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What Causes Unexplained Bilateral Heel Pain?
Brief Answer:
Can be due to plantar fasciitis.
Detailed Answer:
Hello,
Thanks for posting your query.
The pain in the heels may or may not be related to the epidural shots that you had a year ago.
The pain in heels can be due to a condition called plantar fasciitis. Its one of the commonest reason for heel pain. Pain in morning and improvement on walking for some time is its classical presentation. The initial treatment with anti inflammatory medicines with rest and cold fomentation works fine for most of the patients. Cortisone injection is a good mid to long term treatment.
Consider using soft silicone heel cushions for preventing any further damage to fascia. The HEEL PADS/ HEEL CUSHIONS of soft rubber orthosis and multiple designs and softness grades are available. Typical good quality stuff would give a feel of jelly like softness and flexibility.
Try it and you will feel a great relief. They are effective in both osteoarthritis and plantar fascitis.
Exercises also play an important role and I'm afraid they are the only long term mainstay of the treatment. Do consult a physiotherapist for it.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Can be due to plantar fasciitis.
Detailed Answer:
Hello,
Thanks for posting your query.
The pain in the heels may or may not be related to the epidural shots that you had a year ago.
The pain in heels can be due to a condition called plantar fasciitis. Its one of the commonest reason for heel pain. Pain in morning and improvement on walking for some time is its classical presentation. The initial treatment with anti inflammatory medicines with rest and cold fomentation works fine for most of the patients. Cortisone injection is a good mid to long term treatment.
Consider using soft silicone heel cushions for preventing any further damage to fascia. The HEEL PADS/ HEEL CUSHIONS of soft rubber orthosis and multiple designs and softness grades are available. Typical good quality stuff would give a feel of jelly like softness and flexibility.
Try it and you will feel a great relief. They are effective in both osteoarthritis and plantar fascitis.
Exercises also play an important role and I'm afraid they are the only long term mainstay of the treatment. Do consult a physiotherapist for it.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I don't know why only this was posted... I have posted much more information.
In any case the pain is in BOTH HEELS and started suddenly after the injection.
Its been 13 month and been just getting worse for the most part. It does Not hurt more in the morning, actually it hurts more after standing for more than a minute or walking over 50 meters. The pain is symmetric.
I have pain in my other joints as well which I'll describe later.
I have seen many doctors and preformed many tests:
Neurologis: did not find anything did a nerve study.
MRI: - show very very mild hugland deformity, but its its not very likely that it would cause pain in both feet and also start suddenly
Xray: nothing is detected
Physical Therapy: No help
Rheumatologist: Thought that he identified (considering all my history) what I have as undifferentiated ankylosing spondylitis but so far no help with the medication. I took Arava 20mg for 5 weeks with no signs of improvement...he stopped that and changed it to Enbrel shots i had so far 4 shots and after 12 days there is also no sign of improvement.
So here is my history. I have listed the symptoms in a chronological order and not by severity.
Knees : Started 18 years ago mild and has not been worsening, there is some crackling noise with certain motions. Symmetric pain/discomfort mainly when standing for over 5 minutes. Walking is not as painful as standing.
--------------------------------------------------------------------------------------------------
Back: Started 15 years ago but has been progressing over the years. Started with pain level of “1” and progressed to a pain level of “8” during flare ups periods. Now, it is usually at pain level of 5-6. I have 2 disc herniation L3-L4 and L4-L5. There is no radiation of pain down the legs. MRI available.
I had 3 sets of transforaminal cortisone shots at the end of 2013 and beginning of 2014 with very minimal pain relief that lasted for a short period.
The last time that I had a shot (January 2014), two days later my heels started to hurt. Its been worsening lately, 11 month later.
----------------------------------------------------------------------------------------------
Neck: Started 3 years ago with a bad movement. Pain has been there constantly after but it had its up and downs unlike the back and knees. Never performed MRI’s.
----------------------------------------------------------------------------------------------
Heels: Started a year ago 2 days after my back shots. With symmetric pain that worsens with walking or standing. I cannot walk more that ½ mile without strong pain. also cannot stand for longer that couple of minutes without strong pain. MRI and CT were performed 8 months ago showed something similar to Haglund's Deformity, since then it has been getting worse.
----------------------------------------------------------------------------------------------------------------
Hives: A one time episode of hives when I was in Las vegas in August of 2013, lasted for about 3 weeks.
In any case the pain is in BOTH HEELS and started suddenly after the injection.
Its been 13 month and been just getting worse for the most part. It does Not hurt more in the morning, actually it hurts more after standing for more than a minute or walking over 50 meters. The pain is symmetric.
I have pain in my other joints as well which I'll describe later.
I have seen many doctors and preformed many tests:
Neurologis: did not find anything did a nerve study.
MRI: - show very very mild hugland deformity, but its its not very likely that it would cause pain in both feet and also start suddenly
Xray: nothing is detected
Physical Therapy: No help
Rheumatologist: Thought that he identified (considering all my history) what I have as undifferentiated ankylosing spondylitis but so far no help with the medication. I took Arava 20mg for 5 weeks with no signs of improvement...he stopped that and changed it to Enbrel shots i had so far 4 shots and after 12 days there is also no sign of improvement.
So here is my history. I have listed the symptoms in a chronological order and not by severity.
Knees : Started 18 years ago mild and has not been worsening, there is some crackling noise with certain motions. Symmetric pain/discomfort mainly when standing for over 5 minutes. Walking is not as painful as standing.
--------------------------------------------------------------------------------------------------
Back: Started 15 years ago but has been progressing over the years. Started with pain level of “1” and progressed to a pain level of “8” during flare ups periods. Now, it is usually at pain level of 5-6. I have 2 disc herniation L3-L4 and L4-L5. There is no radiation of pain down the legs. MRI available.
I had 3 sets of transforaminal cortisone shots at the end of 2013 and beginning of 2014 with very minimal pain relief that lasted for a short period.
The last time that I had a shot (January 2014), two days later my heels started to hurt. Its been worsening lately, 11 month later.
----------------------------------------------------------------------------------------------
Neck: Started 3 years ago with a bad movement. Pain has been there constantly after but it had its up and downs unlike the back and knees. Never performed MRI’s.
----------------------------------------------------------------------------------------------
Heels: Started a year ago 2 days after my back shots. With symmetric pain that worsens with walking or standing. I cannot walk more that ½ mile without strong pain. also cannot stand for longer that couple of minutes without strong pain. MRI and CT were performed 8 months ago showed something similar to Haglund's Deformity, since then it has been getting worse.
----------------------------------------------------------------------------------------------------------------
Hives: A one time episode of hives when I was in Las vegas in August of 2013, lasted for about 3 weeks.
Brief Answer:
Can be due to osteoporosis.
Detailed Answer:
Hello.
Thanks for the detailed history.
The heel pain and other symptoms that you have described can be due to generalised osteoporosis or neurogenic pain. You can try local steroid injections in the heels and see if it helps. Taking medicines like Pregabalin and Gabapentin will also help.
Do get your serum vitamin D3 levels evaluated and start with proper supplements in case the levels are low. Do follow the treatment as suggested by your rheumatologist.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Can be due to osteoporosis.
Detailed Answer:
Hello.
Thanks for the detailed history.
The heel pain and other symptoms that you have described can be due to generalised osteoporosis or neurogenic pain. You can try local steroid injections in the heels and see if it helps. Taking medicines like Pregabalin and Gabapentin will also help.
Do get your serum vitamin D3 levels evaluated and start with proper supplements in case the levels are low. Do follow the treatment as suggested by your rheumatologist.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i just read about osteoporosis it seems that it is not painful unless there is a fracture, and I know that I don't have any from all the MRI's CT, X-RAY i have done over the years, am I missing something?
Neurogenic pain is very broad...are you suggesting that I refer my questions to a neurologist?
Neurogenic pain is very broad...are you suggesting that I refer my questions to a neurologist?
Brief Answer:
Nerve related cause can be there.
Detailed Answer:
If nothing has been detected on MRI scans then a nerve related cause is likely. A nerve root irritation or swelling at the level of lumbar spine can cause such a persistent pain. You can consult a neurologist and get medicines like Gabpentin or methylcobalamin prescribed.
Regards.
Nerve related cause can be there.
Detailed Answer:
If nothing has been detected on MRI scans then a nerve related cause is likely. A nerve root irritation or swelling at the level of lumbar spine can cause such a persistent pain. You can consult a neurologist and get medicines like Gabpentin or methylcobalamin prescribed.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
In the Mri of Lumber Spine I have two herniated discs 4-6mm L3 - L4 and L4-L5. Throughout the 14 years that I had back pain it never radiated to any part of the body. It was always kind of a local pain. About 2 days after the epidural shots my both heels started to hurt. The pain in mechanical meaning i have when i press anywhere in the heel...against the calcaneus etc. In x-ray or mri there are no sign of anything wrong with the calcaneus except some very mild hugland's deformity. I went to see a foot specialist they don't think that the source of the pain is the Hugland's deformity.
So I guess my question to you is that is there a possibility an epidural shots in the lumbar spine can cause such LOCALIZED in both heels? I would also appreciate any other thoughts you might have.
So I guess my question to you is that is there a possibility an epidural shots in the lumbar spine can cause such LOCALIZED in both heels? I would also appreciate any other thoughts you might have.
Brief Answer:
Can be a possibility.
Detailed Answer:
If all other causes have been ruled out then an epidural shot can cause a localized pain in the heels. The shot can cause a damage to the nerve roots supplying the area of heels. The bilateral pain can be due to disc herniation or a nerve root inflammation also. Accupressure in the lower lumbar spine can help in relieving such nerve related pain.
Regards.
Can be a possibility.
Detailed Answer:
If all other causes have been ruled out then an epidural shot can cause a localized pain in the heels. The shot can cause a damage to the nerve roots supplying the area of heels. The bilateral pain can be due to disc herniation or a nerve root inflammation also. Accupressure in the lower lumbar spine can help in relieving such nerve related pain.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I tried acupuncture which didn't help. I have hard time functioning standing walking etc. The state just issued an handicap tags for me. What else can I do or try to get out of this situation ?
Brief Answer:
Pain killers and massage.
Detailed Answer:
Other then that regular pain killers , massage and local steroid injections in the heels to reduce the ongoing inflammation can help.
Regards.
Pain killers and massage.
Detailed Answer:
Other then that regular pain killers , massage and local steroid injections in the heels to reduce the ongoing inflammation can help.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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