Heel pain is one of the most common complaint that we see in our practice. Heel pain can sometimes be misdiagnosed as plantar fasciitis. If you have been suffering from heel pain and you haven't had relief with aggressive conservative treatment such as stretching, icing, NSAIDS, cortisone injections, night splints, and custom orthotics than MRI may be an option. MRI will aid in ruling out a heel fracture or plantar fascial tear. The typical course of treatment for a heel fracture or plantar fascial tear is different from the treatment of plantar fasciits. Here is some treatment options and long term outlook for three common complains of heel pain.
- If you have a positive MRI for calcaneal (heel) fracture, the treatment is 3 months in a removable boot.
- If you have a positive MRI for plantar fascial tear, the treatment is 3 months in a removable boot.
- If you have a positive MRI for intense inflammation only, the tapered cortisone course, with contrasts and ice, with a short course of removable boot, with some PT or accupuncture are all helpful.
- If you have a positive MRI for any of the above, you may still have nerve trauma/sensitivity concurrently. The pain from nerves is difficult to treat, and has been solutions.
- If you have a negative MRI, then you have plantar heel bursitis (may not show well on MRI) or nerve trauma, or both. If I think there is bursitis, with a negative MRI, I like ice massage, physical therapy, or cortisone shots (which you correctly are not a fan of, but may be crucial).
For more information on heel pain please refer to our website at carolinafootspecialists.net