Heel Pain / Plantar Fasciitis
Heel pain is a common complaint and we have had great success in treating it. Patients describe the symptoms they have in different ways, but most center around pain on the bottom of the heel. Most have pain when they take their first steps in the morning or when they sit down for a while and then get back on their feet. The discomfort has been described as a burning, tingling or sharp stabbing pain, and it often continues at later times during the day. This heel pain may be worse at the end of the day. It might just come and go at first and this is why many people put off going to get treatment for several weeks. Without treatment, the heel pain will often get worse and last for longer periods of time.
Some people have tried to treat their heel pain themselves by purchasing store-bought pads or insoles, which help a little. Others take anti-inflammatory medications but wonder why the pain persists.
Diagnosis
The first step in treating your heel pain is to perform a complete podiatric history and physical. X-rays may be necessary to evaluate the bony structures of the foot and determine the cause of the heel pain. IN addition to this Ultrasound can also be very helpful. Both of which we do in the office.
Plantar fasciitis (pronounced fash-itis) is perhaps the most common cause but there are many other problems that cause heel pain. These include tarsal tunnel syndrome (compressed nerves), heel spurs, Baxter’s neuritis, neuropathy (from a variety of causes including diabetes, chemotherapy, alcoholism), stress fracture of the heel bone, tumors, tendon tears and arthritis. These problems all have different causes and differ in the way they are treated.
Plantar fasciitis refers to pain and inflammation within a tight band of tissue on the bottom of the foot where it inserts into the heel. The plantar fascia supports the architecture/ arch of the foot. It becomes inflamed when excessive strain is placed on it. Wearing improper shoes, increasing activity, standing or walking on concrete, or injury can cause. When one is resting, the foot is relaxed and this band of tissue contracts. When you stand again, the inflamed tissue has to stretch to its former length. Even though the plantar fascia goes completely across the bottom of the heel bone, the most common discomfort is in the center or front of the heel. Dr. Williams will discuss your problem and possible treatments to decide how best to get rid of the pain and prevent recurrence.
Treatment Options
Usually, treatment begins with physical therapy (therapeutic ultrasound, interferential, stretching). Medications such as anti-inflammatory medications and injections may also be used and often padding or taping is applied for a couple of days to support the arch and plantar fascia.
The use of orthotics is helpful in the treatment of heel pain. An orthotic device that is placed in your shoe to help rebalance your foot will take the pressure away from the fascia and will also prevent the recurrence of the heel pain. Orthoses are made from plaster impressions of your feet and are designed specifically to treat your particular problem. About 80% of our patients do find success with these conservative treatments.
What's New? AMNIO FIX INJECTION OF GROWTH FACTORS FROM PLACENTAAmniofix effectively reduces inflammation and scar tissue formation. Heals micro-tears and is very helpful in tendinitis, fasciitis, and arthritis. We prefer it over cortisone in longstanding painful conditions.
However, if you are one of those who are still having discomfort, or seek a quicker course of treatment, a minor surgical procedure known as plantar fascia release may be the answer. Recovery can be as low as 3 weeks!
Other Causes
Not all heel pain is plantar fasciitis. Pain can come from the nerve as it enters into the heel and foot. If you have burning, numbness, electrical sensation, stinging in your heel, arch and sometimes even your toes, you may have tarsal tunnel syndrome. Very similar to carpal tunnel syndrome in the hands, it is treated differently from plantar fasciitis, which is inflammation of the band of tissue at the bottom of the heel. To make things worse, you can actually have both conditions exist at the same time. If you have heel pain that has not gone away, make an appointment with Dr. Young. Get a thorough evaluation and treatment plan that will get your lifestyle back.
Background information on Tarsal Tunnel Syndrome: Pressure can exist on the nerve where it passes along the inside of the ankle and foot. Factors that cause this are repetitive stress with activities, flat feet, excess weight, injuries. Also you may have a medical condition, like diabetes, alcoholism, chemotherapy, and varicose veins. Symptoms include pain, numbness, burning and electrical sensations along the course of the nerve along the ankle and heel into the arch and toes. Worse with prolonged standing and walking, with some shoes, and exercise. Treatments include anti-inflammatory medication, injections, padding and elastic ankle supports. Orthotics can also be designed to control overpronation or rolling over of the foot and compressing the nerve.
