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Sunday, February 28, 2021

Pain in the Back of the Heel: Could the Pain be from this big spur when the Pain is only 10 days old?

This patient presented to me several weeks ago with pain in the back of her heel for 10 days. No prior history of pain and could not remember what started it. She was really limping as she did not want to put her heel down. There was no swelling (which is a sign of an inflammatory response) and the patient did not feel it the patient was nerve related (no numbness, tingling, electrical, buzzing, burning, radiating). I placed her on some achilles stretches and heel lifts. As she did not improve, I took these xrays showing the heel spur posteriorly (back of the heel area). This spur has been there forever, so really did not explain the sudden pain. An MRI taken a few days ago shows marked internal swelling in the soft tissue, spur, and achilles tendon, but not in the heel bone deep to it. I will rest the heel in a removable cast this month and send her to PT for both calf mobilization and heel anti-inflammatory measures. Wish her luck! Of course, in situations like these, you are not sure if she will calm this right down, or the spur will need to be removed. Or, if it is really the achilles tendon that is failing, and won't respond. Surgery is spur removal and achilles clean up to make sure it is healthy. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.