Are you suffering from heel pain? We can help!

By Dr. Gary Prant, D.P.M., F.A.C.F.A.S.

Heel pain, or the technical word: Plantar Fascitis, is usually caused by excessive strain on the strong ligament on the bottom of the foot. (The Plantar Fascia). The plantar fascia is wide at the toes and narrow at the heel; that is why a tight plantar fascia causes pain in the heel. In fact, the pull of the plantar fascia is so strong on the heel that after awhile, it may actually pull the bone into a heel spur. The average 150 person walks 2.7 miles a day and puts 545 tons of pressure on their heels!

Interestingly, the heel spur itself does not cause pain. Sometimes a heel spur shows up on a person's x-ray and they are totally unaware of it.

So what does cause the pain? The pain is usually caused by swelling of bursal sacs (fluid filled sacs) around the plantar fascia or spur. These fluid filled sacs fill up when the person is off their feet (sleeping or sitting). That is why the first few steps of the day are usually the most painful. After the person walks a few steps these bursal sacs flatten out and then walking is usually less painful. Sometimes the bursal sacs slowly fill up from standing all day an causes the pain to return. There are many other causes of heel pain that must be ruled out, but the one I've just described is the most common.

Treatment:

It may be determined that your heel pain is caused by a tight plantar fascia and bursal sacs. Those problems are almost always the results of biomechanical imbalance in your feet. (Bone structure problems) This is sometimes treated by a series of three injections of a small amount of cortisone right into the bursal sac. A taping applied to the foot and sometimes oral anti- inflammatory drugs are prescribed.

I also recommend wearing a well padded sneaker with a good arch support and molded heel (to cup the heel) for 4 to 6 weeks. Wear the sneaker all the time; don't go barefoot.

Follow up treatment depends on the response to initial treatment. It may include orthotic shoe inserts, physical therapy, or surgery. Approximately 10% of heel spurs require ESWT or Shock Wave treatment to obtain relief.. Dr. Prant is certified in ESWT treatment and we have current information available if you are interested.

My philosophy is to pursue the simplest treatments first and progress as needed. Fortunately, you can get rid of heel pain if we work together.

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