What are the common causes of heel pain. How can plantar fasciitis be identified and treated. Why does Achilles tendinopathy occur and what are its symptoms. When should you suspect a calcaneal fracture.

Common Causes of Heel Pain: Mechanical, Neurologic, and Rheumatologic Factors

Heel pain is a widespread issue that can stem from various sources. To better understand and address this condition, it’s helpful to categorize the causes into three main groups: mechanical, neurologic, and rheumatologic. Each category encompasses different conditions and factors that contribute to discomfort in the heel area.

Mechanical Causes of Heel Pain

Mechanical causes are often related to wear and tear or external factors affecting the heel. These can include:

• Acute problems like plantar fascia rupture due to trauma or sports injuries
• Degenerative conditions such as plantar fasciitis
• Calcaneal stress fractures
• Excess foot pronation due to walking gait or running style
• Shortened Achilles tendons
• Inadequate footwear
• Regular high-impact physical exercise

Is plantar fasciitis the most common cause of heel pain? Indeed, plantar fasciitis accounts for approximately 80% of all heel pain cases. This condition occurs when the plantar fascia, a fibrous band connecting the heel bone to the front of the foot, becomes inflamed due to increased tensile load and repeated trauma.

Plantar Fasciitis: Symptoms, Causes, and Treatment Options

Plantar fasciitis is characterized by a stabbing pain in the back of the heel, which is typically worse in the morning or after periods of inactivity. Understanding this condition is crucial for effective management and treatment.

Recognizing Plantar Fasciitis Symptoms

How can you identify plantar fasciitis? The primary symptom is a sharp, stabbing pain in the heel area, particularly noticeable:

• Upon waking up in the morning
• After long periods of sitting or standing
• When taking the first steps after rest
• After intense physical activity

Effective Treatment Strategies for Plantar Fasciitis

What are the most effective treatments for plantar fasciitis? Treatment typically involves a combination of approaches:

1. Targeted physical exercises to reduce inflammation and provide pain relief
2. Range of motion exercises to improve flexibility as symptoms subside
3. Stability exercises to enhance foot balance and prevent future injuries
4. Strengthening exercises for muscles in and around the foot
5. Stretching exercises to prevent future damage and ensure complete healing

Can you start rehabilitation immediately? It’s essential to assess your readiness for rehabilitation. Many resources, including online screening tools, can help determine if you’re prepared to begin a targeted exercise program for plantar fasciitis.

Achilles Tendinopathy: An Often Overlooked Cause of Heel Pain

While plantar fasciitis is the most common cause of heel pain, Achilles tendinopathy is another significant condition that can lead to discomfort in the back of the heel. This ‘overuse’ injury results in irritation and inflammation of the Achilles tendon.

Identifying Achilles Tendinopathy

How does Achilles tendinopathy manifest? The primary symptoms include:

• Intermittent, sharp pain in the posterior heel area
• Pain that worsens with activity or pressure
• Tenderness of the Achilles tendon
• Possible thickening of the tendon

Why is early detection of Achilles tendinopathy crucial? Early identification and treatment can prevent further damage and reduce the risk of tendon rupture, which is a more severe complication associated with this condition.

Treatment Approaches for Achilles Tendinopathy

What are effective treatments for Achilles tendinopathy? Treatment options include:

1. Controlled movements, particularly eccentric exercises
2. Use of orthotic devices such as heel lifts
3. Reducing pressure on the affected tendon during the acute phase
4. Gradual return to activity as symptoms improve

Is professional guidance necessary for treating Achilles tendinopathy? While some cases can be managed with self-care, consulting a healthcare professional is advisable, especially for persistent or severe cases, to ensure proper diagnosis and treatment.

Calcaneal Fractures: A Serious Cause of Heel Pain

Calcaneal fractures represent a more severe cause of heel pain, often occurring in athletes or individuals subjected to prolonged weight-bearing activities. Understanding this condition is crucial for proper diagnosis and treatment.

Causes and Risk Factors for Calcaneal Fractures

What leads to calcaneal fractures? Common causes include:

• Repeated stress on foot bones, especially in athletes
• Prolonged weight-bearing activities
• High-impact trauma, such as falls from height
• Sudden, forceful twisting of the foot

Are certain individuals more prone to calcaneal fractures? Yes, athletes, particularly those involved in high-impact sports, and individuals with occupations requiring long periods of standing or walking are at higher risk.

Identifying and Treating Calcaneal Fractures

How can you recognize a potential calcaneal fracture? Key indicators include:

• Severe pain in the heel area
• Difficulty walking or bearing weight on the affected foot
• Visible swelling or bruising around the heel
• Deformity of the heel in severe cases

What should you do if you suspect a calcaneal fracture? Immediate medical attention is crucial. Treatment may involve:

1. Immobilization of the foot with a cast or boot
2. Pain management and anti-inflammatory medications
3. Surgical intervention in severe cases
4. Gradual rehabilitation and physical therapy

Neurologic Causes of Heel Pain: Beyond Physical Trauma

While mechanical causes are more common, neurologic factors can also contribute to heel pain. Understanding these causes is essential for comprehensive diagnosis and treatment.

Common Neurologic Causes of Heel Pain

What neurologic conditions can lead to heel pain? Some prevalent causes include:

• Tarsal tunnel syndrome
• Peripheral neuropathy
• Nerve entrapment syndromes
• Referred pain from spinal issues

How does neurologic heel pain differ from mechanical causes? Neurologic pain often presents as burning, tingling, or shooting sensations, sometimes extending beyond the heel area.

Diagnosing and Treating Neurologic Heel Pain

What steps are involved in diagnosing neurologic heel pain? The process typically includes:

1. Detailed medical history and physical examination
2. Neurological tests to assess nerve function
3. Imaging studies such as MRI or CT scans
4. Nerve conduction studies in some cases

Are treatments for neurologic heel pain different from mechanical causes? Yes, treatments often focus on addressing the underlying neurological issue and may include:

• Medications to manage nerve pain
• Physical therapy targeting nerve function
• In some cases, surgical intervention to relieve nerve compression
• Lifestyle modifications to reduce pressure on affected nerves

Rheumatologic Conditions and Their Impact on Heel Pain

Rheumatologic conditions represent another significant category of heel pain causes. These systemic diseases can affect various parts of the body, including the heel area.

Common Rheumatologic Causes of Heel Pain

Which rheumatologic conditions are associated with heel pain? Key conditions include:

• Psoriatic arthritis
• Rheumatoid arthritis
• Osteoarthritis
• Ankylosing spondylitis
• Gout

How do rheumatologic conditions cause heel pain? These conditions often lead to inflammation in the joints and surrounding tissues, which can affect the heel area and cause pain.

Identifying and Managing Rheumatologic Heel Pain

What are the signs that heel pain might be due to a rheumatologic condition? Indicators include:

• Pain in multiple joints, not just the heel
• Systemic symptoms such as fatigue or fever
• Morning stiffness that improves with activity
• Family history of rheumatologic conditions

How is rheumatologic heel pain treated? Treatment typically involves a multifaceted approach:

1. Medications to manage inflammation and pain
2. Disease-modifying antirheumatic drugs (DMARDs) in some cases
3. Physical therapy to maintain joint function
4. Lifestyle modifications to reduce joint stress
5. Regular monitoring and management by a rheumatologist

Preventive Measures and Lifestyle Modifications for Heel Pain

Regardless of the underlying cause, certain preventive measures and lifestyle modifications can help reduce the risk of heel pain or manage existing symptoms more effectively.

Effective Strategies for Preventing Heel Pain

What can you do to prevent heel pain? Consider implementing these strategies:

• Wear properly fitting, supportive footwear
• Maintain a healthy weight to reduce stress on your feet
• Warm up properly before exercise and avoid overtraining
• Incorporate low-impact exercises into your routine
• Practice good foot hygiene and care

Are there specific exercises that can help prevent heel pain? Yes, regular stretching and strengthening exercises for the feet and calves can be beneficial:

1. Calf stretches
2. Plantar fascia stretches
3. Toe curls and toe spreads
4. Ankle rotations
5. Heel raises

Lifestyle Modifications to Manage Existing Heel Pain

How can you modify your lifestyle to manage heel pain? Consider these adjustments:

• Use orthotic inserts or custom orthotics for better foot support
• Apply ice to the affected area to reduce inflammation
• Practice proper posture and ergonomics at work and home
• Gradually increase activity levels to avoid overexertion
• Consider alternative exercises like swimming or cycling during recovery

Is it necessary to completely avoid all physical activity when experiencing heel pain? Not always. While rest is important, maintaining some level of activity, as advised by a healthcare professional, can often be beneficial for recovery and overall foot health.

When to Seek Professional Help for Heel Pain

While many cases of heel pain can be managed with self-care measures, there are situations where professional medical attention is necessary. Recognizing these instances is crucial for proper treatment and prevention of complications.

Red Flags: When Immediate Medical Attention is Needed

What are the warning signs that indicate a need for immediate medical care? Be alert for:

• Severe pain that limits your ability to walk
• Sudden onset of heel pain following an injury
• Visible deformity or severe swelling of the heel
• Signs of infection such as fever, redness, or warmth around the heel
• Heel pain accompanied by numbness or tingling

Should you wait to see if severe heel pain resolves on its own? No, severe or sudden-onset heel pain, especially following an injury, warrants prompt medical evaluation to rule out serious conditions like fractures or tendon ruptures.

Chronic Heel Pain: When to Consult a Specialist

At what point should you consider seeing a specialist for ongoing heel pain? Consider consulting a podiatrist or orthopedic specialist if:

1. Heel pain persists for more than a few weeks despite home treatment
2. Pain interferes with daily activities or sleep
3. You have a medical condition that affects healing, such as diabetes
4. You experience recurrent episodes of heel pain
5. Conservative treatments have not provided adequate relief

What types of specialists might be involved in treating heel pain? Depending on the underlying cause, you might consult:

• Podiatrists for foot-specific issues
• Orthopedic surgeons for bone and joint problems
• Rheumatologists for systemic inflammatory conditions
• Neurologists for nerve-related pain
• Physical therapists for rehabilitation and exercise guidance

By understanding the various causes of heel pain and knowing when to seek professional help, you can take proactive steps to manage your foot health effectively. Remember, early intervention often leads to better outcomes and faster recovery in cases of heel pain.

Typical causes of pain in the back of the heel

Pain in the back of the heel is one of the most frequent manifestations of plantar fasciitis. his condition occurs when the plantar fascia, a fibrous band of connective tissue connecting the heel bone to the front of the foot, becomes inflamed.

Injurymap helps you treat your pain Learn more

Christian Petersen Senior editor

Medically reviewed by 

Pierre Schydlowsky, Ph.D

Pain in the back of the heel is one of the most frequent manifestations of plantar fasciitis. This condition occurs when the plantar fascia, a fibrous band of connective tissue connecting the heel bone to the front of the foot, becomes inflamed. Apart from plantar fasciitis, plantar heel pain can be caused by stress fractures, nerve compression and rheumatologic conditions, such as psoriatic arthritis, rheumatoid arthritis and osteoarthritis.

The causes of pain in the heel can be split into three different categories: mechanical, neurologic, and rheumatologic.

Mechanical causes

This category includes acute problems caused by wear and tear or other external factors such as the rupture of the plantar fascia due to trauma or sports injuries (athletic competitions). This category also includes degenerative conditions, such as plantar fasciitis and calcaneal stress fractures.

A degenerative condition is defined as a progressive disorder that will continue to worsen, especially if no treatment measures are taken. There are often exacerbated by other intrinsic factors, such as excess foot pronation due to a particular walking gait or running style, and shortened Achilles tendons. In addition, inflammation can also be triggered by extrinsic factors like inadequate footwear or regular high impact physical exercise.

Plantar fasciitis

plantar fasciitis accounts for around 80% of all cases of heel pain. Due to a number of factors, including increased tensile load and repeated trauma to the feet, the plantar fascia becomes inflamed and irritated. Typically, this type of heel pain tends to be worse in the morning shortly after waking or after long periods of inactivity.

Plantar fasciitis

Targeted physical exercises constitute an effective treatment solution for the symptoms caused by the inflammation of the plantar fascia. During the acute phase, any sort of movements performed should aim to reduce inflammation and provide relief from the pain.

As initial symptomatology improves, so the goal of rehabilitation will change from pain relief to improving the range of motion in the affected foot. Movement exercises designed to increase flexibility levels are most effective at this point in the recovery process. Targeted physical exercises aimed at helping one to regain foot stability can also be useful, thereby improving balance overall and preventing the likelihood of future falls or injuries due to twists or sprains.

Once one has regained both physiological range of motion and core stability, the focus should shift towards exercises that can strengthen local muscles in and around the foot.

Stretching exercises complete the rehabilitation program. These will help to prevent any future damage to the plantar fascia and ensure that the healing process is completely successful.

Test if you are ready to start rehabilitating your foot with the screening tool on our plantar fasciitis info page.

Achilles tendinopathy

This condition can be defined as a type of ‘overuse’ injury, which results in the Achilles tendon becoming irritated and inflamed (causing pain in the back of the leg, amongst other symptoms). This particular combination of pain and inflammation tends to impair overall performance, and is associated with an increased risk of tendon rupture.

Achilles tendinitis

Inflammation of the Achilles tendon is almost always accompanied by intermittent, sharp pain in the posterior heel area. It is important to remember that the pain becomes worse when one is active or when pressure is applied to the area. Moreover, the Achilles tendon is usually tender (even thickened in some cases) upon palpation.

Controlled movements, such as those found in eccentric exercises, are recommended for this type of injury. Orthotic devices, including heel lifts, can also be very effective at improving overall symptoms. During the acute period, however, it is imperative that pressure on the affected tendon is reduced. Find out more about more how to treat an inflamed Achilles tendon here.

Test if you are ready to start rehabilitating your foot with the screening tool on our achilles tendonitis info page.

Calcaneal fracture

One of the most common fractures that can occur at the level of the foot, this condition primarily occurs in athletes, often as a result of repeated stress (hence the name) on the bones of the feet. It can also arise in cases of prolonged weight bearing or as a result of walking on hard surfaces. Pain becomes worse with activity but is also present at rest.

Calcaneal stress fracture

When the calcaneus, which is the biggest bone in the foot, is subjected to repetitive stress (either as a result of prolonged mechanical loading or due to structural fatigue, as tends to happen with athletes), then bone strain and fractures can occur (as seen in the image above). This typically results in pain in the heal area.

The higher the level of strain, the larger the risk of damage becomes. Fracturing will occur when the bone can no longer withstand any further mechanical loading, structural fatigue or both.

Neurologic causes

Not all pain or injury is caused by mechanical injury to the muscle and bones. Sometimes the root cause can lie within the nervous system itself, nerve compression being the predominant issue. When one or several nerves are compressed or entrapped, irritation, pain and other symptoms can follow, including sensory disturbances.

Sensory disturbances relates to abnormal sensations that sometimes occur because of nerve compression or entrapment. For example, if the tibial nerve is compressed (as happens in tarsal tunnel syndrome), patients can experience excess sensitivity in the sole of the foot.

One can also experience a reduction in sweat production, as well as burning pains or stinging sensations. These manifestations occur when the sensory part of the nerve is affected.

Tarsal tunnel syndrome

This is a medical condition similar to carpal tunnel syndrome (which occurs in the wrist) in which the posterior tibial nerve in the ankle suffers from damage, often as a result of extrinsic factors such as repeated pressure or compression. For example, those who have suffered crush injuries can develop this syndrome.

Typical symptoms of tarsal tunnel syndrome include plantar heel pain due to compression of the posterior tibial nerve. It is also possible to experience tingling, numbness or burning sensations in the ankle or heel. Less frequently, there may be other symptoms such as shooting pains and sensations similar to an electric shock.

The first line of treatment for tarsal tunnel syndrome should be physical rest and cold applications (ice packs). NSAIDs (anti-inflammatories) can also help to provide pain relief, while targeted physical exercises are recommended to restore normal quality of life.

Peripheral neuropathy

Peripheral neuropathy can be defined as a medical condition in which the peripheral nerves suffer from damage as a side effect of wider health problems like diabetes, rheumatoid arthritis or acute trauma. Over time, these nerves begin to malfunction, leading to sensory disturbances, loss of coordination and muscle weakness.

This type of neuropathy is often found in patients who suffer from pre-existing conditions or systemic diseases like diabetes. High levels of glucose leads to nerve damage, which, in turn, can cause other symptoms such as the plantar heel pain.

Physical exercises and water therapy are recommended for the treatment of heel pain associated with peripheral neuropathy. In general, one has to perform low-impact exercises, so as not to aggravate any extant nerve damage.

Rheumatologic causes

When plantar heel pain is accompanied by other joint symptoms and there is a history of rheumatologic problems, then the cause of the pain needs to be investigated further using diagnostic tools such as imaging studies and laboratory tests.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune, inflammatory condition, in which the body’s immune system attacks the joints, eventually leading to progressive bone and joint damage, accompanied by generalized and often constant pain, inflammation and stiffness. Inevitably, this leads to an overall loss of function and reduced mobility, which ultimately affects quality of life.

In patients who suffer from rheumatoid arthritis, the joints of the foot are usually the first to be affected. Cartilage tears and any subsequent joint erosion can lead to plantar heel pain, as well as inflammation, stiffness and activity restriction. People will usually experience walking difficulties, especially in the morning, with the condition gradually worsening with the passing of time.

A final note

In the majority of cases, the pain in the back of the heel is a symptom of plantar fasciitis, often brought about via mechanical stressors. In this case, the most effective treatment is targeted exercises, which you can read more about here However, as has been outlined above, occasionally heel pain is the result of more serious neurologic and/or rheumatologic conditions. Correct diagnosis is essential for determining the most appropriate treatment plan in order to ensure the best outcome. This is why it’s always important to consult a medical expert before starting any treatment.

Sources and links

• RACGP / Heel pain – a practical approach

• AAFP / Diagnosis of heel pain

• Current Osteoporosis Reports / Stress fractures: Pathophysiology, epidemiology, and risk factors

• The Physician and sportsmedicine / The Pathophysiology, Diagnosis, and Management of Foot Stress Fractures

• Medical Clinics of North America / Plantar heel pain

• Biomed Research International / Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments

• IJSPT / Why Are Eccentric Exercises Effective For Achilles Tendinopathy?

• Foot and Ankle International / Nerve entrapment in painful heel syndrome

• Mount Sinai / Tibial nerve dysfunction

• Foot Health Facts / Tarsal Tunnel Syndrome

• St. Luke’s Hospital / Tibial nerve dysfunction

• Podiatry Today / A Guide To Neurogenic Etiologies Of Heel Pain

• NHS / Rheumatoid arthritis

Image credits

• Calcaneal stress fractures By James Heilman, MD [CC BY-SA 4.0 ], from Wikimedia Commons

Why does my heel hurt? 5 top causes

Stabbing heel pain in the morning after a night’s rest. A reoccurring ache that comes on after activity and sticks around for a couple days. A new, painful bump on the back of your heel. Are your heels just sore? Or is something else causing your heel pain?

You use your feet a lot every day. So occasional aches and pains are pretty common. But if pain is coming and going, or sticking around for a bit, there may be something else going on. And the one thing all heel pain has in common is this: It’s a signal that your heel needs healing.

Read on to learn the top causes of heel pain and when to get help.

The most common cause of heel pain: Plantar fasciitis

Plantar fasciitis is caused by inflammation or damage to the plantar fascia, which is the ligament that runs along the bottom of your foot and attaches to your heel. This condition is usually caused by repetitive motion or anything that puts a lot pressure on the arch of your foot.

When and where does your heel hurt with plantar fasciitis?

Plantar fasciitis pain can flare up at any time. Sometimes you’ll get heel pain during or after exercise, or from being on your feet for a long time. If your heels hurt after walking or other exercise, you’ll likely feel a sharp stabbing pain in the arch of your foot or the bottom of your heel. This signals that the plantar fascia is inflamed or damaged from overuse, and probably needs some rest and care.

One of the most common signs of plantar fasciitis is heel pain after long periods of rest. In the morning, the muscles in your feet might feel tight while lying in bed. Then, when you put your foot on the ground, it’s the worst kind of shooting, stabbing pain. So why does this happen? Why is heel pain worse in the morning?

The way people rest their feet in bed causes the plantar fascia ligament to tighten during sleep. This is the same reason you’re likely to experience heel pain after sitting for a while. The good news is the rest is probably helping your foot heal. Once you get up and walk around a bit, the tissue will stretch out and feel better.

How is plantar fasciitis diagnosed and treated?

Plantar fasciitis can be officially diagnosed by a podiatrist, a doctor who specializes in foot and ankle conditions. Fortunately, there are at-home treatments for plantar fasciitis that are very effective for managing and healing pain. These include investing in more supportive footwear, rest, hot and cold therapy, and targeted stretches and exercises.

Another thing that can help? Avoiding bare feet, even at home. Going barefoot puts additional strain on your feet. So, slip on supportive slippers or shoes instead.

If your heel pain gets worse or begins to impact daily activities, a podiatrist may recommend a cortisone injection. In more serious cases, surgery can be an option if conservative treatments have lost their effectiveness.

Other common heel pain causes

Achilles tendonitis

If you’re consistently experiencing pain above your heel, or in the back of your ankle during and after activity, Achilles tendonitis may be the cause.

This condition happens when the Achilles tendon becomes inflamed, usually due to overuse or when there is a big increase of frequency or intensity of exercise. This condition is especially common in runners.

You’ll likely notice a mild ache that gets more intense with continued activity. For example, you may experience tenderness or stiffness after long periods of rest or after working out. However, the pain usually starts getting better with mild activity or stretching throughout the day.

Like with other overuse injuries, the best treatment for Achilles tendonitis is usually rest, and avoiding or modifying activities to reduce strain. But if you have small tears in your Achilles tendon, there’s a chance you may need surgery.

If you think you have Achilles tendonitis, a podiatrist can give you an official diagnosis. They can also recommend additional treatments such as physical therapy, or wraps, braces or splints to reduce strain and help the tendon heal.

Haglund’s deformity

People with Haglund’s deformity have a bony enlargement on the back of their heel. Haglund’s deformity is often called the “pump bump” because it can be very common for people who wear high heels. However, any shoes with a rigid back, including men’s dress shoes and ice skates, can irritate the back of the heel.

Beyond the painful bump, symptoms of Haglund’s deformity include:

• Pain in back of heel where your Achilles tendon attaches to your heel
• Swelling in the back of your heel
• Skin redness and inflammation on the back of your heel

One of the best things you can do to relieve any pain is to invest in supportive shoes that have soft backs. Taking over-the-counter anti-inflammatory medications and icing your heel can also help.

But it’s also a good idea to make an appointment with a podiatrist – especially since Haglund’s deformity can lead to another painful condition called bursitis.

Heel bursitis

Heel bursitis is another reason for pain in the back of your heel. Bursitis is inflammation of the bursa, which is a small sack of fluid that cushions and lubricates areas where the tissues rub against each other. You have bursae throughout your body, both in and on the joints that are at risk for rubbing and pressure. There are two types of heel bursitis, and they are related to the locations of specific fluid pockets.

• Subcalcaneal bursitis – The calcaneal bursa is located between the Achilles tendon and the skin at the back of the heel. Calcaneal bursitis is often linked to Haglund’s deformity and usually comes from wearing ill-fitting shoes that dig into the back of the heel. Women who wear high heels or athletes who wear shoes with the wrong fit are at most risk for this type of inflammation. You may have calcaneal bursitis if you notice pain, redness and swelling on your heel that make it hard to put on your shoes.
• Retrocalcaneal bursitis – The retrocalcaneal bursa is located between the heel bone and the Achilles tendon, just above where the Achilles tendon meets the heel bone. This type of bursitis happens after repeated irritation of the bursa and can be related to both Achilles tendonitis and Haglund’s deformity. It’s also common for those who have posterior calcaneal bone spurs, which may need to be surgically removed to get relief. You may have this type of bursitis if you have severe pain and swelling where the Achilles tendon joins the heel bone.

Bursitis treatments are similar to other heel conditions – rest, anti-inflammatory medications, and applying heat or ice packs. It’s also best to avoid activities that would make pain worse – like another round of tennis or slipping into uncomfortable shoes. If the pain doesn’t go away or if your heel is hot to the touch, talk to a podiatrist.

Heel fracture

It’s also possible to fracture the large bone of your heel called the calcaneus. Sometimes this happens suddenly, following a traumatic event. At other times, a heel fracture develops more slowly as a result of overuse.

Calcaneus fracture following a traumatic event

If you fracture your heel – for example, after a fall or jump from a great height or in a car accident – you’ll probably know it by the sudden pain you feel in your heel. To diagnose your condition, the doctor will do a physical examination and take X-rays to determine the severity of the problem, which will determine the type of treatment you need.

Heel fracture resulting from overuse

Stress fractures typically begin with a small hairline fissure in the bone, so pain can come on slowly.

Symptoms of a stress fracture can vary based on the location and the severity of the fracture. There’s a good chance you’ll experience heel pain when walking, but it may or may not go away while you’re resting. Pain may be more manageable in the morning and worse at night.

If you think you have a stress fracture in your heel, hold off on physical activity and try to limit the amount of weight you place on your heel. You’ll also want to make an appointment with a podiatrist. Without treatment, the pain will become more severe and possibly lead to a complete fracture.

The most

uncommon cause of heel pain: Plantar bone spurs

Long-term, repetitive straining of the ligaments that connect your heel to your toes can cause a bone spur to develop on your heel. And actually, these bony growths form as your foot tries to heal itself.

Plantar bone spurs are relatively common – about one in 10 people have one. But only 5% experience foot pain because of bone spurs. If you have heel pain, it’s more likely from another condition, like plantar fasciitis. Many people with plantar fasciitis have plantar bone spurs.

Getting help for heel pain is a step in the right direction

If your heel is hurting, it wants your attention. There are a lot of ways to treat heel pain at home, including rest, ice or heat therapy, exercises and stretches, and investing in supportive shoes. But if your pain continues, make an appointment with a podiatrist.

Podiatrists specialize in all things foot and ankle. They can treat certain conditions in the office, as well as recommend products, pain medications and therapies to help relieve or heal pain. Most are also foot and ankle surgeons who can provide more advanced care when needed.

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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 tendonitis 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 is manifested by pain below and behind the heel, at the point of attachment of the Achilles tendon to the calcaneal tuber, redness and swelling in the area of ​​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 bones of the tarsus – 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 bone and cartilage growth occurs 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 apophysis of the calcaneal tuber, 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, careful history taking and instrumental investigations 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

Available with home visit

RUB 560

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Mycobacterium tuberculosis, DNA detection (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

Available with home visit

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.

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900 02 Heel pain – wide range of discomfort with multiple pathological processes of the calcaneus or surrounding soft tissues. Almost every person is familiar with heel pain in the morning, pain when stepping on, standing or walking. The nature of the pain is diverse: aching, stabbing, arching, and others. Depends on the disease and the degree of its progression. Repeatedly recurring pain in the heel, regardless of their severity, is an indication for an indispensable visit to a specialist doctor. The causes of discomfort are established on the basis of a survey, visual examination and according to hardware diagnostic methods. Let’s take painkillers analgesics until an accurate diagnosis is established, as well as temporary unloading of the foot.

Anatomical structure of the heel

The heel consists of bones, ligaments, tissues that can cause pain in various lesions. Among them:

• skin and subcutaneous structures – react with pain to gout, sprain, spur and diabetic angiopathy;
• calcaneus – sore with arthritis, osteomyelitis, tuberculosis or fractures;
• bursae – affected by bursitis;
• ligaments, fascia – vulnerable to bruises, sprains, react to the “heel spur”;
• Achilles tendon – inflamed;
• vessels, nerves – hurt with any pathologies, bruises, tuberculosis and others;
• intertarsal joints – affected by gout.

Causes of heel pain on foot

The most common physiological causes of heel pain. Among them:

• wearing uncomfortable shoes, narrow, tight, with high heels. The foot is overloaded, as well as the entire musculoskeletal system;
• prolonged static or physical stress on the legs;
• a sharp increase in the load on the foot due to weight gain, pregnancy, heavy physical exertion.

In the early stages, the appearance of soreness can be relieved by a long rest. The development of pathology is accompanied by swelling, heaviness in the legs, circulatory disorders, leading to the development of concomitant diseases.

Pain in the heel due to injuries

• Fracture of the calcaneus. Occurs when falling or jumping from a significant height. The pain is sharp, sudden. Swelling increases in the damaged area and the intensity of pain increases. The heel increases its size, turns blue, palpation is painful, may be accompanied by a crackling sound;
• Bruise. Characteristic for children jumping in the process of playing. The pain has a pulling character, localized along the surface of the foot. Edema is moderately insignificant. When the limb is given rest, the pain subsides;
• Achilles tendon rupture. It is typical for athletes who violated the warm-up technology or gave a sharp load to the leg. It is determined by a sharp pain in the back of the leg, combined with a sharp crack of a rupture. Movement of the heel is impossible, the pain is severe, but tolerable in a state of immobility;
• Fracture in osteoporosis. Age-related injury with reduced strength of bone tissue. Pain is moderate to intense. Edema of moderate severity, may be absent;
• Ankle ligament injury. Accompanied by severe pain and increasing swelling.

Pain associated with inflammation of the tendons and ligaments

• Achilles tendonitis. Consequence of overload. Soreness can increase for several months, periodically accompanied by swelling, painful palpation and fever of the affected area;
• Haglund deformity. Pressing pains on the back of the heel while walking. A dense painful bump is revealed;
• Heel spur. The pain is pronounced, most acute at the beginning of the movement, walking is disturbed, the gait changes. During periods of exacerbation, movement is impossible even with support;
• Sever’s disease. Typical for teenage boys. Aching pain aggravated by movement. External changes are not detected.

Heel pain in diseases of the joints

Arthritis also causes pain in the heel area. Starting pains are pulling in nature, discomfort increases with time, aggravated by the weather, at night, during exercise. Are fraught with deformation of the limbs and limited mobility.

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Pain associated with infection

• Hematogenous osteomyelitis. The result of the introduction of infection from another focus. More often found in children. It is characterized by a rise in temperature, general intoxication of the body, bursting pain;
• Post-traumatic osteomyelitis. The pain is intense, tearing, a sharp wound discharges a large amount of pus, and fistulas may also form.

Dermatological problems characterized by pain in the heel

• Callus. Corn abscess can give painful symptoms with the formation of an abscess. Opening the pathological focus facilitates the condition, reducing the severity of pain;
• Wart. A protruding plantar wart gives pain with constant injury, after a long walk;
• Hyperkeratosis of the feet. Leads to the formation of cracks, calluses, bruising. The pains are burning and jerking;
• Trophic ulcers. Specific manifestation of diabetes mellitus, severe varicose veins, thrombophlebitis. The pain syndrome is moderate.

Diagnosis of the disease

Proper diagnosis and differentiation from diseases with similar symptoms is essential for the successful treatment of heel pain. The complex of studies is carried out by therapists, traumatologists, surgeons, neurologists and other specialists. Possible diagnostic procedures are very diverse.

Test type	Diagnostic target
Complete blood count	Detects inflammation, anemic decrease in hemoglobin, changes in platelet levels in clotting problems
Blood chemistry	Shows changes in metabolic processes, diabetic manifestations, arthritic disorders, infectious component
Tumor marker test	Required for suspected neoplasms in bone or adjacent tissues
Radiography	Takes pictures of the bone and soft tissues of the foot. Indicated for post-traumatic pain, suspected degenerative-dystrophic processes, pain of uncertain cause or inaccurate localization
ultrasound	Enhances diagnostic information for arthritis, bursitis, inflammatory lesions
CT, MRI	Clarify the state of tissue structures in any type of pathology
Punctures	If neoplastic lesions or infections are suspected, bone or bursa punctures are taken

Treatment of heel pain

If the cause of pain is an injury, immobilize the foot, apply cold, and take pain medication. Then the victim is taken to the emergency room and transferred to the hands of specialists. The necessary treatment is being carried out.

The inflammatory process in the heel area is stopped by limiting or completely eliminating any load, applying local anesthetics or anti-inflammatory drugs. It is not necessary to relieve a sharp pain with medication, it is recommended to contact a medical institution. The same procedure is necessary in case of deterioration of the patient’s well-being, signs of suppuration, and an increase in body temperature.

Treatment can be carried out:

• Conservative methods. They include a mode of carefully reducing the load on the painful area until complete recovery, wearing special orthopedic shoes, heel pads, a plaster cast or splint, moving with a cane or crutch. Additionally, drug therapy prescribed by a doctor is used. NSAIDs, antibiotics, phlebotonics and other drugs are appropriate. In the case of concomitant diseases, the entire range of medications used by the patient is adjusted to obtain the optimal result. The feet are regularly treated, the affected area is bandaged. In most unburdened cases, specialized physiotherapy exercises and physiotherapy are indicated;
• Surgical methods. Surgical intervention is chosen by the attending physician, taking into account the nature of the existing pathology: trauma, infection, trophic ulcers, and others. The postoperative period for any possible disease is characterized by a long and complex rehabilitation, which is the process of developing a limb with the help of physical education and physiotherapy.

Pain in the heel when walking: effective treatment in Moscow

The specialists of our clinic have been successfully dealing with the problem of heel pain for many years, diagnosing the diseases that caused painful symptoms, and achieving stable positive results in the cure. Doctors widely use an integrated approach that includes time-tested classical methods of therapy, as well as the latest achievements of modern medicine. The professional arsenal of experienced specialists includes a huge number of rehabilitation programs and methods. The doctors of the clinic regularly undergo education and training in the best medical centers in Israel, the USA, Germany, get acquainted with the achievements of innovative therapy and surgery. Each patient can attend a free appointment and have our specialists diagnose their problem. Therapeutic sessions guarantee a quick improvement in well-being, removal of pain manifestations in 1-2 visits.

Call our contact numbers and sign up for a free appointment with recognized experts!

Frequently asked questions

Can heel pain go untreated?

Ignoring this serious symptom is not recommended. The disease can progress rapidly, causing severe pain. In the most critical cases, surgery will be required. Under the external symptoms of arthritis, benign or malignant neoplasms can be masked, for which timeliness is a guarantee of successful treatment.

Which doctor should I consult for heel pain?

Make an appointment with a general specialist or orthopedic traumatologist. At the first stage, a comprehensive diagnosis will be carried out and the exact cause of the painful manifestations will be established. After that, the patient will be referred to a specialist in the desired profile.

How common is heel pain?

Complaint of pain in the heels when visiting an orthopedist-traumatologist is one of the most common symptoms of various diseases. Athletes, people with overweight, representatives of professions who are forced to spend a long time on their feet and many others suffer from it. At risk are patients with diabetes, as well as men over 35 years of age.

What is a heel spur?

The vernacular name “calcaneal spur” is firmly attached to plantar fasciitis, an inflammatory disease of the connective tissue in the sole of the foot. The disease is associated with a high load on the fascia and its microtrauma. The dying cells of the tissue are rich in calcium, which forms a painful bone formation, shaped like a spur.

Material checked by an expert

Marshenin Konstantin Vladimirovich

Chief physician. Neurologist, chiropractor, vertebrologist, psychoneurologist, doctor of the highest qualification category

Work experience – 22 years

Video testimonials from patients

Hernia in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months, my lower vertebrae completely disappeared and crunches in my neck disappeared …

Hernia of the lumbosacral region

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot.”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Cervical osteochondrosis

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Osteoarthritis of the knee joint, 2nd degree

Came with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort.”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Pain in the back

“At the beginning of the path of therapy, my back hurt very badly. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine. ”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I came to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, stay at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months. I’m fine, my back doesn’t hurt.”

Hernia and protrusion

“I came to the clinic with L4-L5 hernia and L5-S1 protrusion. Today the course of treatment has ended. Lower back hurt, it was difficult to bend down. After completing the course and receiving instructions in the form of physical exercises, it became much easier. After a month of treatment, I do not feel any stiffness of movements. ”

Pain in the lower back and hip joint

“From a young age, I was troubled by back pain. When they became unbearable, I went to Dr. Length’s clinic. Already after the first procedure, the pain in the hip joint was gone. After the third procedure, the shooting pains in the lower back stopped.

Very effective procedures

The procedures turned out to be very effective. I used to go to other clinics and 100% did not relieve my pain, they bothered me. After this specialist, after three or four sessions, my functions were restored, the pain in the joints disappeared.