Is a common problem but can be very troublesome especially in the mornings when it is difficult to put the foot down and bear weight on it. Ouch! the first step has been the most painful especially the first thing in the morning. This is a relatively common condition that goes by the name of calcaneal spur in orthopaedic parlance . This term refers to a small protrusion on the heel bone seen on X ray. The pain is around the area of the spur but not necessarily because of it. The pain could be because of the pull of the heel tendon commonly called the Achilles tendon on the.
Spur. This pull is usually because of a shortening of the calf muscles that terminate in the Achilles tendon.
Alternatively the pain could be because of the pull of the muscles of the foot arising from the heel to terminate on the balls of the foot. Either way it is a pain that originates from the muscles around the heel bone. Once this is understood. Relief of the pain can be logically achieved by dry needling of these muscles. In addition deficiency of vitamins B12 and D3 have to be looked for and corrected.
X-rays do show a spur in the heel bone , called calcaneus hence the name calcaneal spur. However in our experience spur is more the result than the cause of the problem. The spur develops because the shortened calf muscles have been tugging on the heel bone for quite a while . Though shortened they are still very strong muscles that cause the spur to develop. Once the pull on the spur exceeds the equilibrium capacity of the body, pain ensues. By the time pain manifests, the problem has been brewing for a long time. This can make walking, standing and working very painful.
The patients actually have to hobble because of the pain. After a while these pains may become nagging and bothersome. Simple physical treatments like Physical therapy, ultrasound exercises etc these can reverse the problem In early cases but make only a temporary difference in most established cases. Steroid injections have been tried but there is a possibility that steroid injection into this load bearing tendon can cause it to rupture.
IMS, however can make a lasting difference as it restores elasticity to the shortened gastrocnemius and soleus muscles of the calf. Once elasticity is restored exercises can stretch the muscles to their normal length and maintain them there . Nutritional correction for deficiencies, gait and posture correction can successfully reverse a large number of such cases. In our practice reversal of the problem is the norm. In rare cases where the pain has developed neuropathic features it may require additional neuromodulator therapy to prevent recurrence of pain.