Calcaneal Congestion Syndrome

The feet support the weight of our body throughout our lives. For this reason, it is vitally important to take care of them on a daily basis, in order to avoid areas of excessive pressure which, over time, can lead to gait problems and foot deformities.

Talalgia, also called calcaneal congestion syndrome, is a symptom that indicates heel pain and is caused by repetitive impacts on the back of the foot, such as prolonged exercise, walking on thin soles or inappropriate footwear on hard surfaces.

In general, rest and custom-made orthopaedic insoles are usually sufficient to solve the problem. In some cases, where early symptoms of heel pain are ignored or insufficient rest is given, the problem worsens and becomes chronic.

Heel pain is mainly caused by plantar fasciitis or pain in the plantar musculature. Other less frequent causes of heel pain can be:

Injury or inflammation of the Achilles tendon.
Bursitis.
Haglund’s spur.
Calcaneal spur.
Peripheral neuropathy
Rheumatoid arthritis
Tarsal tunnel syndrome

If you suffer heel pain, consult a specialist to determine the cause and apply the most effective treatment. A physical examination of the foot is essential, together with a pressure study to assess the degree and cause of the pain.

It is important to distinguish between pain behind the heel and pain just below the heel.

Pain behind the heel is related to inflammation or disruption of the Achilles tendon, which inserts into the calcaneal bone that corresponds to the heel. This bursitis is often seen in patients who wear footwear that continually rubs against the back of the heel or who have heel deformities (such as Haglund’s spur). When this process becomes chronic, it can become disabling.

If you have pain in the back of the heel, you may have increased temperature, tenderness or even deformity on palpation. The pain is more intense with the first steps in the morning. Finally, an X-ray may be necessary to determine the existence of bony deformity.

On the other hand, when pain occurs under the heel, it often indicates plantar fasciitis, which may be caused by inflammation of the plantar fascia or by a heel spur. When fasciitis becomes chronic, microfractures occur at the insertion of the plantar fascia causing calcium deposits that eventually form the spur. Treatment in these cases requires orthopaedic insoles with heel elevation, anti-inflammatory drugs and rest.

Solution to talalgias

In cases resistant to conservative treatment, minimally invasive surgery to resect the spur may be necessary. It is also possible to have a heel spur that is asymptomatic and does not require surgical intervention.

Finally, a trauma or blow to the sole of the foot may result in a plantar contusion. In these cases, it is advisable to take an X-ray to rule out fractures and if there is no fracture, rest until the pain disappears.

For more information about this syndrome, we suggest you contact our staff at the San Román Chiropody Clinic.