What Causes Heel Pain?

Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that affects the spine. It produces inflammation and causes the vertebrae to gradually fuse together. This condition is more common in men, and symptoms generally start in early adulthood. Patients with ankylosing spondylitis have reduced flexibility in the spine, and they may adopt a posture that hunches forward. If the condition affects the patient's ribs, it might become difficult to take deep breaths. In addition to the spine, the hips, shoulders, and heels are often affected. At first, symptoms may only be present in the morning or after periods of inactivity. They may worsen over time, and some patients experience temporary remission or improvements in symptoms as well. Doctors will perform a physical exam and imaging studies to diagnose ankylosing spondylitis. During the exam, the patient will be asked to take a deep breath so the doctor can check if the chest expansion is normal. The patient's range of motion will be examined, and the physician may press on the pelvis or move the legs into specific positions to check for pain. MRI scans can detect signs of this condition at earlier stages than other types of imaging studies, and x-rays may be performed as well. Treatment options usually center around medication. Doctors may prescribe non-steroidal anti-inflammatories like naproxen and indomethacin, and patients might be prescribed an interleukin-17 inhibitor or a TNF blocker. Physical therapy may help patients with maintaining posture and flexibility in the joints.

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