Treatment of heel pain in the elderly

As we age, the body's defense and self-healing functions decline, so elderly people often experience body pain. Now that there are more and more elderly people in our country, the treatment of elderly diseases has also received attention. Heel pain is a common disease among the elderly. Heel pain will have a great impact on the lives of the elderly and is not conducive to their normal life. So how to treat heel pain in the elderly?

1. Prevention and treatment of senile heel pain

Heel pain is a common disease among the elderly. Although it does not appear red or swollen on the outside, it can cause stabbing pain when standing or walking, causing great inconvenience to movement. Heel pain has many causes, including heel spurs, heel bursitis, Achilles tendonitis, heel pad inflammation, and calcaneal fracture. When exposed to cold and dampness, standing for long periods of time, walking long distances, running, and walking on uneven roads, the tendons and ligaments in the heel will suffer chronic and repeated injuries, causing aseptic inflammation, exudation, edema, adhesion or bursa formation, and increased local pressure, resulting in pain and lameness.

Why do older people tend to suffer from heel pain, while younger people who are much more active rarely experience it? The reason is that as people age, the plantar fascia begins to undergo degenerative changes. The fibrous tissue that makes up the plantar fascia gradually loses its elasticity, making it easy to get injured when walking long distances or jumping from a high place. It is also difficult to restore its original structure, often forming scar tissue, which makes the plantar fascia even less elastic, and the pain persists without being relieved. If the traumatic inflammatory reaction at the attachment of the plantar fascia to the calcaneal tuberosity exists for a long time, it will irritate the periosteum of the calcaneus, causing bone hyperplasia and forming a bird-beak-like bone spur. When the foot bears weight, the bone spur can produce mechanical compression on the soft tissue of the plantar foot and cause pain. Bone spurs are generally not absorbed after they are formed, but with treatment, the symptoms of heel pain can be eliminated.

The two commonly used treatment methods are:

1. Local blockade method: Use 2% lidocaine plus 1 ml of Diprosone, dilute it to 5 ml with normal saline, and inject it directly into the painful point, that is, the heel bone where the plantar fascia is attached. It is most effective for plantar fasciitis. It can also be used for calcaneal bursitis and calcaneal tuberosity bursitis. Once a week: 4-6 times as a course of treatment. This is the most effective and optimal treatment method, and is also the main treatment method in the pain department. The small needle knife can directly remove bone spurs and loosen adhesions, and combined with drug injection, it can directly block the nerve conduction pathway of pain, improve local blood circulation, and promote the dissipation and absorption of inflammatory edema, thereby achieving the purpose of pain recovery.

2. Homemade vinegar fumigation method: Use 1000 ml of vinegar, add 30 grams each of papaya, radix polygoni aviculare, safflower, and Achyranthes bidentata, add half a pound of stones and put them in a cloth bag. Boil it over the fire, take it out, and place it on the painful soles of the feet and heels after it no longer burns the feet. Twice daily. Once in the morning and evening.

3. Physical therapy: physical therapy, local hot compress, and vinegar ion penetration therapy can be performed.

4. In addition, you can also dig a hole in the heel of the plastic sponge insole so that the painful heel is not pressed when walking, and the pain can be relieved. During the treatment, you should rest adequately, walk less, jump less, and wear loose, soft, light and comfortable shoes. When the above conservative treatments are ineffective, surgical treatment can be used. The treatment methods include: ① Heel spur resection. For stubborn heel pain, if the X-ray confirms the presence of a bone spur, make an incision on the medial side of the calcaneus, enter the calcaneus, and remove all the bone spurs on the medial side of the calcaneus. ② Calcaneus drilling: It is suitable for those with high calcaneal pressure. The purpose is to reduce the increased calcaneal pressure and treat stubborn heel pain without bone spurs. The incision is still made on the medial side of the calcaneus. After reaching the calcaneus, 7-10 holes are drilled on the medial side of the calcaneus, with an effect of 90%. ③ Calcaneous nerve transection: This method can be used for unexplained intractable heel pain, but it is a destructive surgery that cuts the posterior tibial nerve branch and the sural nerve branch of the calcaneus. The pain department can also use radiofrequency thermocoagulation surgery to destroy the nerves related to heel pain. ④Calcaneous bursectomy: the bursa of the calcaneal tuberosity and the subcalcaneal bursa are removed. ⑤ Calcaneus osteotomy for flatfoot: The purpose is to increase the calcaneal angle through calcaneal osteotomy, straighten the everted calcaneus, and provide the calcaneus with a good biological scaffold.