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

Dr. Silver specializes in the treatment of chronic and acute heel pain (plantar fasciitis) and has helped many patients who had failed treatment elsewhere. He uses several conservative (non-surgical) methods of treatment that are alternatives to traditional heel pain surgery with a 90-95% success rate! 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.

What is plantar fasciitis?

The plantar fascia is a thin layer of tissue that goes from the bottom of your heel into the ball of your foot. This rubber band type of tissue helps to hold up your arch. When the plantar fascia is pulled, stretched, irritated or weakened it can cause a dull to sharp pain in your heel called “plantar fasciitis”-inflammation of the fascia on the bottom or plantar surface of your foot. This often progresses into severe, persistent pain. This pain typically occurs on the bottom inside of the heel, but may be also occur in the center, outside and occasionally further up in the arch.

Why does plantar fasciitis hurt so much?

The pain of plantar fasciitis is often at its worst upon taking the first morning or after sitting down for an extended period and then resuming activity. Sufferers may notice hobbling or limping for a few minutes before a comfortable stride can be resumed. Some patients even describe the pain as feeling like a nail is being driven up the heel. This pain may ease up after walking or standing for a while, but mild to severe pain may persist or get worse the more you are on your feet. Often the ankle or leg will start to hurt from walking differently to take pressure off of the heel. Diagnostic ultrasound often shows swelling of the fascia along with frayed or split fascia fibers. This swelling then causes pressure against a small nerve that runs up to the fascia on the inside of your heel. The pain that occurs upon first steps is similar to a small cut that scabs over when you are off your foot but is pulled apart when you step on it.

What causes plantar fasciitis?

Typically, there are two causes of plantar fasciitis. The first is from an injury to the area, similar to tendonitis. The fascia can become injured from excessive activities, sports or shoes that are worn out, ill- fitting or inappropriate for a particular activity. The injury can stretch out, pull, tear or weaken your plantar fascia. The second cause is from a weak or imbalanced foot structure. This can run in the family or can result from changes caused by injury, surgery or deformity (i.e. knee, hip or back problems). This in turn causes chronic low-grade pulling, stretching and irritation to the plantar fascia to the point of becoming inflamed and painful.

How do I get rid of painful plantar fasciitis?

A thorough evaluation by Dr. Silver at the Westwood Foot Clinic can determine the best treatment to resolve your heel pain caused by plantar fasciitis. This typically involves evaluating your foot structure, the plantar fascia and the way you walk. Evaluation of the foot structure will be done using visual analysis and digital x-rays. This shows your foot structure and changes that may have occurred. Diagnostic ultrasound is often used to inspect the fascia for any defects, tears, scar tissue, bone spurs or swelling, in or around the fascia. Evaluation of how you walk is essential to look for any underlying weakness or imbalance in your foot or overall body structure that may be causing your heel pain.

Prescription foot orthotics are often necessary to strengthen and balance your foot structure for long term relief of pain in the heels. Impressions of your feet are taken and sent to a local orthotic lab with a prescription to make your custom fit orthotics.

An injection of cortisone with a long acting anesthetic is excellent in knocking out plantar fasciitis pain. Dr. Silver often uses a series of up to three cortisone injections targeted to the area of pain, with excellent results. Unfortunately this is only a temporary fix if the underlying cause of your heel pain is not treated with prescription orthotics.

Night splints are excellent in eliminating the severe pain when you first step on your foot in the morning. This is a comfortable splint that we can fit you with in our clinic. It is worn during the night or then sitting for long periods of time, such as when working at a computer, to stretch the fascia. There are also several exercises that Dr. Silver may prescribe to stretch and massage the plantar fascia.

Resistant cases may require advanced treatment procedures by Dr. Silver. This may involve a fascia peppering technique or a radio-surgical ablation procedure. These are considered minimally invasive procedures which are an alternative to traditional heel pain surgery. These procedures require no stitches or prolonged recovery. Dr. Silver has a 90-95% success rate with the above mentioned treatment. Occasionally there is a patient who does not respond to the above treatment or who experiences only temporary relief. For resistant cases, an open plantar fasciotomy is performed. This procedure is done in the convenience of our clinic. With the heel numbed, the fascia is partially released through a one inch incision. This does require wearing a cast boot for about a month after surgery to allow the fascia to heal properly. Fortunately this procedure is very successful (85-90%) in resolving heel pain. According to Dr. Silver “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 communities of St. Louis Park, New Hope, Plymouth, Wayzata, and Minneapolis.