Heel Pain & Acupuncture
Honora Lee Wolfe, Dipl. Ac., Lic. Ac., FNAAOM
Keywords: Chinese medicine, acupuncture, heel pain
Heel pain may be due to a number of different causes. Calcaneal spur syndrome (a.k.a. plantar fasciitis) may cause pain on the plantar surface of the heel. Sever’s disease (a.k.a. epiphysitis of the calcaneus) can cause pain in the medial and lateral margins of the heel and is primarily seen in children. Haglund’s deformity (posterior Achilles tendon bursitis) results in pain posterior to the Achilles tendon. Pain in the retromalleolar space anterior to the Achilles tendon may be due to fracture of the posterolateral talar tubercle, bursitis, or posterior tibial neuralgia. Pain at the calcaneal insertion of the Achilles tendon may be due to overuse (as in athletes) and a tight heel cord secondary to abnormal foot structure and function. In Western medicine, these disorders are treated with everything from rest, stretching, night splinting, shoe protheses, and oral NSAIDs to corticosteroids and surgery. In issue #2, 2003 of Gan Su Zhong Yi (Gansu Chinese Medicine), Wang Xiu-zhen reports on the treatment of 40 cases of heel pain with acupuncture. The title of this report is “A Short Discussion of the Acupuncture Treatment of 40 Cases of Heel Pain.” This article appeared on page 39 of that journal and a summary is given below.
All 40 patients in this study were examined with x-ray and those with osteotuberculosis, bone cancer, or rheumatoid arthritis were ruled out. Among these 40, there were eight males and 32 females aged 24-60 years who had suffered from heel pain for from two days to one year. All these patients had received prior medical treatment which had not been obviously effective. X-rays of these patients’ heels failed to show any pathological changes in the bones of the heel.
The main acupoints used in this study were: Kun Lun (Bl 60), Shen Mai (Bl 62), Tai Xi (Ki 3), and Zhao Hai (Ki 6). Auxiliary points included: Jue Gu (GB 39), Pu Can (Bl 61), Shang Qiu (Sp 5), and Qiu Xu (GB 40). After disinfecting the skin in the affected area a one inch needle was used to perpendicularly puncture the main points to a depth of 0.5 inches. In addition, one auxiliary point was also chosen each time to be needled. Needles were left in place for 40 minutes and twisted and twirled once each 20 minutes. If the pattern was one of repletion, draining technique was used; if it was one of vacuity, supplementing technique was used. One treatment was given per day and 10 treatments equaled one course of therapy.
Cure was defined as complete disappearance of the heel pain. Marked effect was defined as marked improvement in heel pain and any associated swelling. Some effect meant that the heel and swelling improved somewhat, and no effect meant that there was basically no change in the clinical symptoms. Based on these criteria, 28 out of 40 patients were judged cured, four got a marked effect, six got some effect, and two got no effect. Therefore, the cure rate was 70% and the total effectiveness rate was 95%.
According to Dr. Wang, heel pain is due to either external evils entering and assailing or loss of regulation of the function of the viscera and bowels. In both cases, the movement and flow of qi and blood in the affected area loses its normalcy and the channels and vessels lose their nourishment. Thus there is aching and pain. Based on the saying, “If there is free flow, there is no pain,” Dr. Wang believes that the treatment principles for this condition are to course and free the flow of the channels and network vessels, regulate and harmonize the qi and blood, and regulate and balance the function of the viscera and bowels. Based on these principles, Dr. Wang has chosen points in the affected area. The foot tai yang bladder channel traverses the lateral part of the posterior of the foot, while the foot shao yin kidney channel traverses the medial part of the posterior of the foot. These two are interior-exterior channels, and their transport points are able to treat diseases on both the interior and exterior channels. In addition, Shen Mai and Zhao Hai are meeting points of the eight extraordinary vessels. One frees the flow of the yang qiao mai and the other frees the flow of the yin qiao mai. However, this protocol is contraindicated in pregnant women.
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