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heel pain

Posted by Robert D on 8/22/00 at 12:17 (026021)

I'm experiencing pain along the outside edges of the bottom of my heel.If I am on my feet alot, specially standing, the pain becomes progressively worst.Due to job requirements staying off my feet is not an option. Ive tried arch supports, but this made my arches hurt and swell up.I was fitted with orthodics,which I wear almost exclusively(8 months), but this has had limited to no positive effect upon the pain. What could be causing the pain,something my Dr. is missing.

Re: heel pain

Dr. Biehler on 8/22/00 at 12:36 (026024)

Pain on the outside of the heel can be caused by standing too long if the heel bone is in varus or there is a bony build up on the out side of the heel bone. Both of these situations cause the bodies weight to be spred over an area not wide enough to disperse the weight. On the other hand, if you are extremly flat footed, it could be a sural nerve entrapment between the ankle and the heel. Dr. Biehler

Re: heel pain

suzi on 8/22/00 at 17:56 (026054)

Dr. Biehler how do you diagnose a seral nerve entrapment? I've never heard of this!

Re: heel pain

Dr. Biehler on 8/22/00 at 21:45 (026071)

I have never read about it in books but I diagnose it by following the path of the sural nerve and the discription of the pain or parathesas. I find that after a posterior tendon rupture or chronic flat foot with tibia vera, there comes a time when the outer edge of the foot starts to hurt. In these patients their ankle bone seems to be resting on their heel bone, In every case the pain went a way after I posted the medial side of their foot. What this does is to take enough pressure off the nerve for it to function normal again. I start with 1/8' felt. Sometimes that is all that is needed. Dr. Biehler

Re: heel pain

Fred on 8/23/00 at 17:17 (026102)

Dr. Biehler, re pain on the outer edge of the foot, you said in your last message 'In every case the pain went a way
after I posted the medial side of their foot.' Can you please explain what posting the medial side of the foot means? I have had pain on the outside edge of my foot concurrent with pf. Not strong pain, but present more than the pf, which seems under control now.

Re: outer edge heel pain in flat feet

Dr. Biehler on 8/23/00 at 19:56 (026104)

When a person has an extremly collapsed arch and their outside ankle bone starts to push or rest on the outside of their heel bone it can compress the nerves and cause pain and parathesias. When I put a small lift under just the inside (medial) half of the heel bone, it causes the outside ankle to lift up off the heel releasing the nerve compression. It you are not flat foot and if you are standing on the out side of your foot, you might need a larger build up on the medial side to spread out your body weight distribution which decreases the outer pressure. Just because you have an orthotic doen't mean it is accomplishing the right thing. Dr. Biehler

Re: heel pain

Dr. Biehler on 8/22/00 at 12:36 (026024)

Pain on the outside of the heel can be caused by standing too long if the heel bone is in varus or there is a bony build up on the out side of the heel bone. Both of these situations cause the bodies weight to be spred over an area not wide enough to disperse the weight. On the other hand, if you are extremly flat footed, it could be a sural nerve entrapment between the ankle and the heel. Dr. Biehler

Re: heel pain

suzi on 8/22/00 at 17:56 (026054)

Dr. Biehler how do you diagnose a seral nerve entrapment? I've never heard of this!

Re: heel pain

Dr. Biehler on 8/22/00 at 21:45 (026071)

I have never read about it in books but I diagnose it by following the path of the sural nerve and the discription of the pain or parathesas. I find that after a posterior tendon rupture or chronic flat foot with tibia vera, there comes a time when the outer edge of the foot starts to hurt. In these patients their ankle bone seems to be resting on their heel bone, In every case the pain went a way after I posted the medial side of their foot. What this does is to take enough pressure off the nerve for it to function normal again. I start with 1/8' felt. Sometimes that is all that is needed. Dr. Biehler

Re: heel pain

Fred on 8/23/00 at 17:17 (026102)

Dr. Biehler, re pain on the outer edge of the foot, you said in your last message 'In every case the pain went a way
after I posted the medial side of their foot.' Can you please explain what posting the medial side of the foot means? I have had pain on the outside edge of my foot concurrent with pf. Not strong pain, but present more than the pf, which seems under control now.

Re: outer edge heel pain in flat feet

Dr. Biehler on 8/23/00 at 19:56 (026104)

When a person has an extremly collapsed arch and their outside ankle bone starts to push or rest on the outside of their heel bone it can compress the nerves and cause pain and parathesias. When I put a small lift under just the inside (medial) half of the heel bone, it causes the outside ankle to lift up off the heel releasing the nerve compression. It you are not flat foot and if you are standing on the out side of your foot, you might need a larger build up on the medial side to spread out your body weight distribution which decreases the outer pressure. Just because you have an orthotic doen't mean it is accomplishing the right thing. Dr. Biehler