Heel pain is a very common complaint among patients coming into the clinic. Heel pain can be caused by various issues but most commonly heel pain is caused by plantar fasciitis which is an inflammation of the plantar fascia, a ligament on the bottom of the foot which inserts into the heel bone. Other causes include trauma, a stress fracture, a nerve irritation, or heel spurs. Plantar fasciitis usually causes significant pain in the area that the plantar fascia inserts into the heel bone. This is often characterized by pain while getting out of bed in the morning or when getting up from a seated position. Often times the pain will improve after weightbearing for a period of time but sometimes increased weightbearing can make the pain symptoms worse. A good thing about plantar fasciitis is that there are a number of very helpful treatment options for it. One of the best things that you can do to treat plantar fasciitis is to start wearing functional orthotics to help support the arch and relieve pressure from the heels. Please keep in mind that orthotics are not all created equal and as a matter of fact I would say the majority of orthotics are of very low quality and do not help. Even orthotics bought for $1000 can be of low quality although their advertisements say the opposite. A medical grade orthotic is recommended because these orthotics sufficiently support the arch and alleviate pressure on the heels as well as the ball of the foot. Medical grade orthotics can only be obtained in a medical clinic and at Fusion Foot and Ankle we have an assortment of medical grade orthotics that are very reasonably priced starting out at $45 per pair. Custom orthotics should be reserved for things such as significant foot deformities or pain that is unresolved by prefabricated orthotics. We are also able to manufacture custom orthotics at Fusion Foot and Ankle when needed or requested. Another thing that is very important is to wear supportive shoes as much as possible. I have always told patients to wear supportive shoes at all times if they have plantar fasciitis. This will decrease the stress on the bottom of the feet and it will also allow the orthotics to function appropriately. When pain is significant and over 5 out of 10 pain at times I will often recommend a cortisone injection into the plantar fascia. A cortisone injection as a steroid which helps to decrease the inflammation within the plantar fascia and subsequently decrease the pain symptoms. Often times cortisone injections can resolve plantar fasciitis within a few days. Other things that can help plantar fasciitis include anti-inflammatories such as ibuprofen or Aleve, icing the area with an ice pack for 20-30 minutes 2-3 times a day, and calf stretching exercises to alleviate the stress in the area of the plantar fascia and taping of the foot. In rare instances when conservative treatment does not resolve plantar fasciitis there is a surgery which involves a small incision in the area of the plantar fascia insertion site and the plantar fascia is partially released. This is outpatient and takes about 15 minutes to perform. The patient wears a postop shoe for about 3-4 weeks postop then into a regular shoe. If you have heel pain feel free to schedule an appointment and we’ll get you feeling better soon. Call us to schedule an appointment today! 515-348-1977
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