzuki beans and papaya separately, put them into a casserole together, add 500 grams of water, boil for 5 minutes on a rapid fire, change the fire to cook for 30 minutes, remove the dregs and take the juice, and drink in portions. Suitable for early heel pain, heel pain, pressure pain, especially after a long walk 2, wolfberry 20 grams, Shou Wu 20 grams, 500 grams of pork spine, ginger, onion, yellow wine, salt and other seasonings. Usage: the wolfberry, Shou Wu washed separately, pork spine cut into pieces, placed in a pot, add 1 000 ml of water, ginger, onion and people, boil in a hurry, go froth, cook for 3 minutes, then add yellow wine, salt and other seasonings, simmer for 1 hour, divided. Suitable for heel pain in the middle and late stages of heel pain, liver and kidney deficiency type, heel pain, accompanied by weakness of the waist and knees.