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Q. What can cause heel pain?

Answered by
Dr. Akshay Kumar Saxena
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 02, 2016 and last reviewed on: Jun 19, 2019

Hi doctor,

I am a 67 year old male. I am overweight, mildly diabetic and have high BP. I have pain on backside of my left heel. It increases in the evening. I think I have Achilles tendinitis. Please help.

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Hello,

Welcome to icliniq.com.

  • You have mentioned pain in your heel region. Also you have stated that you are diabetic, hypertensive and overweight.
  • There are actually many causes of pain in the heel region, so it can be due to plantar fasciitis which is very common in your age group.
  • It can be due to bony spurs causing recurrent inflammation.
  • As you have stated it can also be due to Achilles tendonitis (Achilles tendinitis) which is an inflammatory condition at the site of attachment of Achilles tendon.
  • Also sugar levels have to kept under strict control because it can sometimes lead to cellulitis like situation in which patient experiences pain, swelling, local warmth, etc., and treatment is entirely different for it.
  • So, the treatment depends upon the cause of the pain.
  • Also kindly tell me whether there is any swelling or any other signs and symptoms of inflammation like skin discoloration or local warmth etc.
  • Initially if pain is of recent origin with no other signs and symptoms of inflammation as written earlier, you can initiate with:
  1. Ice packs for local application at tender site.
  2. Physical therapy especially ultrasonic for local application or laser therapy can be initiated.
  3. Take gentle pain killers like tablet Ultracet (Tramadol hydrochloride and Acetaminophen) twice a day for 3-5 days.
  4. Shoe modification and avoidance of those activities which increase your pain.
  • Do let me know how you are feeling in next 3-5 days and come revert back with your investigation reports and a clinical picture.

Investigations to be done:

1. Recent blood tests like CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and serum uric acid.

2. X-ray ankle - lateral view.

3. A clinical picture showing exact site of pain and inflammation, so that the pathology can be estimated.

Differential diagnosis:

1. Achilles tendonitis (Achilles tendinitis).

2. Plantar Fasciitis.

3. Bony spurs.

Regarding follow up:

Follow up with investigations to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


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