Talalgia – What is it, Symptoms and Treatments!

Talalgia – What is it, Symptoms and Treatments of this very common syndrome. In addition, Talalgia or plantar facitis is a very painful syndrome, and despite being very common, its exact etiology remains unclear. The diagnosis is essentially clinical, based on history and physical examination.

Complementary laboratory tests and imaging tests may be useful for differential diagnoses. Treatment is essentially conservative, with a high success rate (about 90%). The essence of conservative treatment is the home exercise program to stretch the plantar fascia.

Indications for surgical treatment are only made when symptoms persist without significant improvement, after at least six months of conservative treatment directly supervised by the physician.

Talalgia usually causes a stabbing pain in the bottom of the foot near the heel . The pain is usually at its worst with the first few steps after awakening, although it can also be triggered by long periods of standing or sitting. Pain is usually worse after exercise , not during exercise.

Causes of Talalgia: Talalgia canbe caused by anatomical and physiological changes of the foot such as flat foot or cable foot, i.e. a flattening of the arch of the foot or an increase. Hindfoot varus and valgus can cause poor foot support on the ground and increase strain on the rear or lateral structures of the heel , ankle, knee, and hip.

The type of footwear worn can be the source of Talalgia , especially in athletes. A woman who usually wears high heels, if she starts wearing flats, can strain the Achilles tendon because low shoes cause a stretch in the tendon and can contract a calf muscle.

People who play football, hiking, basketball, volleyball, athletics and other sports where the foot is particularly overloaded are the ones who more easily develop talalgia . The terrain athletes run or play on can be a contributing factor in the emergence of Talalgia , in fact running on asphalt or hard surfaces causes repetitive microtrauma to the joint during stance.

Unbalanced athletic training or resuming very intense training after a long break can traumatize the heel causing Talalgia . Elderly people develop heel inflammation due to the degeneration and thinning of the fatty tissue located under the heel , which occurs with age.

Symptoms of Talalgia: The most common complaints are pain, stiffness and burning in the sole of the foot. The pain can be acute or chronic, and it is usually worse:

  • In the morning, when taking the first steps
  • After standing for a long time
  • when climbing stairs
  • After intense physical activity.
  • The pain can develop slowly over time, but it can also come on suddenly after intense activity.

Talalgia treatments:

We have the following types of treatment for Talalgia:

Non-Pharmacological Treatment:

  • Rest: avoid activities that aggravate pain
  • Use of suitable footwear and insole: avoid walking barefoot on hard surfaces, avoid flat shoes, preferably wear new shoes with a good heel cushioning system , consider the use of insoles à Assess the type of foot (flat foot = insole with support to
  • medial longitudinal plantar arch; hyperpronation = medial wedge insole).

Physiotherapy:

  • Warming up the plantar fascia before the first steps of the day with horizontal friction massage
  • Plantar fascia stretch = dorsiflexion of toes, rolling foot on tennis ball
  • Correct functional risk factors à Assess anatomical changes: (shortening Gastrocnemius and soleus stretch = lean-to-wall exercise, step stretching (care in elderly patients); intrinsic foot muscle weakness = towel exercises .

Orthotics:
Night splints; anklets for daytime use.

Pharmacological Treatment: Non-spheroidal
anti-inflammatory drugs (use early only as symptomatic for pain relief); corticosteroid infiltration (avoid as much as possible due to possible complications such as fascia rupture; short-term response only.

Surgical Treatment:
Partial plantar fasciotomy (consider only after failure of conservative treatment for 12 months; 70-90% success rate; recovery after weeks to months).

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