What causes heel pain?

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Posted on Tue, 14 Nov 2017 in Skin Hair and Nails
Question: what is the problem if the bottom of my feet fill like I am walking on water blisters?
doctor
Answered by Dr. Ishu Bishnoi 1 hour later
Brief Answer:
Differential diagnosis

Detailed Answer:
Hi Kolava, thanks for asking from HCM.


I can understand your concern. You are having complaint of pain in plantar aspect of feet. It could be due to multiple reasons

- nerve involvement - painful sensations can occur due to sensory nerve damage. It can be due to
Diabets
B12 deficiency
L5-S1 central disc herniation
Neuritis
Symmetrical sensory polyneuropathy

- Plantar fasciitis - It occurs due to prolonged standing, lifting weight. In it, pain occurs more on standing and relief on lying down.

- Peripheral vascular disease like atherosclerosis/Burger's disease/vasculitis- Pain occurs more on walking, doing exercise. Skin becomes pale, hair loss.

These are the probable reasons. Kindly give me details of your complaint to suspect some diagnosis.

What is the duration?
What is condition of feet, skin?
Is there any history of alcohol, diabetes, smoking?
Is there any history of prolonged standing, lifting heavy weights?
Is there any other chronic illness?

Hope it will help you. If any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ishu Bishnoi 4 hours later
doctor: I first felt the sensation of the bottom of my feet hurting when I walk, after I was attacked by a nest of California yellow jackets. I received about 20 stings around my my feet and legs. Shortly after that I noticed this sensation of blisters under the skin of the bottom of my feet. This happened in August of 1997. the sensation has been getting slowly worst until now. Now two of my toes on my right foot are sore and very red. Also when , I lay in bed at night both of my feet feel hot and the the toes become very sensitive to touch. If they brush across the bed sheets ,it is very very painful . It started with the big toe on my right foot. Now it is, Big toe and middle toe with bad pain. I started taking metformin for diabeties , about a month ago. Also my finger tips seem to be getting sensitive , but not like my red toes. What do you think is my problem?
doctor
Answered by Dr. Ishu Bishnoi 19 hours later
Brief Answer:
Painful neuropathy or reflex sympathetic dystrophy

Detailed Answer:
Hi Kolava, welcome back.


Thank you for providing me the detailed history and answers. Your history is suggesting you are having extremely sensitive extremities, redness, burning pain. There is history of injury. Such kind of sensitivity following injury can be due to

- Painful sensory neuropathy

- Reflex sympathetic dystrophy

In neuropathy, there is no swelling or redness. So it is more likely reflex sympathetic dystrophy. In it, there is pain, tenderness, burning sensations, redness, flushing, discolouration, shiny skin.
It is also known as complex regional pain syndrome.

For diagnosis, you need to consult doctor. It is diagnosed based on the clinical features described previously. Blood tests are not abnormal because of it, though the associated triggering events mentioned previously may lead to abnormalities in laboratory testing. Plain film X-ray testing and MRI scanning can show patchy thinning or significant osteoporosis. Nuclear bone scanning can show characteristic uptake patterns.

The treatment is greater in the earlier stages of the condition than in the later stages.

- Cool, moist applications to the affected areas can provide some relief of burning symptoms.
- Gradual exercise can help prevent contractures.
- Medications for pain and inflammation can also reduce symptoms.
For persisting symptoms, high doses of prednisone (cortisone) may be used for periods of weeks, depending on the response, and then gradually reduced.
- Other medications that may be of benefit include amitriptyline, pregabalin and clonidine.

You can discuss it with your doctor. Please let me know what was the examination findings and investigations?
If any doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 830 Questions

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