1. Causes of Severe Heel Pain:
   
   • Most common cause: Plantar fasciitis
   • Other serious causes that require immediate treatment:
   • Fracture of the heel bone
   • Deep Infection
   • Cyst in bone
   • Arthritis
   • Foreign body
2. Causes of Persistent Heel Pain:
   
   • Wrong diagnosis
   • Wrong treatment
   • Plantar fasciosis (a degenerative disorder of the plantar fascia)
3. The Wrong Diagnosis for Your Heel Pain:
   
   • Not all heel pain is due to plantar fasciitis.
   • Possible alternative causes of heel pain can include radiculopathy, autoimmune disease, neuropathy, systemic issues, nerve entrapment, tarsal tunnel syndrome, sciatica, plantar fascial rupture, calcaneal stress fracture, rheumatoid arthritis, and other medical conditions.
   • Accurate diagnosis is important for proper treatment.
4. The Wrong Treatment for Your Heel Pain:
   
   • Even with the correct diagnosis, improper treatment can lead to ongoing pain.
   • It's important to choose a podiatrist who stays updated on research and developments in heel pain therapy.
   • Example of incorrect treatment: Improperly made orthotics for plantar fasciitis.
5. Plantar Fasciosis – A Common Cause of Chronic Heel Pain:
   
   • Plantar fasciosis is a degenerative disorder of the plantar fascia.
   • It is different from plantar fasciitis, which is an inflammatory disorder.
   • Diagnosis is often done through ultrasound imaging.
   • Newer treatments involve inducing trauma to the plantar fascia to stimulate healing.
6. Advanced Therapies for Severe or Chronic Heel Pain:
   
   • Custom Orthotics for Plantar Fasciitis (properly prescribed and made)
   • MLS IV laser therapy
   • Steroid injections
   • Surgery (only considered as a last resort)
7. Custom Orthotics Designed to Treat Plantar Fasciitis:
   
   • Plantar Fasciitis Orthotics have been found to be effective in treating heel pain, especially when caused by plantar fasciitis.
   • Multiple studies have supported the use of foot orthotics for this condition.
   • These studies have also highlighted the importance of prescribing orthotics in a specific manner to maximize their effectiveness in relieving heel pain.
8. MLS IV Laser Therapy:
   
   • Non-invasive and painless treatment using specific light wavelengths
   • Stimulates healing, reduces pain and inflammation, improves blood circulation, and repairs tissue.
   • Effects include increased blood flow, reduction of swelling and inflammation, and pain relief through improvement in nerve function.
9. Platelet Rich Plasma (PRP) Therapy,
   
   • PRP uses the patient's own blood platelets to stimulate healing
   • PRP injections can accelerate healing in injured or diseased plantar fascia
10. Surgery for Chronic Plantar Fasciitis:
    
    • Considered as a last resort when all other treatments have failed.
    • Typically involves releasing a portion of the plantar fascia from the heel bone.
    • Success rates are generally good, but surgery carries inherent risks.
11. Seeking Help for Heel Pain:
    
    • Consider a visit to Lexington Podiatry's Heel Pain Clinic led by Dr. Freels or Dr. Carter.
    • Try a self-treatment plan for a few weeks, and if it doesn't improve, give us a call!