Causes of heel pain The causes of heel pain are numerous and complex. Clinically, it is mainly caused by metatarsal tendonitis, heel fat pad lesions, heel bursitis, heel hypertension, heel spur, and nerve entrapment, etc. The incidence of metatarsal tendonitis can be seen in both men and women. Metatarsal tenosynovitis can occur in a wide range of people, including men and women, young people, middle-aged people and old people. However, it is more common in middle-aged women. The onset of the disease is usually unilateral and rarely bilateral. Heel pain is often located in the lower part of the heel. The pain is caused by degenerative changes and inflammation of the metatarsal tendon membrane at the beginning of the heel bone due to repeated trauma. In severe cases it is impossible to walk. The pain of metatarsal tendonitis has a very unique presentation, starting with the worst pain in the morning when you take the first few steps out of bed, which is similar to stepping on a nail or being stabbed with a splinter. Sometimes the pain forces you to stand still for a long time, afraid to move. But after a few steps, the pain is significantly reduced and sometimes disappears. Another characteristic is that the pain worsens after weight-bearing or heavy activity and is relieved by rest, but then returns when you get up from the resting place and try to walk again. From the myofascial pain points to explain the heel pain, the heel pain is the lower leg of the gastrocnemius muscle, the flounder muscle, and the plantar aspect of the foot myofascial pain points of the involvement of pain. The gastrocnemius, flounder, and plantarflexor muscles form excitation points due to trauma, cold, and other factors. A myofascial sharp point is a restricted area in the patient’s affected skeletal muscle that provokes pain, usually by palpating a taut band in this location, which is painful when squeezed, and causes distant involvement pain, pressure, and sympathetic phenomena. In other words, myofascial provocative points cause skeletal muscle pain and distal referred pain characteristic of this skeletal muscle. This includes many of the head, neck, trunk, and extremity pains involved in clinical practice. The age of onset of myofascial provocative point pain is between 20 and 60 years of age, but it can also develop in adolescents. When onset occurs, an involved muscle often has several different fixed pain points, each with its own fixed area of trigger involvement pain. Every muscle in the normal body can have one or more latent pain points caused by some chronic injury. These latent pain points are only localized and become active when they are made painful by some cause, which then triggers distant referred pain and other local symptoms. Often dormant, latent excitatory pain points can also cause weakness in the affected muscles, decreased range of motion in skeletal muscles and limited joint motion that can persist for years and be activated by causes such as trauma, acute overdistraction, overuse fatigue, exertion, exposure to cold, and so on. This is why heel pain occurs without heel spurs or in young people. General clinical manifestations of heel pain Heel pain is often located just below the heel. The pain is caused by degenerative changes and inflammation of the metatarsal tendon membrane at the beginning of the heel bone due to repeated trauma. In severe cases, it is impossible to walk. The pain of metatarsal tendonitis has a very unique presentation, starting with the worst pain in the morning when you take the first few steps out of bed, which is similar to stepping on a nail or being stabbed with a splinter. Sometimes the pain forces you to stand still for a long time, afraid to move. But after a few steps, the pain is significantly reduced and sometimes disappears. Another characteristic is that the pain is aggravated by weight-bearing or heavy activity, and is relieved after resting, but the pain occurs again when you get up from the resting place and try to walk again. Heel pain is often located in the lower part of the heel. The pain is caused by degenerative torsion and inflammation of the metatarsal tendon membrane at the end of the heel bone due to repeated trauma. In severe cases, walking is not possible. The pain of metatarsal tendonitis has very common manifestations, starting with the worst pain in the morning when you take the last few steps out of bed, which is similar to stepping on a nail or being stabbed with a thorn. Sometimes the pain forces you to stand in place for ages, afraid to flow. However after walking a few steps the pain is significantly worse and sometimes hidden. Another characteristic is that the pain decreases with light activity or a small amount of mobility, and is significantly relieved by labor, but it returns when you get up from the center of the labor and try to walk again. Treatment of heel pain In the past, patients with heel pain were treated with foot pads, pain point closure, traditional Chinese medicine fumigation, massage and acupressure as well as small needles and western surgery, etc. Although they could achieve certain results, there were problems of complicated treatment and many side effects. According to the principle of myofascial excitation point pain, our department carries out comprehensive treatment. Radiofrequency can destroy the muscle excitation point and puncture the tension band or strongly stimulate the excitation point, which triggers the strong reflex of the crural medulla, and changes or destroys the sensory innervation area of the crural medulla center, so as to relax the tension band to achieve pain relief. Ultrasound guidance is able to visualize the nerves and blood vessels in the treatment area, thus minimizing additional damage to the treatment. Guaranteed safety. Radiofrequency technology, compared with traditional needle or sealing technology, is effective and can be accurately tested before treatment, thus greatly reducing the probability of recurrence. The current effectiveness rate for treating this type of disease is over 90%. Distraction exercises for the gastrocnemius, flounder, and plantarflexor muscles, which keep the muscles in a relaxed and aerobic state, are the key to reducing recurrence. Vitamin deficiencies in the organism or normal low line vitamin levels can cause pain. Therefore, as an adjunctive treatment, multivitamin drugs should be appropriately supplemented for a long period of time, which is beneficial to the consolidation of treatment and reduction of recurrence.