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What Causes Severe Pain In Heels When Diagnosed With Bursitis?

Posted on Thu, 16 Jun 2016

Question: I have had bursitis both sides for 18 months, after 3 steroid injections now better. Seeing a physiotherapist to strengthen mainly gluteus muscles. Recently I have had nerve pain down my left leg, worse side, and my GP thinks the nerves may have been irritated. Taking Gabapentin which kills the pain completely. But with the sudden onset of nerve pain I also started to limp and my left leg became week, and also I cannot stand on my left heel. (I'm 77 by the way but have been very fit mentally and physically). Can you explain what the inability to walk on left heel or support myself on left heel means please.

Answered by Dr. Ajay Panwar (3 hours later)

Brief Answer:
Possibly lumbosacral radiculopathy.Some more details.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Though,the description of pain down the leg with limp in setting of gluteal muscles involvement,appears to be due to lumbosacral radiculopathy,however,I need to know some more details so that I can answer this well further-
1)Is the pain worse in standing,lying down or bending forward position?Alternatively,which of the these postures improve the pain?
2)Does the pain increases on walking and improves on rest?If yes,after how many minutes of rest after walking,it improves?
3)Do you have tingling or other paresthesias and numbness in lower limbs?
4)Do you have any difficulty in passing urine?

I shall be glad to have you in follow-up with details so that I can answer this well further.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (6 hours later)

Mistake , it is my right leg. Not sure now because gabapentin has completely killed the pain. It was excruciating, went down outer side of me leg, numbness and tingling in my shin and into my big toe which was very painful. I think it was better at night although cannot remember exactly. No urinary problems, although ankles have started to swell slightly at night. I have had problems with L4/5facet joints for years . My physio says the pain is at the insertion of the gluteus XXXXXXX . I do veer slightly to the right when walking. Although I can't Remember how the pain was worse . I know I was almost in tears with the pain when sitting down. As I said gabapentin has c ompletely cured the pain. I am curious to know why I am unable to support myself on my right heel.
Thank you. XXXX

Answered by Dr. Ajay Panwar (19 hours later)

Brief Answer:
Possibly lumbosacral radiculopathy.Needs MRI Spine.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.

Closely following your clinical details, give indications that this is probably right lumbo-sacral radiculopathy due to degenerative spine changes in L-S Spine. Inability to support on right heel is possibly due to distal muscles weakness of anterior compartment of leg. I suggest that you should undergo a MRI of L-S Spine.Meanwhile,gabapentin is the right drug and should be continued.Along with calcium/vitamin D supplements should be taken.

Further,considering facet joint issues and history of severe pain,I would also like you to get examined by a Rheumatologist in person.I just don't want to miss out on any rheumatological involvement.

Hope that helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar