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Friday, October 10, 2014

Heel Pain - Causes and Homeopathic Treatment



Heel pain is a very common problem in present era. A number of patients knock at the door of Doctors daily for heel pain only. There are so many drugs under Homoeopathy for the same and very frequent failures are there in treating heel pain, and consequently the patient turn towards another sort of treatments. This is our lack of knowledge, nothing else. To over come these problems, we must first know the basic causes for heel pain.
First, we must know the anatomy of heel. I am not going to take space here for this point, as this is easily available in various textbooks on anatomy. I am coming to causes of heel pain directly.

1- Attenuation of Achilles tendon.
2- Achilles tendon bursitis.
3- Stress fractures of bones in heel. (Diffuse tenderness).
4- Cyst formation.
5- Plantar fasciitis.
6- Haglund's disease (Prominent Posterio - superior calcaneal tubrosity.)
7- Reactive osteosclerosis of the posterio - inferior tuberosity ( Due to abnormal Achilles tendon insertion)
8- Calcaneal spur.
9- Plantar fat pad atrophy.
10- Traumatic disruption of plantar fat pad septa.

Now, we must we aware of the symptoms of each disorder stated above are different but all of them are localized to heel. Almost all the patients feel unable to explain their sufferings so clearly as to make distinction easy to the physician.
Here radiological diagnosis is of great value. After a very careful examination and investigation the doctor can reach to the cause of pain.
I am giving here a work on short repertorizations based upon various repertories. Only particular rubrics are used here to understand role of various remedies related to pain in heels. However, during prescribing Homoeopathically, all the rules must strictly be followed.

Main rubrics pertaining to Heel-Pain:
1. EXTREMITIES - PAIN - Foot - heel
2. EXTREMITIES - INFLAMMATION - Ankle
3. EXTREMITIES - PAIN - Ankle - tendo achillis
4. EXTREMITIES - PAIN - Ankle - malleolus - internal
5. EXTREMITIES - PAIN - Ankle - malleolus - outer
6. EXTREMITIES - PAIN - Ankle - malleolus - outer - walking
7. EXTREMITIES - PAIN - Ankle - jarring
8. EXTREMITIES - PAIN - Ankle - stepping, on
9. EXTREMITIES - PAIN - Ankle - walking, while
10. EXTREMITIES - PAIN - Ankle - motion
11. EXTREMITIES - PAIN - Ankle - pulsating
12. EXTREMITIES - PAIN - Ankle - rheumatic
13. EXTREMITIES - PAIN - Ankle - sitting
14. EXTREMITIES - PAIN - Ankle - standing
15. EXTREMITIES - PAIN - Ankle - step, from a false
16. EXTREMITIES - PAIN - Ankle - touch
17. EXTREMITIES - PAIN - Ankle - walking - amel.
18. EXTREMITIES - PAIN - Ankle - warmth - agg.
19. EXTREMITIES - PAIN - Foot - heel - ascending stairs
20. EXTREMITIES - PAIN - Foot - heel - bone
21. EXTREMITIES - PAIN - Foot - heel - elevating the feet amel.
22. EXTREMITIES - PAIN - Foot - heel - gouty
23. EXTREMITIES - PAIN - Foot - heel - nails under the skin; like
24. EXTREMITIES - PAIN - Foot - heel - pressure agg.; least
25. EXTREMITIES - PAIN - Foot - heel - resting, with boot off, amel.
26. EXTREMITIES - PAIN - Foot - heel - pulsating
27. EXTREMITIES - PAIN - Foot - heel - rheumatic
28. EXTREMITIES - PAIN - Foot - heel - rising from a seat
29. EXTREMITIES - PAIN - Foot - heel - rubbing amel.
30. EXTREMITIES - PAIN - Foot - heel - sitting
31. EXTREMITIES - PAIN - Foot - heel - splinter; as from a
32. EXTREMITIES - PAIN - Foot - heel - standing
33. EXTREMITIES - PAIN - Foot - heel - ulcerative
34. EXTREMITIES - PAIN - Foot - heel - walking
35. EXTREMITIES - PAIN - Foot - heel - walking - amel.
36. EXTREMITIES - PAIN - Foot - heel - warmth amel.
37. EXTREMITIES - INFLAMMATION - Foot - heel
38. EXTREMITIES - INFLAMMATION - Foot - heel - rheumatic
39. EXTREMITIES - INFLAMMATION - Foot - periosteum
40. EXTREMITIES - INFLAMMATION - Foot - bone
41. EXTREMITIES - INFLAMMATION - Joints - synovitis
42. EXTREMITIES - INFLAMMATION - Tendons
43. EXTREMITIES - INFLAMMATION - Foot - sole
44. GENERALS - INFLAMMATION - aponeurosis
45. GENERALS - INFLAMMATION - bones; of
46. GENERALS - INFLAMMATION - bones; of - periosteum; of
47. GENERALS - INFLAMMATION - bones; of - bone marrow; of
48. GENERALS - INFLAMMATION - bursae; of
49. GENERALS - INFLAMMATION - cartilages; of
50. GENERALS - INFLAMMATION - cellulitis
51. GENERALS - INFLAMMATION - joints; of - arthritis deformans
52. GENERALS - INFLAMMATION - muscles; of
53. GENERALS - INFLAMMATION - nerves; of
54. GENERALS - INFLAMMATION - synovial membranes; of
55. GENERALS - INFLAMMATION - tendons; of
These are the rubrics available in various repertories, which are related to heel- pain. However many among them can be related to numerous other problems, the synthesis of a particular rubric for heel- pain may need single or combination of one or many of these. A doctor can now reach to the point of illness and may diagnose and ascertain the real site or structures of involvement and use the given rubrics in making the similimum.
A Homoeopath, after very keen observation and very careful evaluation of the signs and symptoms taken, can most precisely make the similimum picture of the suffering and thenceforth can heal the ailments best.

Plantar Fascitis is inflammation of the plantar fascia or arch tendon of the foot. It is an overuse injury causing heel pain which may radiate forward into the foot. Plantar fasciitis can also be known as a heel spur although they are not strictly the same. A heel spur is a bony growth that occurs at the attachment of the plantar fascia to the heel bone (calcaneus). A heel spur can occur (with repetitive pulling of the plantar fascia) on a foot with no symptoms at all and a painful heel can have no heel spur present.
The Plantar Fascia or arch tendon is a broad, thick band of tissue that runs from under the heel to the front of the foot. A rupture can sometimes occur at the origin of the arch ligament and result in inflammation and pain.
Plantar Fasciitis is an inflammation (irritation and swelling with presence of extra immune cells) of the thick tissue on the bottom of the foot that causes heel pain and disability.

Cause of Plantar Fascitis

The cause of plantar fasciitis is unclear and may be multifactorial. Because of the high incidence in runners, it is best postulated to be caused by repetitive microtrauma. Possible risk factors include obesity, occupations requiring prolonged standing, heel spurs, pes planus (excessive pronation of the foot), and reduced dorsiflexion of the ankle.
Sex-The condition occurs equally in both sexes in young people. Some studies show a peak incidence may occur in women aged 40-60 years.
Age-The condition can occur at any age. As mentioned, a peak incidence may occur in women aged 40-60 years.

Clinical features of Plantar Fascitis

Symptoms
• Pain beneath heel.
• Pain extends medially into sole.
• Pain worse on standing, walking.
Signs
• Marked tenderness at site of attachment of planter fascia to calcaneum.
• Tenderness at heel pad.

INVESTIGATION for Plantar Fascitis

X-Ray heel
• Usually no abnormality.
• Occasionally calcaneal spur is evident but its significance in causing pain is doubtful.

GENERAL MANAGEMENT for Plantar Fascitis

• Reassurance.
• Exercise.
• Avoid precipitating causes.
• Correct maintaining causes.
• Advise foot wears having soft rubber cushioned soles.
• Short wave diathermy helpful in relieving pain.

Homeopathy Treatment & Homeopathic Remedies for Pain in Feet, Soles, Heel

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.

Homeopathic Remedies

Causticum
Cramps in the feet. Pains in the instep, in the ankle bones, in the soles of the feet, and in the toes, on walking. Neuralgic pains in the soles of the feet. Contraction in the instep, with tensive pain when stepping. Coldness of the feet. Swelling of the feet. Pains in the varices. Tingling in the soles of the feet. Festering vesicles and ulcerations on the heels.
Adapted to persons with dark hair and rigid fibre; weakly, psoric, with excessively yellow, sallow complexion; subject to affections of respiratory and urinary tracts.
Graphitis
Congestion in the legs and in the feet, when standing upright. Swelling of the legs and of the feet, with hardness and shooting pain. Stiffness of the instep. Shooting pain, like that of an ulcer, in the heel and in the soles of the feet, on rising from the sitting posture. Cold feet, even in the evening in bed. Feet burning. Fetid sweat on the feet. Contraction of the toes. Swelling and distortion of the toes.
Suited to – Excessive cautiousness; timid, hesitates; unable to decide about anything. Fidgety while sitting at work. Sad, despondent; music makes her weep; thinks of nothing but death.
Medorrhinum
Burning in feet, wants them uncovered and fanned. Cold feet with chills all over. Oedema of feet followed and better by diarrhea. Soreness in ball of foot under toes. Cold, sweating feet.
For the constitutional effects of mal-treated and suppressed Gonorrhoea.
For persons suffering from gout, rheumatism, neuralgia and diseases of the spinal cord and its membranes- even organic lesions ending in paralysis- which can be traced to a sycotic origin.
Pulsatilla
Painful sensation of numbness in soles of feet and in balls of the toes. Red-hot swelling of feet, extending up to calf, with stinging pain. Swelling of top of foot. Oedematous swelling of feet, worse in evening. Piercing shootings and incisive pains in heels (towards evening). Shootings in soles of feet and extremities of toes. The complaints are worse when one allows the feet to hang down.
Adapted to persons of indecisive, slow, phlegmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears; affectionate, mild, gentle, timid, yielding disposition- the woman’s remedy. Weeps easily: almost impossible to detail her ailments without weeping.
Sulphur
Shootings in feet. Coldness in feet, especially in evening, in bed, or burning sensation, chiefly in soles of feet. Burning in feet, wants to find a cool place for them, puts them out of bed to cool them off. Burning in soles, on stepping after sitting a long time, and itching, especially on walking, wants them uncovered. Cramp in soles at every step. Soles cold and sweating. Sweat on right foot. Swelling of feet, and especially of the ankles. Gnawing vesicles on soles. Ulcer on instep.
Adapted to persons of a scrofulous diathesis, subject to venous congestion; especially of portal system. Persons of nervous temperament, quick motioned, quick tempered, plethoric, skin excessively sensitive to atmospheric changes. For lean, stoop-shouldered persons who walk and sit stooping like old men. Standing is the worst position for sulphur patients; they cannot stand; every standing position is uncomfortable. Dirty, filthy people, prone to skin affections. Aversion to being washed; always <. after a bath.
Zincum met
Stiffness of joint of the foot after being seated for some time. Wrenching pain in joints of feet and toes. Burning sensation in feet. Inflammatory swelling of feet. Weakness and trembling of feet. Feet sweaty and sore about toes, fetid suppressed foot-sweat with much nervous excitement. Coldness of the feet at night. Nervous, fidgety movement of the feet, after retiring and during sleep. Tearing in margin of right foot. Ulcerative, boring pains in heels, worse when walking than when sitting. Profuse sweat on the feet.
Persons suffering from cerebral and nervous exhaustion; defective vitality; brain or nerve power wanting; too weak to develop exanthemata or menstrual function, to expectorate, to urinate; to comprehend, to memorize. Incessant and violent fidgety feeling in feet or lower extremities; must move them constantly.


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