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pain at the back of heel

Posted by mary b on 3/19/03 at 09:18 (113441)

I have had alot of trouble with pain between the achilles insertion point and the insertion point of the plantar fascia. I have a hanglunds deformity. I am unable to stretch at all. If i do stretch the back of my heel burns like crazy. When its really bad i need to take my shoe off. Usually this will get better if i dont do anything for a few days. I believe that i have retrocalcaneal bursitis. Is there a surgery that will help this? Is the surgery dangerous or beneficail? Believe me i have tried everything here i think. I wear orthotics and ice my heel everyday. I know that i have a tight gastro complex but i cant do anything about it cause i cant strtch it with that area causing sever pain. Please help...

Re: pain at the back of heel

Dr. Z on 3/19/03 at 09:39 (113445)

Do you have pain if there is no shoe on the area. Do you limp when you first get up in the morning. Is there pain in the haglunds area. Why I am asking these questions is you may be a good candidate for ESWT which is a non-surgical procedure for chronic insertinal achilles tendonitis. Will tell you more about the surgery which type depends on what where you pain is and the condition of your achilles tendon. Has a doctor recommended surgery for you?

Re: pain at the back of heel

mary b on 3/19/03 at 13:13 (113474)

yes there is pain at the haglunds area. But there is more pain below it to. When its really bad it seems to cause the rear bottom of my heel to hurt to. I can also see some swelling on the back of the heel and on the bottom of the heel but not where the plantar fascia inserts. I do have a spur under the achilles wchich is somewhat painful. How will eswt help this if i am unable to stretch? Wont surgery help lentghen the achilles by moving it up higher at the back of the heel? The surgeon wants to remove the spur and the haglunds deformity. he said that he would have to detach the achilles and anchor it back in higher up. Is this advisable? What is the recovery period for this type of surgery

Re: pain at the back of heel

Dr. Z on 3/19/03 at 14:36 (113499)

Surgery will help to lengthen the achilles tendon if the insertion is changed. IF you are having pain in both the haglunds and the achilles insertion then we have to determine which came first. This is clinical judgement. This is very hard for me to determine from just an examination.

The recovery time for having the achillest detached and then repositioning
could take up to one year. You are in a cast anywhere from six to twelve years depending on the surgeon and what was needed. There will be some level of physical therapy post surgery

Re: pain at the back of heel

mary b on 3/23/03 at 07:15 (113967)

I have had the haglunds for many years. Probably from steel toe shoes. That surgery sounds pretty invasive. Are the outcomes usually good? Thanks Doctor Z