Heel pain is a condition that affects millions of people worldwide. It’s one of the most common orthopedic conditions in middle-aged men and women from age 40 through 80 years old. It can occur at any time, but often is not accompanied by other serious health problems or symptoms such as fatigue, sleep disturbances, back pain, and poor sleep quality. Although the cause of heel pain is not always clear, there are many unknowns related to its pathogenesis which include poor nutrition, smoking, obesity, high levels of stress, alcohol use, chronic pain condition such as diabetes or cancer, and certain medications.
Here are some of the possible diagnoses for heel pain, including a blood clots or thyroid problem, surgery, cancer, arthritis, and heart attack. The U.S Food and Drug Administration has approved treatments for heel pain and it’s up to the medical provider to decide whether those treatments will be necessary. To determine whether these medications are right for you, your doctor should first discuss with you your risk for heel pain and which factors might be making this condition worse.
What Is Hemiparesis?
Hepatic artery disease, also known as a large vessel arterial blockage (LAVA), is where plaque builds up in an artery. When this plaque narrows a blood vessel (and the muscle of the artery wall becomes too brittle) and a clot forms which blocks the artery (or an artery branch) causing the blood flow to stop. A person has an acute and severe form of this condition, called femoral artery thrombosis (FAT), which often goes in people over 50 years of age.
This type of stroke can lead to limb amputation, as well as brain damage, but early treatment usually helps to avoid long-term disability.
While there are no FDA-approved drugs to treat heel pain, these treatments can make your overall health a lot better than if you had the original condition which is very rare. If you have heparin sodium heparin (also referred to as blood thinners), they can help prevent major events such as stroke or death, even when used alone. Some research has been done comparing heparin with aspirin, which appears to be effective against arterial spasms, while others look at the two drugs together as being effective, though not against all artery spasms. Even though there is little evidence on these therapies in people who already had a stroke, there have been studies, mostly small and not randomized, that show heparin can prevent death or long-term disability when used alone.
The best way to know if a given combination therapy you’re considering is safe or not is to talk to a healthcare professional, such as a primary care physician, urologist, rheumatologist, cardiologist, or vascular surgeon, about the treatment.
They will likely give you the best guidance on whether these treatments will work for you, for example, if you’ve had previous heart attack or heart-failure surgery and had low or high cholesterol, heart attack, or liver disease. Many people already have these conditions, so these types of tests may not be relevant to you. For instance, you may need to have coronary artery stents implanted or taken off if your doctor suspects you’re at high risk of having another heart attack or stroke due to these medications.
Treatment of Nonhealable Occlusive Arterial Thrombosis (Nonhealable CAAT)
For nonhealable CAAT, a blood clot or clotting agent such as warfarin (Coumadin or Jantovene®) remains at the site of injury when an artery supplying blood to something such as your leg or arm becomes blocked with plaque. These treatments can relieve swelling and blockages to the artery.
There is good evidence that warfarin can reduce hospitalization or death in patients with nonhealable CAAT, but this is not without controversy because many of the trials did not compare himparin or aspirin to each other. More recent research shows warfarin’s effectiveness for nonhealable CAAT in patients who’ve had stroke and received high-dose intravenous heparin or aspirin. However, studies have not shown that either drug works in people without these conditions. Also, heparin is associated with bleeding into the urinary tract. A new study published in 2017 looked at the effect of ticagrelor (formerly known as Pradaxel) on nonhealable CAAT in patients treated with warfarin, aspirin, and heparin. After 21 days, there were no differences in hemodynamic outcomes between those who received ticagrelor plus aspirin compared to those who received just aspirin. At 4 years, the addition of ticagrelor did not show any difference in hemodynamic results between the groups, suggesting that when treating nonhealable CAAT, clinicians should choose a regimen that includes both aspirin and ticagrelor.
Treatment of nonhealable CAAT has also been found helpful with antiphospholipid syndrome (APS). Patients with APS have abnormal cholesterol in their blood. Ticagrelor can act like aspirin to break down LDL or HDL lipids in the body, thus reducing total cholesterol levels. In one trial, ticagrelor reduced low-density lipoprotein cholesterol and increased HDL lipids for patients with APS compared to the control group.
What Causes Nonhealable CAAT?
Several factors can cause nonhealable CAAT. Risk factors and coexisting conditions can increase your risk of nonhealable CAAT, including:
High Blood pressure or diabetes
Hypertension or diabetes
Family history may also raise a patient’s risk with comas
Treatment for nonhealable CAAT uses different medications. Generally speaking, most nonhealable CAAT treatment involves acetylsalicylic acid (AHA) injections, such as Coumadin. Other less commonly used drugs used are aspirin and non-steroidal anti-inflammatory drugs (NSAIDS).
If you have a significant contraindication to use of Coumadin or other NSAIDS such as ibuprofen or naproxen, it may not be possible to do a CT angiogram. That means your doctor will not be able to tell the whole story, however, and it’s important to get an MRI, MRI angiogram which may show more detail of your arteries. An ultrasound of the abdomen will show any large vessels in the abdominal area and how your veins are located. Your doctor will also be able to tell you if you have a heart murmur, which happens when your lungs contract differently than they should. You’ll also know if you need angioplasty (a catheterization procedure to open blocked up a narrowed artery) or if you have a blocked artery that needs to be closed off using a balloon or stent.
Your healthcare provider will then recommend one or more of those nonhealable CAAT medications based on what can be safely done to treat your condition. Common medications include:
Oral acetylsalicylic acid
Oral acetylsalicylic acid
Oral treprobulin fumarate
Oral venlafrese (narrowing of vein in extremities)
Oral vardenafil (narrowing of vein in extremities)
Oral warfarin (Coumadin or Jantovene®)
There are many medications that help to ease symptoms such as itching and burning when they first occur, especially if a lesion is present or an angioplasty had already been made. Antihypertensive medications, such as metoprolol, can decrease your risk of having a stroke if you already have them. Medications for osteoporotic bone, such as BMS and Z-PT, can help alleviate symptoms or to speed healing if the fracture is caused by something such as bone density (eg, bone mineral density) loss or bone resorption. Your doctor may recommend physical therapy, dietary changes, and possibly exercise changes in the hope of helping you return to normal function.
Talk to a Healthcare Professional About Heel Pain Treatment Whether it’s a new addition to a current list of chronic diseases or a long-time condition that puts you out of commission for weeks, months, or even year-plus, it can feel overwhelming to go from feeling the crushing weight of your condition to being completely incapacitated by it. With a headache, tiredness, insomnia, fatigue, and anxiety all causing problems, your discomfort can make it difficult for you to function, and leave you unable to function any of your daily activities.
Because heel pain most often comes on slowly, sometimes chronic pain medication isn’t enough to relieve the symptoms that accompany it. Chronic muscle pain can cause cramping, numbness, and stiffness, leaving you with limited mobility. Sometimes doctors will prescribe opioids to relieve its symptoms, but unless your pain condition is a life-threatening emergency, it’s not recommended. Instead, a pain management program can help improve your quality of life by combining pain medications with lifestyle changes, such as a healthy diet, physical activity, sleep hygiene, and