Posts for tag: Heel Pain
Are you dealing with heel pain? If so, you aren’t alone. Foot pain, particularly heel pain, is one of the most common complaints and most people will deal with pain at some point during their lifetime. Whether you are on your feet all day for work or you are a runner, there are many risk factors that can play into your likelihood to deal with heel pain. If heel pain is happening to you, you may be wondering what’s causing it and how you can get rid of the pain quickly.
Causes of Heel Pain
As you might imagine, there are many reasons why you might be experiencing heel pain. The root cause will also determine the best course of action for getting your symptoms under control while providing the optimal healing environment for a speedy recovery.
The most common cause of heel pain is an acute inflammatory condition known as plantar fasciitis, in which the thick band of tissue that runs along the soles of the feet from the toes to the heel (known as the plantar fascia) becomes inflamed. Of course, there are other reasons people experience heel pain. Other causes include:
- Achilles tendinitis
- Achilles tendon rupture
- Stress fracture
- Tarsal tunnel syndrome
- Heel spur
- Osteomyelitis (an infection of the bone)
- Page’s disease of bone
- Peripheral neuropathy
Heel Pain Treatment Options
For more mild-to-moderate cases of heel pain, your podiatrist may recommend simple conservative treatment options that you can incorporate into your daily routine from the comfort of home. This is usually the first course of action, unless the condition is more serious. Only once we’ve exhausted at-home care and pain is still present do we decide on more aggressive tactics for handling your symptoms.
Common at-home heel pain treatment options include:
- OTC pain relievers (e.g. ibuprofen)
- Icing the heel several times a day
- Bracing or splinting the foot
- Wearing custom orthotics (shoe inserts)
- Wearing protective and supportive shoes
- Resting and avoiding certain activities or high-impact exercises
If you’ve tried these treatment options for weeks and still don’t notice any change in your symptoms—or if symptoms get worse—then it’s time to visit your foot doctor again to determine the next step. If pain and swelling are severe we may recommend steroid injections, extracorporeal shockwave therapy (ESWT) or ultrasound therapy. In rare cases, surgery may be necessary to correct the imbalance, deformity, or problem that’s causing your chronic or severe heel pain.
Don’t let heel pain affect your day-to-day life when there are simple and easy solutions to manage your symptoms and promote faster healing. Turn to a podiatrist who will be able to handle your heel pain and get your foot health back on track.
My heel pain will not go away and I have tried it all …Now What?
Generally speaking there needs to be 6 months of non-operative measures that have failed before surgery is suggested. There are multiple surgical procedures to combat heel pain. There is open release of the plantar fascia that one will look for nerve entrapment. There are also minimally invasive procedures that try to stimulate healing. Our physicians perform a range of these procedures, including but not limited to use of TOPAZ which is radiocoblation therapy. There is also a newer procedure that will help regain your active lifestyle via the FAST technique.
What is the FAST Technique and Is It Right For Me?
The FAST technique is a fasciotomy and surgical tenotomy that can address your foot and ankle pain in an innovative and minimally invasive way. Eventually scar tissue in the tendon or fascia will limit your ability to move and perform the activities you may like or need to do. The damage may be due to trauma or repetitive motion- damage to the tendon from overuse in work, exercise or activity. It can cause the tendon tissue to break down and form scarring and pain. The FAST technique is advanced technology that was developed in collaboration with the Mayo Clinic. FAST is a minimal invasive treatment designed to remove tendon scar tissue, allowing you to return to your active lifestyle. It is performed with the guidance of ultrasound to identify the scar tissue and with the aid of a small instrument that delivers ultrasonic energy specifically designed to break up and remove damaged tissue safely and quickly, without disturbing the surrounding health tendon tissue. With such a wide array of options in techniques, it is best to schedule a consultation with one of our physicians and discuss the best option for you.
MY HEEL HURTS
By now you have probably already diagnosed yourself with Plantar fasciitis as you have goggled heel pain. Like many people that come into the office, they will tell me that their heel pain is worse after they have been sitting and once they have taken a couple of steps it will improve.Plantar fasciitis is sometimes known as a "heel spur". The term commonly used to refer to heel and arch pain is traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Generally it is considered an overuse injury and over time, this causes inflammation. People will ask me if their weight influences their heel pain. It may if you are overweight and a decrease in approximately 10lbs can be helpful.
Generally we will take x-rays to determine if there is a spur and to check for fractures and tumors that can occur in the heel bone. We are also able to measure the amount of inflammation a patient has with an ultrasound and monitor it over time. There can be times when the planatar fascia will actually rupture and will need to be treated appropriately.
Things you can try first is stretching and most people will have already tried OTC inserts. The problem with them is that if your heel pain does not go away is that it does not brace your foot enough to help with the uncontrolled overstretching that is occuring. A true custom orthotic that properly supports and braces your arch is the mainstay of treatment. It is imperative that you also perform proper controlled stretching exercises. As with any inflammatory condition one can also use of anti-inflammatory medications and ice packs. Often times Physical therapy is also helpful. There are times when your pain is so great that in order to calm things down a steroid injection is necessary.
So what if you have done all these things and you are not better. You may need to allow the foot to rest and decrease your activity with immobilization. Well doc, I have done that, now what. There are times when your heel pain needs to be addressed with surgery and depending on how your pain presents to your doctor you may need to have an open release along with lengthening your gastroc (heel cord area). Sometimes there is a nerve that also gets entrapped and we will look for that. There can be an alternative to the open release and that may be the use of Topaz and PRP. What does that mean you may ask. It essentially works at trying to convert your chronic inflammation to acute to get the body to heal itself. It is done through tiny holes about the size of a large needle and a wand is introduced that stimulates the fascia. PRP or platelet rich plasma is take from your own blood and the good things ie platelet is injected back into your heel to help the process along. It is up to your doctor to make the plan that is right for you depending on what is going on with your feet because often times more than than one thing may influence your treatment protocol. Here is to your feet, may they carry you through the rest of your days.