Question
I have reoccurring on my medial calcaneus of my right foot. The pain is felt most when I stretch my calf or put pressure on it. The area I'm describing is seems to be close to where the tibial nerve branches off toward the calcaneus. The pain seems more like a crushing feeling than I nerve type sensation. What do you think is the cause and the best course of treatment?

Answer
Hi, Rick,

Thank you for submitting your question.  I'm sorry to hear that you're having that kind of pain.  To have an answer for you, I would need to ask a lot more questions and do a thorough physical exam and workup.  It really takes a much more complete evaluation than I can do here, and you'd need X-rays and possibly a diagnostic ultrasound or more extensive tests.  For a complete answer and treatment solutions, I recommend that you see a specialist in their office.

You asked for possible causes.  The pain could be from a stress fracture, a bone contusion, or arthritic changes.  It could involve a nerve entrapment or a tendon tear.  It might be Baxter's neuritis or plantar fasciitis, tarsal tunnel syndrome or a retrocalcaneal exostosis.  It might involve a muscle tear or Achilles tendinitis.  There could be a bony or soft tissue lesion that's causing pressure on surrounding tissues, or the pain could be from the lesion itself.  There are a lot of possibilities, and like I said, your best bet is to get it checked out by a podiatrist in his or her office.  Unfortunately, I can't give you a recommended course of treatment without knowing the cause.

In general, foot pain can be relieved with rest, ice, compression, elevation, and taking NSAIDs such as Motrin or Ibuprofen...as long as there are no contraindications to those kinds of treatments, that is. From what you've described, my guess is that in your case, compression would not be beneficial...and I don't know if ice would be appropriate, either.  You could see if certain shoes make it feel better or worse, but that won't address the actual problem.  Sometimes stretching exercises can help, but again, I really cannot make a recommendation without having the full clinical picture.

I would love to be able to tell you exactly what's going on and how to treat it, but heel pain has too many different causes that can't be evaluated online.  There are some "classic" presentations that exist with certain conditions, but what you have described doesn't fit clearly into any of those categories.  I wish you the best of luck, and I hope you are able to make an appointment with a podiatrist who can perform the necessary tests to give you more answers.  No one should have to deal with foot pain.  Despite what people say, it is not normal.

Wishing you health, happiness, and peace,
Dr. Bodart