Heel Pain and Plantar Fasciitis

Heel pain is a common medical complaint among both women and men, especially among athletes and those who are middle-aged or older. At Upperline Health, our patients enjoy state-of-the-art care for heel pain, including noninvasive approaches like shockwave therapy as well as traditional treatment options designed to promote optimal healing.

What causes heel pain?

Different issues can contribute to heel pain, including deep bruises (sometimes called “stone” bruises), Achilles tendon problems, repetitive or overuse injuries, bone spurs and plantar fasciitis. Having an in-depth exam and evaluation is the key to receiving the proper diagnosis and most appropriate care for long-term relief of pain and related symptoms.

What is plantar fasciitis?

The plantar fascia is a strong band of fibrous tissue that extends across the bottom of the foot from the heel to the base of the toes, providing support for the midfoot region and the arch. Sometimes, this band of tissue can become inflamed and irritated, resulting in pain in the heel and along the side of the foot. Plantar fasciitis occurs most commonly among older men and women, and it can also occur in athletes as a result of repetitive impact or in people who stand for long periods of time each day.

While treatments such as custom orthotic bracing, strapping and cortisone injections can provide some relief, a more advanced way to actually heal the injury and provide long-lasting improvement is through biologic regenerative treatments such as Platelet Rich Plasma therapy. Platelets initiate tissue repair by releasing growth factors in the area. These growth factors start the healing process by attracting cells that repair the plantar fascia, including critical adult stem cells. Platelet Rich Plasma (PRP) therapy intensifies this process by delivering a higher concentration of platelets than normally incurred from injury. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated plasma is then injected into and around the area of pathology, in this case the plantar fascia, significantly strengthening the body’s natural healing.

For even more severe cases however, there are still things that can be done. Extra Corporeal Shockwave therapy has become a common solution for plantar fasciitis because it effectively addresses the inflammatory tissue on the bottom of your foot via medically enhanced sound waves which facilitates healing and regeneration, allowing you to overcome the chronic pain caused by plantar fasciitis.

What are bone spurs?

Bone spurs are small, hard projections that form along the side or edges of the bone. In the feet, bone spurs occur most commonly along the heel. Sometimes, these spurs cause few or no symptoms; but other times, they can press into the surrounding soft tissues and cause pain and irritation, especially when the foot is flexed or pressure is placed on the heel.

Conservative Therapy Of Heel Pain

Heel pain therapy for plantar fasciitis only requires surgery in approximately 20% of cases. However, if proper conservative care is not performed, the number of surgical cases is much higher. Upperline Health utilizes the latest testing techniques to diagnose the exact cause of pain. Following diagnosis, a multitude of care techniques can be used to treat heel pain including physical therapy, injection therapy, orthotic therapy and stretching protocols. We can also perform gait analysis studies to diagnose the cause of the heel pain.

Orthotic Therapy for Heel Pain

A major part of the care and recovery process of heel pain is orthotic therapy. A well made orthotic will decrease the amount of stretch on the heel region and will also increase the stability of the foot and ankle. Following resolution of pain, a proper orthotic can allow years of pain free comfort and decreased foot and ankle strain.

Shock Wave Therapy

Through the use of high intensity ultrasound waves, shock wave therapy can be used to treat heel pain. The high intensity ultrasound waves will cause mild increase in circulation to the heel and plantar fascia region resulting in increased healing potential. The procedure is virtually pain-free and can be done under local anesthesia. Following therapy, complete return to activity is possible with return to sports and running in one month. Although the therapy is not ideal for all patients, 85% of patients report dramatic decrease and improvement in pain and function.

Endoscopic Plantar Fasciotomy

If all else fails, surgical intervention may be necessary. We perform the endoscopic plantar fasciotomy procedure. Through the use of two tiny incisions, the fascia is visualized and the region of thickened fascia is released. Through is revolutionary procedure, a speedy recovery and limited down time is necessary.

Baxter’s Neuritis And Neurolysis

One common and poorly diagnosed and treated ailments resulting in heel pain is entrapment of the medial calcaneal nerve also known as Baxter’s nerve. This nerve is part of the complex of nerves that supply the sole of the foot. In the case of Baxter’s nerve, the nerve supplies the heel region. In certain cases, heel pain may be only partly from plantar fascitis and partly from a trapped nerve. An Upperline Health podiatrist is able to diagnose and treat Baxter’s neuritis in cases of heel pain. If you have had heel pain for an extended period of time without resolution of pain, make sure that you don’t have a trapped nerve.