When we get a new patient in the office that's complaining of pain in their heels and arch, the most common culprit is plantar fasciitis (pronounced planter fash-e-itis). This condition is one of the many that will get worse if you don't seek treatment, so ignoring the pain is not to your advantage. Fortunately, at Lexington Podiatry heel pain and specifically Plantar Fasciitis is one of the most common issues we treat.
There are a few other things that might cause heel and arch pain, like:
- tarsal tunnel syndrome
- infection and
- some types of disease, so we'll rule any of those out first.
"Plantar" means bottom and "fascia" refers to the tissue affected, which is a thick band that stretches from the heel across the arch to your toes.
Sometimes a person's natural gait (the way they walk) puts too much stress on the heel bone. This can inflame this plantar fascia tissue.
One major cause of that inflammation is over-pronation, which just means the foot rolls inward when you walk.
Over time, this will cause the arch to flatten and lengthen, which can inflame the plantar fascia…that's where the plantar fasciitis (and the pain) comes in to play.
- Pain and stiffness in your arch or heel, especially in the morning when you get out of bed or if you've been sitting on the couch watching TV, sitting at work or driving for awhile.
- However, you may not experience classic symptoms such as pain after standing. Pain in the arch or heel that gets worse towards the end of the day is a very common symptom.
- A feeling that your feet are tired and worn out at the end of the day.
- Many patients that have suffered from plantar fasciitis for a long time can also develop heel spurs.
- Reduce the inflammation: We have a few different options here, ranging from laser therapy to ice treatments to anti-inflammatory medications, arch supports, or in more severe cases, steroid injections or physical therapy. It just depends on the severity of the inflammation and pain.
- Relieve the tightness: You might need semi-custom or custom orthotics to support your arch, which can be tucked unseen into many shoe styles. If you are in a lot of pain, we might prescribe a walking boot to relieve the pain and allow your foot to heal. Or it could be as easy as changing your shoes and using a stretching splint. Please bring the shoes that you wear most often to your appointment so we can see if they're the cause. Using a heel rocker for calf stretches is VERY effective. It works best in conjunction with a Theraband kit (stretching band, freezable foot roller and Biofreeze). Check out Dr. Freels' favorite stretching tools here!
- Prevent future problems: If plantar fasciitis is caused by how you walk, the problem won't easily go away. Most likely, you've been walking that way since you were a kid, and that's a hard habit to change. So we can prescribe custom orthotics or arch supports that will prevent your arch from collapsing and lessen the chance that you'll have this problem again. We might also recommend physical therapy, special exercises or changing the type of shoes you wear.
To diagnose plantar fasciitis, we first do a thorough examination of your feet including an ultrasound which is real time imagery of the inside of your foot to determine the evaluate of extent of inflammation of the plantar fascia.
If necessary, we'll then take a look at how you walk (gait analysis), extensively discuss the kind of shoes you wear that could be triggering your pain. We then discuss what kind of activities and exercises you do most often and provide guidance on how best to minimize pain during or after. All of these factors provide clues to what's hurting your feet. If it's plantar fasciitis, we can usually have you feeling significantly better in just a few weeks with our aggressive treatment plans.
During your appointment, we'll fit you with a plantar fascial brace or air heel, which supports and lifts up the fascia and offloads the heel. Most patients see an immediate relief in the pain when with this splint. Air heels are very comfortable, and you can even sleep and work out in them. They will fit into anything from dress shoes to work boots.
To treat plantar fasciitis, we need to reduce the stress on that tissue to allow it to heal and minimize future problems. We tailor your treatment around your job, activity level, age and lifestyle.
If traditional techniques don't relieve the pain or you want to expedite your healing process, we offer a wide arrange of Regenerative & Advanced Medical options. To name a few, we will consider a PRP or Platelet Rich Plasma Injections, Stem Cell Therapy, and the ever popular pain laser therapy which is performed in the office. Laser therapy typically decreases your heel pain by 40% in 10 days.
In rare cases, surgery might be necessary if the foot doesn't respond to treatment. We offer Minimally Invasive Surgery (MIS) in office under local anesthesia as well or at multiple outpatient hospitals and surgery centers. But again, that's only the last resort if several months of treatment don't get rid of the pain.
The important thing to know is that you don't have to live with heel or arch pain, and that if you try to, it will most likely get worse. The quicker you get treatment, the faster you return to normal, pain free activity!