Heel Pain Treatments
Heel Pain Causes and Treatments
Heel Pain/Plantar Fasciitis
Heel Pain is one of the most common problems seen in our office. Pain may occur in the morning, after rest and after a long day on your feet. The pain may feel fluctuate like a tearing pain that may worsen with time.
Heel Pain can occur on the bottom of the heel or on the back side of the heel. Pain on the bottom of the heel is the most common and is often referred to as heel spur or plantar fasciitis. Heel pain on the back of the heel is often called Haglund’s deformity and may be associated with swelling of the Achilles tendon or Achilles tendonitis. Haglund’s is less common but can be a painful condition requiring treatment.
Plantar fasciitis is swelling of the large flat ligament-like band that is on the bottom of the foot. This large band typically swells and develops micro-tears where it attaches to the heel bone. This swelling process leads to pain. When looking at an x-ray there may also be a heel spur which a small piece of bone that enlarges where the plantar fascia attaches. The heel spur is not the cause of heel pain x-rand the spurs are not removed or dissolved as part of the treatment process. Other causes of heel pain may include an irritated or entrapped nerve, a stress fracture or injuries to the surrounding muscle.
All types of heel pain are caused by an imbalance of the foot structure and mechanics or function of the foot. These imbalances can occur with a high arched foot (supination) or a foot with a flat or fallen arch (pronation). In either case, there is abnormal pulling of the plantar fascia against the heel bone or calcaneus. Problems with function can occur with abnormal strength or position of joints, tendons, muscles and ligaments.
Many people will not remember a specific injury that started their pain but noticed worsening of their pain over time with morning pain and pain after rest. In some cases there can be an injury with partial tear of the plantar fascia. Pain is typically worse walking barefoot or without support.
The most important long-term treatment involves returning the foot to normal function and alignment using arch supports or custom orthotic devices made by a podiatrist.
Early treatment is recommended because waiting too long can lead to a prolonged frustrating treatment course. Early treatment involves, rest, ice, compression, stretches, physical therapy and in some cases anti-inflammatory medication.
More advanced in-office treatments include cryotherapy or cryosurgery, EPAT or shockwave therapy, laser therapy and alternative types of non-cortisone injections known as prolotherapy, PRP and ozone. The last option is traditional heel surgery to partially release the plantar fascia band. Luckily, most patients respond well conservative options and advanced treatments are rarely require traditional surgery.
If you suffer from heel pain, call Dr. Klein’s office today for a complete evaluation of your heel situation. Waiting only makes the condition prolonged and harder to treat.