Why is it advised not to poke the back of the heel?

Poking the back of the heel is advised against primarily because it poses a risk of damaging the heel bone, which can potentially lead to osteomyelitis, an infection of the bone. The anatomy of the heel is such that the calcaneus (the heel bone) is situated close to the surface, and puncturing or improperly drawing blood from this area can easily cause injury to the bone. Additionally, if an infection were to develop in the bone (osteomyelitis), it could lead to serious complications, including chronic pain, potential loss of function, and the need for more invasive treatments.

While concerns like excessive bleeding, increased risk of infection, and patient discomfort are important considerations in the context of blood sampling, the specific risk of damaging the heel bone and causing osteomyelitis is a critical factor in avoiding this practice. Safely collecting blood samples from more appropriate sites minimizes these risks and ensures patient safety and comfort.