Podiatrist in Dallas TX Shares Heel Pain Treatment

The human body relies on a coordinated effort by many parts and systems working in conjunction to keep us alive and participate in our favorite activities. This can be seen in various areas, but the lower limbs are clear examples of complex structures that work together and affect one another. In some instances, the effect one part has on another is not necessarily a good thing, and such is the case when heel pain starts radiating up the leg.

Heel Pain Radiating Up the Leg

There are a couple of different potential explanations when pain starts down in the heel and then begins to travel up the leg. These include:

1. When heel pain is caused by Achilles tendinitis, the painful sensation can travel up the tendon and be experienced in the back of the leg.
2. Some cases of heel pain develop from nerve inflammation or irritation. When this happens, the nerve pain may radiate either up or down along the affected nerve. This creates the possibility that heel pain radiates up into the leg.
3. Whenever pain is experienced in a foot, it can lead to either subtle or significant gait changes. The most obvious example of this is limping as the result of an injury. Depending on the nature of the gait change, this can potentially affect how other areas of the foot or even the leg moves. As a patient compensates for the injury, muscles, bones, and nerves can experience abnormal stress loads, and this is then perceived as radiating pain.

Heel Pain Treatment

Naturally, treatment will depend on the specific injury and its severity, but it is important to have heel pain properly addressed to avoid the pain radiating up the leg. In a vast majority of cases, the treatment needed to address the original issue will be conservative in nature. This can include such nonsurgical methods as rest, ice, medication, shoe modifications, and custom orthotics.

Although they are rare, there are heel issues that may require a surgical procedure. When this is the case, though, you can find comfort in the fact that Drs. Joel Brook, Arroyo, and McClurkin are experienced, skilled, and highly knowledgeable when it comes to foot and ankle surgical procedures. Our foot specialists will make sure your issue is properly resolved and you have the post-operative instructions to recover completely.

Preventing Heel Pain

Now that you know how heel pain can travel up the leg and some of the treatment options, let’s take a look at prevention measures you can take on the front end:

• Ease into activity. You can reduce your risk of Achilles tendinitis by starting new activities at low levels of intensity and duration, and then gradually increasing them over time.
• Wear proper footwear. Your shoes should be appropriate for the activities you perform and fit correctly. It’s also important to make sure they offer sufficient cushioning and ample arch support.
• Cross-train. Reduce the amount of physical force your feet face by incorporating low-impact activities into your exercise program. Also, make sure to have rest days so that your body can recover from high-impact exercises.

Professional Heel Care and Treatment in Plano, TX

Whether your heel pain begins to travel up the leg or stays down in the back of the foot, you can benefit from the care and treatment we provide here at Dallas Podiatry Works. Our foot doctors will evaluate your condition, provide an accurate diagnosis, and then create a treatment plan for you to relieve any painful symptoms and allow you to participate in your favorite activities.

Call 972.853.7100 for more information or schedule your appointment at either our Plano or Dallas, TX podiatrist offices online today.

Achilles tendinitis: MedlinePlus Medical Encyclopedia

Achilles tendinitis occurs when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. This tendon is called the Achilles tendon. It allows you to push your foot down. You use your Achilles tendon when walking, running, and jumping.

There are two large muscles in the calf. These create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel.

Heel pain is most often due to overuse of the foot. Rarely, it is caused by an injury.

Tendinitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes.

Achilles tendinitis may be more likely to occur if:

• There is a sudden increase in the amount or intensity of an activity.
• Your calf muscles are very tight (not stretched out).
• You run on hard surfaces, such as concrete.
• You run too often.
• You jump a lot (such as when playing basketball).
• You do not wear shoes that give your feet proper support.
• Your foot suddenly turns in or out.

Tendinitis from arthritis is more common in middle-aged and older adults. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling. Flat feet will put more tension on the tendon.

Symptoms include pain in the heel and along the length of the tendon when walking or running. The area may feel painful and stiff in the morning.

The tendon may be painful to touch or move. The area may be swollen and warm. You may have trouble standing up on your toes. You may also have trouble finding shoes that fit comfortably due to pain in the back of your heel.

The health care provider will perform a physical exam. They will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes.

X-rays can help diagnose bone problems.

An MRI scan of the foot may be done if you are considering surgery or there is a chance that you have a tear in the Achilles tendon.

The main treatments for Achilles tendinitis do not involve surgery. It is important to remember that it may take at least 2 to 3 months for the pain to go away.

Try putting ice on the Achilles tendon area for 15 to 20 minutes, 2 to 3 times per day. Remove the ice if the area gets numb.

Changes in activity may help manage the symptoms:

• Decrease or stop any activity that causes pain.
• Run or walk on smoother and softer surfaces.
• Switch to biking, swimming, or other activities that put less stress on the Achilles tendon.

Your provider or physical therapist can show you stretching exercises or eccentric loading exercises for the Achilles tendon.

You may also need to make changes in your footwear, such as:

• Using a brace, boot or cast to keep the heel and tendon still and allow the swelling to go down
• Placing heel lifts in the shoe under the heel
• Wearing shoes that are softer in the areas over and under the heel cushion

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can help ease pain or swelling.

Other treatment include injections, such as platelet rich plasma or steroids, to reduce the inflammation. However, the tendon can become even weaker following injection and should be protected after the injections.

If these treatments do not improve symptoms, you may need surgery to remove inflamed tissue and abnormal areas of the tendon. If there is a bone spur irritating the tendon, surgery can be used to remove the spur.

Extracorporeal shock wave therapy (ESWT) may be an alternative to surgery for people who have not responded to other treatments. This treatment uses low-dose sound waves.

In most cases, lifestyle changes help improve symptoms. Keep in mind that symptoms may return if you do not limit activities that cause pain, or if you do not maintain the strength and flexibility of the tendon.

Achilles tendinitis may make you more likely to have an Achilles rupture. This condition most often causes a sharp pain that feels as if you have been hit in the back of the heel with a stick. Surgical repair is often necessary. However, the surgery may not be as successful as usual because there is already damage to the tendon.

Contact your provider if:

• You have pain in the heel around the Achilles tendon that is worse with activity.
• You have sharp pain and are unable to walk or push-off without extreme pain or weakness.

Exercises to keep your calf muscles strong and flexible will help reduce the risk for tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

Tendinitis of the heel; Heel pain – Achilles

• Inflamed Achilles tendon

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 247.

Brotzman SB. Achilles tendinopathy. In: Giangarra CE, Manske RC, eds. Clinical Orthopaedic Rehabilitation: A Team Approach. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 44.

Hogrefe C, Jones EM. Tendinopathy and bursitis. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 103.

Waldman SD. Achilles tendinitis. In: Waldman SD, ed. Atlas of Common Pain Syndromes. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 126.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Heel pain – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment

Arthritis

Diabetes mellitus

2522

06 April

Heel pain: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Pain in the heel region not only causes discomfort, but also deprives a person of the opportunity to stand for a long time and move normally. Pain usually results from inflammatory changes in the tissues surrounding the heel bone and is often long-lasting and recurrent. The calcaneus is the largest of all the bones in the foot and bears the greatest stress when walking.

Types of heel pain

Depending on the disease that is accompanied by pain in the heel, the nature of the pain syndrome will vary. Possible acute pain that occurs when walking and standing. Pain may appear in the morning when a person gets up after sleep, then it decreases or disappears completely. In other cases, heel pain is aching in nature and is not associated with a load on the leg. With a number of diseases, pain bothers not only when walking, but also at night, at rest. Sometimes, along with pain, numbness, tingling and “goosebumps” are felt, the skin may turn red, swelling appears.

The pain may worsen with foot extension and in some cases causes limitation of mobility in the ankle joint.

Possible causes of heel pain

The causes of heel pain can be divided into physiological and pathological. The first includes foot strain due to wearing uncomfortable shoes or shoes with a flat sole and no arch support, due to standing for a long time, due to increased stress on the foot during pregnancy or during rapid weight gain.

Pathological causes are various diseases and injuries.

Achilles tendinitis and plantar fasciitis (heel spur) . During physical exertion and overstretching of the tendons attached to the calcaneus, their inflammation occurs, which is manifested by pain in the heel and in the tendon area during physical exertion, local swelling on the back of the heel, and a feeling of weakness in the ankle joint. Flexion and extension of the foot is painful. Tendinitis of the Achilles tendon (Achilledynia) is often the result of spondyloarthritis (disease of the intervertebral discs), hypermobility of the joints (hereditary disease or predisposition), flat feet, shortening of one of the lower extremities due to a pelvic tilt due to intervertebral hernias.

Plantar fasciitis, or heel spur, is also characterized by inflammation of the plantar ligaments. The consequence of this process is the formation of a heel spur, that is, marginal bone growths (osteophytes). Patients report pain when walking and standing along the entire plantar surface of the foot.

Most often, pain makes itself felt at the first steps after a night’s sleep or prolonged sitting.

Tarsal tunnel syndrome is characterized by damage to the fibers of the tibial nerve due to its compression between the ligaments of the ankle in injuries, bone growths and soft tissue tumors. The syndrome is accompanied by burning pain and tingling in the heel area, and sometimes the entire sole. The pain worsens when the foot is extended. There may be a change in the sensitivity of the skin in the area of ​​​​the sole. In tarsal tunnel syndrome, foot function and gait are often impaired.

Traumatic injuries of the calcaneus (contusion, crack, fracture) . A calcaneal injury is more likely to occur when falling or jumping from a height in an upright position. A strong blow leads to a bruise or violation of the integrity of the bone (often combined with fractures of other bones of the lower extremities) and causes sharp pain, the inability to support the heel, and swelling that covers the foot and lower leg.

Damage to the calcaneus is rarely accompanied by an external violation of the integrity of the soft tissues; hematomas are more often noted on the lateral surfaces of the foot.

Achilles bursitis – the disease is characterized by inflammation of the synovial bursa, which is located between the calcaneal tendon and the calcaneus, and manifests itself as pain at the bottom and behind the heel, at the point of attachment of the Achilles tendon to the calcaneal tuber, redness and swelling in the calcaneal tuberosity, as well as partial limitation of foot mobility. The causes of Achilles bursitis can be traumatic injuries due to wearing tight shoes, excessive physical exertion on the ankle joint, Haglund’s deformity. Less commonly, the disease is caused by metabolic and hormonal disorders, allergic reactions, autoimmune diseases, and infections.

Reactive arthritis – arthritis of the joints of which the calcaneus is a part (the articulation of the calcaneus with the tarsal bones – talus and navicular).

The disease develops as a result of infectious diseases (most often urogenital).

Pain syndrome appears two weeks later – a month after the infection. Severe pain is felt not only during exercise, but also at rest. Both heels may be affected, swelling and redness are noted.

Infectious diseases (tuberculosis, gonococcal infection, osteomyelitis of the calcaneus) is a fairly rare cause of heel pain. Mycobacterium tuberculosis and gonococci can develop in spongy bones and epiphyses of tubular bones, which leads to their local destruction. The process is accompanied by pain, swelling in the ankle joint and redness. The mobility of the foot is impaired.

Haglund’s deformity – ossification of the calcaneus, in which there is an osteo-cartilaginous growth in the area of ​​the calcaneal tuber, accompanied by the appearance of a growth (osteophyte) in the area of ​​attachment of the Achilles tendon. Such a pathology can be caused by a high arch or flat-valgus deformity of the foot (a combination of flat feet and valgus deformity of the foot – deviation of the thumb towards the remaining fingers), a decrease in the elasticity of the tendons.

Valgus deformity of both feet

Constant friction of the Achilles tendon leads to the development of an inflammatory process and changes in the cartilage, sometimes with the formation of sharp spikes. Patients may notice a hard protrusion on the back of the heel. The function of the foot, as a rule, is not disturbed, but inflammation of the joint capsule and tendon sheath leads to pain when walking, and sometimes at rest.

The disease is more common in young women due to wearing uncomfortable shoes with high heels.

Calcaneal epiphysitis – this disease develops in children aged 8-15 years due to a violation of the processes of ossification (ossification) of the calcaneus. Normally, the heel bone is formed as a result of the activity of two centers of ossification. One of them functions from the birth of a child, the other – from about 8 years old. Between the centers of ossification is cartilage tissue, which eventually transforms into bone. In case of cartilage overload between these two areas, cartilage degradation or partial rupture is possible, which is accompanied by inflammation and pain on the back and side of the heel, aggravated by the load. There is a limitation of the amplitude of movement, and with a rupture of the cartilage – swelling and redness.

Osteochondropathy of the calcaneal tuber apophysis, or Haglund-Schinz disease – the disease is characterized by aseptic (non-infectious) necrosis of the calcaneal tuber, which occurs due to injury, wearing uncomfortable shoes, due to hereditary predisposition and hormonal imbalance. Tendons attached to the tubercle during overstrain constantly injure the bone, which causes pain and swelling, which increase after the load and when the foot is extended. A swelling can be seen above the heel tubercle. It is noted that Haglund-Shinz disease is more common in girls aged 12-16 years.

To reduce the severity of pain, patients lean on their toes when walking.

Pain in the heel can be caused by dermatological and vascular pathologies that are diagnosed in patients with diabetes mellitus (trophic ulcers in diabetic foot syndrome), with varicose veins, and thrombophlebitis. Patients experience a slight pulling, pulling pain, fatigue. There are swelling of the feet, intermittent lameness.

Doctors to contact for heel pain

For heel pain, especially in case of injury, it is recommended to consult an orthopedic traumatologist. In some cases, consultation with an infectious disease specialist and other specialists is required to determine the diseases that caused the onset of pain.

Diagnosis and examination of heel pain

When heel pain occurs, a careful history taking and instrumental examinations are necessary. First of all, a clinical blood test is prescribed, as well as tests for infectious diseases – chlamydial and gonococcal infections, tuberculosis.

Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

Up to 1 business day

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RUB 810

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Anti-Chlamydia tr.-IgA

Secretory antibodies that appear 1-2 weeks after infection and protect the mucous membranes from deeper penetration of chlamydia. Sharp marker

Up to 2 working days

Available with home visit

830 RUB

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Gonococcus, determination of DNA (Neisseria gonorrhoeae, DNA) in synovial fluid

Determination of DNA of the causative agent of gonorrhea (Neisseria gonorrhoeae) in synovial fluid by polymerase chain reaction (PCR) with real-time detection…

Up to 1 business day

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RUB 560

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Mycobacterium tuberculosis, detection of DNA (Mycobacterium tuberculosis, DNA) in synovial fluid

Determination of DNA of causative agents of tuberculosis, mycobacteria complex: M. tuberculosis, M. bovis, M. bovis BCG, M. microti, M. africanum in synovial fluid by polymerase chain reaction…

Up to 1 business day

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RUB 570

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Imaging includes radiography of the ankle and calcaneus in two standard views.

X-ray of the bones of the foot

X-ray examination of the foot in two projections allows diagnosing injuries and other pathological changes, including flat feet.

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In some cases, computed tomography and ultrasound of the foot may be needed. With tunnel syndromes, the diagnosis is clarified according to electromyography. Magnetic resonance imaging allows you to assess the state of soft tissue structures.

How to deal with heel pain

It is important to limit the load on the foot as much as possible and choose shoes with a low stable heel.

Orthopedic arch support insoles help to reduce the load on the heel bone, before buying which it is advisable to consult with a specialist in an orthopedic salon.

Heel pain treatment

In most cases, conservative therapy is sufficient. In inflammatory processes, non-steroidal anti-inflammatory drugs are prescribed, in infectious diseases – antibiotics. Trophic ulcers are treated with antiplatelet agents and phlebotonics, and in diabetes mellitus, correction of antidiabetic therapy is required.

Surgical intervention is necessary for torn ligaments, fractures, abscesses. Rarely, operations are performed for arthrosis of the tarsal joints, Haglund’s deformity, Schinz’s disease. Rehabilitation after surgery includes exercise therapy and physiotherapy.

Sources:

1. Clinical guidelines for the diagnosis and surgical treatment of injuries and diseases of the peripheral nervous system // Association of Neurosurgeons of Russia. – Moscow, 2015.
2. Traumatology. Clinical guidelines / Ed. S.P. Mironov. – GEOTAR-Media, 2018.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Causes of heel pain – symptoms, which doctor to contact

The frequency of heel pain is difficult to determine. Many people, periodically experiencing pain, prefer to endure it or be treated on their own, without going to a doctor.

Causes of heel pain

The cause of heel pain is inflammation. It, in turn, can be caused by various factors.

• Trauma. Most often, heel pain occurs due to inflammation caused by injury to the heel structures – mechanical damage to the heel bone, tendons, synovial bags or ligaments. Because of this, pathologies accompanied by pain can develop – calcaneal fissures, bruises, sprains of the ankle ligaments and Achilles tendon, heel spurs and bursitis.
• The second most common cause of inflammation and pain in the heel region is a metabolic disorder: diabetes mellitus and gout. In diabetes, the walls of blood vessels are affected. Veins in the legs are the first to suffer from diabetic angiopathy. With gout, uric acid salts accumulate in the joints and periarticular structures. Vascular disorders in diabetes and accumulations of uric acid in gout are the causes of pain.
• Sometimes heels can hurt with inflammation caused by autoimmune diseases, such as reactive arthritis. Rarely, pain in the heel can occur due to inflammatory lesions of the heel structures by pathogenic microbes. As a rule, purulent inflammation of the calcaneus is observed in tuberculosis and osteomyelitis.

What can hurt in the heel

Heel bone. Pain in it occurs due to inflammation in reactive arthritis, epiphysitis, osteomyelitis, tuberculosis, osteochondropathy of the tubercle and fractures.

Skin and subcutaneous tissue. Involved in pathological processes when structures under them are affected. Pain with diabetic angiopathy, gout, ankle sprain, heel spur, etc.

Synovial bags. There are two of them in the calcaneal region – retrocalcaneal and superficial Achilles tendon bag. Pain with bursitis.

Ligaments and fasciae. The lateral ligaments of the ankle joint are most commonly affected. They hurt with bruises and sprains on the dorsum of the foot. Plantar – plantar fascia – usually hurts with plantar fasciitis – heel spur.

Achilles tendon. When it is inflamed, the back of the heel hurts.

Nerves and vessels. Nerves, as a rule, become inflamed in any pathology of the heel structures. Vascular damage causes pain in bruises, diabetic angiopathy, osteomyelitis and calcaneal tuberculosis.

Intertarsal joints. The talocalcaneonavicular and calcaneocuboid joints tend to hurt with gout.

Which doctor to go to when your heel hurts

First of all, if you have heel pain, you need to exclude more dangerous diseases that require urgent treatment. Therefore, the first specialist to contact for heel pain is a surgeon.

Diseases in which heel pains are possible:

• heel spur, or plantar fasciitis;
• bursitis;
• Haglund’s deformity;
• tarsal tunnel syndrome;
• tuberculosis of the calcaneus;
• osteomyelitis;
• reactive arthritis;
• osteochondropathy;
• epiphysitis;
• diabetic angiopathy;
• gout;
• contusions;
• stretching;
• inflammation of the tendons;
• cracks.

Common complaints

If you have pain on the inside of your heel, your first step is to rule out a heel spur by doing an x-ray. If there is no spur, the cause of pain on the side can be injuries, foot deformities or excessive loads – excess weight, uncomfortable shoes, hard physical labor.

If the heel hurts when walking and it hurts to step on it, try to reduce the load and consult a doctor. With the symptoms described, first of all, a heel spur, Achilles, osteochondropathy of the heel tuber, bursitis or loading periostitis are suspected. In addition to them, infectious diseases, oncology and injuries are possible. The tactics of individual differential diagnosis is developed by the attending physician.

Most often, the heel hurts when sleeping with a heel spur. The disease is characterized by intense pain in the heels in the morning, in the afternoon it subsides.

Diagnosis of pain in the heel

When contacting a doctor, the examination is carried out according to a specific plan. The doctor asks in detail about complaints, specifying their nature, type and location of pain, and examines the diseased area. If necessary, he prescribes a number of laboratory tests and instrumental examinations. These include:

• Complete blood count. It is necessary to detect an inflammatory process, a decrease in hemoglobin in case of anemia, changes in platelet levels in case of blood clotting problems.
• Biochemistry of blood. The analysis will show the existing shifts in metabolic processes, will help in identifying diabetic lesions, rheumatoid, gouty arthritis, infections caused by pathogenic streptococci.
• Analysis for tumor markers. It is needed if you suspect bone tumor processes.
• Sowing of purulent discharge on flora. It is necessary in the presence of purulent lesions, the selection of antimicrobial drugs.
• X-ray of bones and soft tissues of the foot. It will help in identifying unexplained pain in the heel, including after an injury, against the background of degenerative processes.
• Ultrasound for the detection of arthritis, bursitis, neuroma, carpal tunnel syndrome with the determination of the localization of the focus of inflammation.
• Puncture of bone or bursa for suspected infectious or neoplastic lesions.
• CT or MRI for accurate diagnosis of damage to any structures in the foot and heel.

Methods for the treatment of pain in the heel

Pathologies of the heel region are tried to be treated conservatively, but this is not always possible. If conservative therapy is ineffective, this is an indication for surgery. Surgical treatment quickly and permanently eliminates the cause of pain in the heel area. Modern surgery is based on minimally invasive outpatient techniques with minimal trauma and a short recovery period.

Heel spur

Surgery for heel spur is indicated if conservative therapy fails within 6 months. Types of operations for heel spurs are osteophyte removal and plantar fasciotomy.

Interventions are performed under local anesthesia. Through a small incision, the surgeon inserts an endoscopic probe and microsurgical instruments. Under the control of a microvideo camera, he cuts out the bone growth, and, if necessary, the inflamed area of ​​the fascia. In order not to compress the nerve in the future, the thick part of the adductor muscle of the big toe is dissected.

For more information on diagnosis and removal of heel spurs, click here.

If the pain associated with a heel spur is not caused by an osteophyte, but by excessive tension on the plantar aponeurosis, a tenotomy is performed – partial dissection of the tendon. The operation is performed without incisions – through punctures using a high-frequency electric current (radiofrequency tenotomy).

Bursitis

Bursectomy – surgical removal of the bursa – is indicated when conservative treatment of bursitis fails. The operation is performed without incisions using arthroscopic technique.

Through 2-3 punctures with a diameter of 4-5 mm, microsurgical instruments and a miniature video camera are inserted into the joint. The joint capsule is dissected and removed. A sterile bandage is applied to the incisions. The duration of the procedure is about 30 minutes. The recovery period is 2 days.

Haglund’s deformity

If conservative treatment of Haglund’s deformity fails, surgery is indicated. During the endoscopic operation – without incisions – the bone outgrowth is removed from the surface of the calcaneal tuber, after which the retrocalcaneal bursa is excised. Thus, the mechanical functions of the Achilles tendon are restored and the cause of pain is eliminated.

Tarsal tunnel syndrome

Tarsal tunnel syndrome caused by mass lesions in the tarsal canal, both congenital and acquired as a result of deformity of the foot, requires surgical treatment. During the operation, pathological formations are removed and the normal patency of the canal is restored.