Heel pain is a common clinical symptom in middle-aged and elderly people. Chinese medicine considers the deficiency of kidney yang as an important factor in causing the disease. Heel pain is a comprehensive set of symptoms caused by lesions in different tissues around the heel bone. Etiology As the body ages, degenerative changes occur in the tissues of the body and long-term strain causes pathological changes in the tissues of the heel. Such as heel fatty fibrous pad inflammation, metatarsal tenosynovitis, heel bursitis, Achilles tendon periarthritis, heel hypertension and heel bone spurs. These corresponding diseases in different tissues around the heel bone are the important causes of heel pain. Clinical manifestations and diagnosis 1, heel fat pad inflammation The heel fiber fat pad, referred to as the heel pad, is composed of elastic fibers separated and wrapped around fatty tissue, which has the effect of absorbing shock and preventing slippage. Heel stabbed by hard objects or long-term compression or wind, cold and damp invasion caused by heel pad inflammation. The patient has pain and swelling under the heel with superficial pressure pain. Heel weight-bearing area medial pressure pain, the elderly heel pad atrophy thinning, easy to cause symptoms, local can be palpable fibrous cord masses. 2, metatarsal tendonitis metatarsal tendon membrane from the heel node and to the metatarsal bone, is the plantar larger elastic tendon membrane. Trauma, strain and cold and humidity can cause inflammation of the metatarsal tendon membrane, and those with valgus foot are especially prone to this disease. Patients often have pain under the heel or the heart of the foot, plantar tugging and tension, the heel node area and tendon membrane in the middle of the pressure pain is obvious. 3, heel bursitis Trauma or repeated friction can cause inflammation of the bursa under the heel, after or before the Achilles tendon. Patients have local pain, swelling and pressure pain. If combined with infection can cause redness, swelling, heat, pain and other typical inflammatory manifestations. 4.Achilles tendon periarthritis Inflammation of the tissues around the Achilles tendon attachment site due to trauma or strain causes swelling and pain in the Achilles tendon. The patient’s Achilles tendon becomes thicker, with localized pressure pain and a sense of friction, and axial griping sounds may appear when the inflammation affects the tendon sheath. The pain can be aggravated by dorsiflexion and plantar flexion of the ankle joint. Achilles tendon periarthritis is often due to wearing hard heel, hard shoes, long-term pressure friction formation. 5, heel hypertension The heel bone itself due to chronic compression or bone degeneration, the internal pressure of the heel bone increases, resulting in heel pain. Achilles hypertension is mostly seen in middle-aged and elderly people, and can develop unilaterally or bilaterally, with pain in the heel affecting walking. Early elevation of the lower extremity may relieve the symptoms, and there is pressure and percussion pain on the medial, lateral and metatarsal sides of the heel. Heel decompression therapy is effective. 6, heel bone spur Repeated strain injury to the metatarsal tendon membrane and toe flexor or Achilles tendon, degenerative changes in the heel bone, the metatarsal tendon membrane of the heel bone attachment part of the formation of cone-shaped bone called bone spur. The direction of the bone spur is mostly consistent with the direction of the Achilles tendon and the metatarsal fascia. The heel spur can be clearly seen on lateral radiographs of the heel bone. However, patients with heel spurs do not necessarily develop heel pain. When heel pain is present, the heel spur is often present after treatment has resolved the inflammation in the soft tissues surrounding the heel bone. The heel spur is a characteristic manifestation of degeneration and aging of the bones and joints in the elderly. Treatment The onset of the disease varies from site to site, but heel pain is a common feature. The pathological changes are inflammatory changes in the soft tissues surrounding the heel and increased intraosseous pressure in the heel bone. Treatment mainly uses acupuncture, massage, physiotherapy, topical blood circulation drugs, hydrocortisone acetate 25mg plus 1% procaine 2ml or hydrogenated prednisone acetate plus lidocaine 2Tnl painful point local seal, so that the local sterile inflammation subsides. Fibrofatty pad inflammation of the heel can be treated with soft insoles hollowed out in the middle of the heel. Surgical excision may be considered for bursitis that is persistent. If conservative treatment of the heel spur under the oblique front is ineffective, surgical excision can be performed, and the muscle attachment point can be relocated, and the inferior heel nerve can be cut in cases of persistent pain. In cases of intraheel hypertension, decompression of the medial and lateral heel spurs is possible to eliminate the symptoms. Heel fracture, fracture deformity healing, heel tuberculosis, osteomyelitis, gout, tumor and metatarsal tunnel syndrome can cause heel pain, which should be differentiated from the above diseases.