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Be well, Dr. Thomas Silver

Golden Valley, MN (763) 231-2341

Heel Pain

heel pain

PLANTAR FASCIITIS (HEEL PAIN) SPECIALIST:
We treat resistant heel pain.

Dr. Silver specializes in the treatment of acute & chronic heel pain, also known as plantar fasciitis. He is often able to help those who had failed treatment elsewhere, with a 90-95% success rate- usually without the need for surgery! If you or someone you care about is suffering from heel pain/plantar fasciitis then the following information will educate you about this condition and what Dr. Silver can do to get rid of your heel pain.

The following are answers to commonly asked questions about heel pain/plantar fasciitis:

What causes heel pain/plantar fasciitis?

Why does my heel hurt when I first step on it in the morning?

Can plantar fasciitis go away on its’ own?

What is the best and fastest way to get rid of heel pain?

Nothing seems to give me long term relief of my heel pain. Now what?

 

What causes heel pain/plantar fasciitis?

The plantar fascia is a tendon-like band of tissue that attaches to the bottom of the heel, goes to ball of the foot and holds up the arch.  

Like any tendon, the plantar fascia can pull or stretched too much, become irritated or weak which can cause inflammation of the fascia (fasciitis). This is identical to a tendonitis but on the bottom of the heel. Some causes include:

  • Injury, especially sports involving running or jumping
  • Ill-fitting or worn out shoes
  • Increased standing or walking on hard, flat surfaces
  • Weight gain
  • A weak, imbalanced foot structure
  • Increased stress on the feet from knee, hip or back problems.

This can progresses into chronic, severe heel or arch pain. Fasciitis pain typically occurs on the bottom inside of the heel, but may be also occur in the center of the heel or along the arch.

Why does my heel hurt when I first step on it in the morning?

Plantar fasciitis pain is often worst upon first steps in the morning or when getting up after sitting for a while. When you are off your feet, the fascia will tighten up and try to heal the sore area. When first stepping down, the sore area that’s trying to heal gets pulled, creating intense pain and the cycle starts all over again. This pain may ease up after walking or standing for a while, but may persist or get worse the more you are on your feet.  Other areas of your feet or body may start to hurt from walking differently from taking pressure off of your sore heel. Diagnostic ultrasound often shows swelling of the fascia along with frayed or split fibers.

Can plantar fasciitis go away on its’ own?

In some instances plantar fasciitis will go away on its’ own certain home treatment, but often it will become a chronically painful condition that limits the activities you are able to do.

What home treatments can I do to get rid of heel pain?

Home treatment can include the following:

  • Rest,including staying away from activities such as running or walking
  • Wearing better fitting or more supportive shoes
  • Massaging the fascia with a frozen water bottle or frozen golf ball
  • Pulling the foot upwards with a towel and holding it for 30-60 seconds before stepping on the foot first thing in the morning.
  • Standing on the edge of a step & slowly dropping the heels downwards
  • Grabbing a towel with your toes several times & calf stretches
  • Store bought insoles or heel cushions
  • Anti-inflammatory medications such as Ibuprofen

Often home treatments work best when you first develop plantar fasciitis but less chance of helping if you’ve had it for a couple weeks or more.

What is the best and fastest way to get rid of heel pain?

The first step to getting rid of your heel pain is by a thorough evaluation by Dr. Silver at the Westwood Foot Clinic.  He can then determine the best treatment for you.

Evaluation often involves:

  • Evaluating your foot structure and the way you stand & walk to determine any underlying weakness or imbalance in your feet or body structure that may be causing your heel pain.
  • Evaluating your bone structure with digital x-rays to look for heel spurs, arthritic changes or heel fracture.
  • Evaluating the plantar fascia with diagnostic ultrasound which can show any defects, tears, scar tissue or swelling in or around the fascia
  • Evaluating the shoes you wear for any changes needed.
  • Evaluating the care you’ve already had-what did & didn’t work.

Treatment can involve:

  • Injections: a small amount of a long acting anesthetic & cortisone are targeted to the exact problem area. Often a series of 2-3 injections are necessary. This can provide long term pain relief, but only if the underlying cause of your heel pain is treated with either non-prescription or prescription orthotics.
  • Prescription foot orthotics is often necessary for long term relief of pain. They support the weak fascia and properly realign the foot structure. Impressions of your feet are taken and sent to a local orthotic lab with a prescription for your custom made orthotics.
  • Fascia stretching device: this can eliminate the severe first step pain in the morning. We can fit you with in a device that’s worn during the night or then sitting for long periods of time, such as when watching television or working at a computer.
  • Several exercises may be prescribed to stretch and massage the plantar fascia.

Nothing seems to give me long term relief of my heel pain. Now what?

A small percent of people with heel pain have minimal or temporary relief from conservative treatment.  These resistant cases may require more advanced treatment procedures including:

  • Fascia Peppering Technique- a minimally invasive procedure which is an alternative to traditional surgery and done in the clinic. This involves having the area numbed but requires no stitches or prolonged recovery with a success rate of approximately 50-60%.
  • Plantar Fascial Release- this is a procedure done in the clinic. The heel is numbed and the fascia is partially released through a small incision to allow the fascia to stretch. This does require wearing a low profile cast boot for about a month afterwards to allow the fascia to heal properly. Fortunately this procedure is 85-90% successful in resolving resistant heel pain.

“Our treatment goal is to knock out your heel pain and to keep it away”

If you or someone you care about is suffering from heel pain/plantar fasciitis, then an appointment is necessary with Dr. Silver at the Westwood Foot Clinic in Golden Valley, MN…the “heel pain specialist”.

At the Westwood Foot Clinic, we can help eliminate your heel pain!

Westwood Foot Clinic proudly serves the surrounding communities of St. Louis Park, New Hope, Plymouth, Wayzata, and Minneapolis.

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