Heel pain and plantar fasciitis is one of the most common things in a podiatrist practice. Patients relate pain in the arch and heel area of their foot in the morning when they get out of bed and put pressure on there foot. Patient’s can have severe pain in the heel. These symptoms can improve as the day progresses but can reoccur if the patient sits or drives for a period time. These problems can be improved by stretching the foot before getting out of bed or activities, this will stretch the tendon of the plantar fascia and Achilles tendon. Changing shoe’s and footwear can reduce heel pain.
My medical advice when treating plantar fasciitis and heel pain when it first starts is extremely important. You should start with wearing shoes and not going barefoot and using OTC arch supports to support and cushion the heel and Arch and compression sleeves. Stretching can be beneficial along with the wrapping the arch to support the plantar fascial and reduce the stress on the heel Pain area. Using ice and rest along with taking oral anti-inflammatories can reduce the inflammation which is a form of bursitis of the. Wearing shoes with a slight heel will take stress off the fascia, this changes the angle of the foot that's why women noticed with a slight heel they have reduced heel pain and plantar fasciitis, men notice wearing cowboy boots helped tremendously also. It is not uncommon to have general foot pain, ankle pain, nerve pain in the heel, and Achilles tendinous these are normally caused by walking differently because of the pain in your heel.
The heel bone is the largest foot bone. The plantar fascia is on the bottom of the arch attaching 10 different spots and the front of the foot and attaching only one on the heel bone. Overtime and chronic use the fascia slowly cause a spur on the heel bone. The causes of the pain in the heel and fascia is incorrect ambulation, with walking or running which causing bursitis to the heel it may seem that there is swelling to the bottom of the heel at times. Old shoes can contribute pick a problem plantar fasciitis and heel pain so changing footwear and getting new shoes can be helpful. Some systemic diseases are involved rarely like rheumatoid arthritis. Patients generally between 30 and 60 years of age are more susceptible to this problem. Activities can contribute to the pain but many times patients with sitting type jobs develop the problem also.
If pain continues treatment is necessary. When you come to our office i thoroughly examine your feet to make a diagnosis an x-ray the foot to determine the exact cause of your heel pain and fasciitis. We review a systematic treatment plan the results can give success rates in the 90-percentile range with no surgery or disability. The causes of heel pain are from and injury or in rare cases a fracture.
Treatments in our office are generally very conservative. The goal is to reduce inflammation and to support the arch this will help reduce foot and ankle pain. Based upon physical examination and location of the pain treatments can be determined and reviewed with a patient. To reduce inflammation, it is generally necessary to consider a mild steroid injection to reduce inflammation, the injection is given from this side of the foot with Cold spray to reduce any discomfort this is given a few times with great success and Improvement. Normally the first injection helps 90% of the people reduce discomfort. With either using wrapping of the arch or more supportive shoes this helps to support the ankle and foot. Custom made orthotics are the gold standard of heel pain and Arch pain treatment. This is considered the long-term cure for the problem; surgery is extremely rare and normally is not necessary. The Orthotics are made from a cast of your foot with no way to capture the highest Arch with no stress on the fascia. They are made from a flexible resilient plastic material so they are flexible on weight-bearing and very comfortable they can be made for both gym shoes and different types of dress shoes. With conservative care Success is highly likely.
When conservative care doesn't give the Improvement, we want then to consider other conservative treatment. Patient’s can consider wearing a Cam Walker which is a below the knee boot. This allows weight to be distributed off the heel. Also, injections using stem-cell derivatives can be used to reduce the inflammation also. Is surgery ever necessary?
Surgery for heel pain plantar fasciitis is very rare. It's indicated after all conservative treatments have failed, then removal of the bone spur or release of the fascia can be performed. These procedures are normally done on an outpatient basis with Twilight sleep with the patient breathing on their own so no general anesthetic. They surgery addresses the problem with success rates high, I follow the patient closely after surgery calling them that night to make sure they're doing well, and review instructions proper medication used to control pain. The major problem with the surgeries is slow recovery because it is the heel area. Patients wear a Cam Walker after surgery and slowly return to normal activities over a few months.
If heel pain and plantar fasciitis are a problem, you are dealing with and we can help. We have offices in Overland Park and Kansas City just off Barry Road.
KC Foot Care: Thomas Bembynista, DPM
8695 College Blvd #220, Overland Park, KS 66210
W8G7+VP Overland Park, Kansas
(913) 894-0660
http://www.kcfootcare.com