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Hielpijn

Geplaatst op 14 januari, 2016 om 10:30

Er moet weer een blog geschreven worden, maarja waarover? Mijn opleiding tot lymfetherapeut is begonnen, enorm interessant. En het wordt steeds drukker met masseren dus dat is goed, maar om daar nou alweer een blog over te schrijven?

Deze keer heb ik maar eens een stukje “geleend”. Een heel duidelijk verhaal over hielpijn, vaak hielspoor genoemd maar eigenlijk is het een peesplaatontsteking onder de voet. Ik hoop dat jullie dit soort info kunnen waarderen. Laat het me maar weten en als je een onderwerp wilt voor de volgende keer dan zoek ik of ik een duidelijk artikel erover kan vinden.

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DOSSIER

Fasciitis plantaris is een ontsteking van de dikke bindweefselband onder de voetzool (de fascia plantaris), die het hielbeen verbindt met de bal van de voet. Deze band helpt de voet stabiliseren en de tenen buigen. Het is de meest voorkomende oorzaak van hielpijn.

Fasciitis plantaris treft ongeveer 10% van de bevolking, vooral mannen tussen de 40 en de 70 jaar die voor hun werk veel moeten lopen of staan. Ook vrouwen met overgewicht hebben een verhoogd risico op deze aandoening.

Klachten

• Erge pijn aan de onderkant van de hiel.
• De pijn is het ergst 's morgens en na lang zitten, of als de voet lange tijd niet is gebruikt.
• De pijn verdwijnt grotendeels in de loop van de dag. Aan het einde van de dag is soms sprake van een doffe pijn aan de binnenkant van de hiel, die door rust verder afneemt.
• De hiel kan rood zijn en enigszins opgezet.
• Lokale drukpijn, vooral in het midden van de voetzool.

Bij sommige mensen is een zogeheten hielspoor te zien: een aangroeisel van extra bot aan het hielbeen.

Oorzaak

Fasciitis plantaris is een typisch overbelastingsletsel ten gevolge van een te zware belasting van de bindweefselband door overpronatie van de voet. Bij overpronatie kantelt de voet, waarbij de binnenrand doorzakt en de hiel onder een scheve hoek onder het onderbeen komt.

Risicofactoren:
• overgewicht,
• veel stappen of lopen op harde bodem of met schoenen met dunne zool (weinig schokdemping), springoefeningen op een harde ondergrond (bv. step-aerobics, volleybal)
• veel staan
• een strak gespannen achillespees (de band die de kuitspier met de hiel verbindt)
• Problemen met de voet, zoals platvoeten of omgekeerd een hoge voetboog.
zie ook artikel : Achillespeesblessures: peesontsteking en peesscheur

Behandeling

Een behandeling kan meerdere weken tot zelfs enkele maanden duren.
• Rust (=geen activiteiten die pijn veroorzaken) tot de pijn (grotendeels) is verdwenen;
• Bij hevige pijn kan de arts pijnstillers voorschrijven.
• Bij een ontsteking zal de arts ontstekingsremmers voorschrijven of soms een injectie met corticosteroïden geven
• Rekoefeningen
• Aanpassing van de schoenen om overpronatie tegen te gaan (met bv. inlegzolen, een hielkussentje...).
• Bij hardnekkige, chronische pijn wordt het been soms gedurende enkele weken in het gips gelegd of getaped, of wordt een nachtspalk aangevolen.
• Operatie: Bij ernstige pijn en wanneer de pijn lang aanhoudt, kan operatief ingrijpen worden overwogen. Daarbij wordt de gespannen bindweefselband operatief losser gemaakt. Na een operatie heeft 95 procent van de patiënten minder pijn. Een operatie helpt niet altijd tegen alle klachten.
• Extracorporale schokgolftherapie: wordt vaak toegepast alhoewel het niet altijd effectief is.
 

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Bron: Gezondheid.be




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