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Heal that Heel Pain


Eli Mannings link on plantar fascial injury

NFL link plantar fascial injury

Heal that Heel Pain
By Dr. Andrew Saffer, DPM
Podiatric Medicine and Surgery

Do your first few steps out of bed in the morning cause severe pain in your heel? If so you may be suffering from "heel pain syndrome", often referred to as "heel spurs." The typical signs and symptoms for this condition are usually severe pain upon first rising in the morning. Resting can provide only temporary relief. Typically, the pain reoccurs after sitting or resting and then rising. The intermittent pain often can progress to a dull aching pain.

Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot. The plantar fascia is a supportive, fibrous band of tissue running from the heel to the ball of the foot. When the fascia becomes injured, pain on the bottom of the foot results.

Heel Spurs

Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. The spur itself is usually not the cause of pain; the pain is actually from the soft tissue injury to the fascia.

Conservative Treatment

A majority of patient's heel pain resolves completely with conservative treatment. Treatment includes rest from strenuous activity, application of ice, stretching exercises, foot strappings, night splints, foot orthotic devices, cortisone injections, immoblization with a walking boot, and physical therapy.

Shockwave Therapy (Non-invasive surgery)

Extracorporeal shockwave therapy, is a non-invasive treatment option for the intense, persistent heel pain associated with chronic plantar fasciitis. This non-invasive out-patient treatment represents a breakthrough for this condition. Using a unique process known as Orthotripsy shock waves are emitted, similar to those used to treat kidney stones, to increase blood flow and stimulate healing of the affected heel. Shockwave therapy usually allows for patients to return to their activities within a day of the treatment. Some patients report immediate pain relief after treatment, although it can take up to four weeks for pain relief to commence. Shockwave therapy takes approximately 30 minutes and is performed as an outpatient or office procedure. In conclusion most patients who suffer from plantar fasciitis fully recover. Patients who have not responded to conservative treatment may benefit from shockwave therapy. It is a reasonable option to consider prior to surgical intervention, which involves releasing the plantar fascial ligament. The potential side-effects of shockwave therapy are minimal. Therefore, shockwave therapy is a safe alternative to surgery when patients have failed a minimum six months of conservative treatment.