Ankle And Heel Pain
Role Of TMJD (Temporomandibular Joint Disorder) In Causing Heel And Ankle Pain-
TMJD is a common etiological factor found associated with heel and ankle pain.
TMJD is an Infratemporal fossa catastrophe, occurring due to inward disc (medial) displacement of the Jaw Joint or TMJ.
Malocclusion of teeth or mal-alignment of jaws or TRAUMA to the jaw joint causes the joint disc (articular disc) to get displaced medially.
This happens due to abnormal teeth grinding, which causes a tilt in the jaw joint leading to abnormal residual forces in the jaw joint.
Inside or on the inside of joint exists major structures travelling from and to the brain like nerves and blood vessels. This leads to compression of these structures.
The first nerve to be encountered, at a distance of just 0.5 cm or an ants length is the accessory nerve or the number 11 cranial nerve. The job of this nerve is to maintain the head on shoulders at the “COG” or the center of gravity.
Irritation of this nerve alters the muscle function and hence the head position, thereby putting undue pressure on heels and ankles, thus causing the pain.
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Heel pain is generally experienced at two sites –
Pain Beneath The Heel
It is usually caused as a result of inflammation of the tissues on the bottom of the foot doe to one or more condition like-
It is one of the most common causes of heel pain.
It refers to inflammation of the band of tissue that connects the heel bone to the toes.
Pain due to plantar fasciitis usually worst during morning on waking up and usually felt in the region of heel or the arch. Most pain is felt while taking the first step after waking up.
Common causes of plantar fasciitis:
A long standing plantar fasciitis may result in a heel spur (calcium deposit) in the region where the plantar fascia tissue band connects with your heel bone. Heel spur usually is not associated with any pain and hence need not be operated.
It usually results due to stepping on a hard object such as a rock or stone. This causes bruise on the fat pad present on the underside of heel. It may or may not appear discolored. The pain usually subsides with rest.
Pain Behind The Heel
Pain behind the heel is usually experienced as a result of the inflammation of the region where the Achilles tendon joins with the heel bone.
This is usually seen associated with too much running or wearing ill-fitting shoes that causes rubbing of the heel too much.
This type of pain usually builds gradually over time.
Skin tends appear red, thick and swollen.
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The bursa functions to provide lubrication when muscles/tendons slide over the bones.
Bursas are usually present around most of the large joints in the body, including the ankle.
The bursa which is present behind the ankle, along the heel, is referred as retrocalcaneal bursa.
Over usage of the ankles may result in the inflammation of the bursa thereby ultimately leading to retrocalcaneal bursitis.
Most common symptoms of retrocalcaneal bursitis:
- Achilles tendon anatomically connects the calf muscle with the heel.
- Achilles tendon helps in walking, running and jumping.
- Excessive or repeated use of the foot causes inflammation of this tendon thereby resulting in Achilles tendonitis.
- Most commonly seen affecting people below 35 years of age.
- Commonly observed in people who are in sports like running and other related athletes.
- Pain felt behind the heel and along the length of the tendon while walking or running.
- Area behind the heel may be tender to touch or move.
- Area behind the heel may appear swollen,
- Increased pain while trying to stand up on one toe.
Risk of Achilles tendonitis is commonly found associated with:
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An ankle sprain is caused due to injury or damage to the ligaments that surround and connect the foot to the bones of the leg.
Such kind of injury may result when accidentally your ankles turn or twist or turn in an abnormal way, thereby causing stretching or tearing of the ligaments that holds ankle bones and joints together.
Rheumatoid Arthritis (RA)
RA is a chronic autoimmune disease of the joints wherein body’s own immune system starts attacking the synovium. Synovium is the thin membrane which lines the joint surfaces.
In majority (almost 90%) patients with rheumatoid arthritis involving the joints of the feet, mostly ankles are affected.
Rheumatoid arthritis is characterized by pain, swelling, inflammation, joint damage, loss of function and disability.
It is a form of arthritis.
Gout occurs as a result of excess uric acid (a bodily waste product circulating in the bloodstream ) in the body. This excess uric acid is deposited as needle-shaped monosodium urate crystals in various tissues of the body, including the joints.
Symptom Of Gout
Patient may experience excruciating pain and swelling in the area of big toe, often following an illness or injury.
Subsequent attacks may occur off and on in other joints, including the ankles.
After years with the disease, lumps of uric acid, called tophi, may form beneath the skin around the ankles.