Heel pain is a common foot problem that can range from the mild annoyance of a "stone bruise" to a cause of missing work. Classically the pain is felt on the bottom of the heel and becomes more frequent and more intense with time.
The classical diagnostic sign is poststatic dyskinesia or pain following rest (i.e. morning pain and stiffness). In the first few months, the heel pain eases off after a few steps. In advanced cases the pain can persist throughout the day and become disabling. Rarely, an actual heel spur can be seen on an x-ray but the pathology of this pain is an insertional enthesiopathy of the plantar fascia into the calcaneus due to underlying biomechanical weakness.
When over the counter anti-inflammatory medications, heel lifts, stretching and shoes with some arch support fail, more resistant cases deserve a podiatry consultation at LifeStyle Podiatry.
At LifeStyle Podiatry, heel pain is a nonsurgical problem. This means that virtually all heel pain is handled using non invasive treatment with success.
After diagnosing the problem (Plantar Fascitis and Tarsal Tunnel Syndrome are the most common), a treatment plan is developed utilizing injection therapy, foot strappings and Foot Centering PadsTM that eliminates pain and disability within two-three weeks while keeping the person active and productive.
Then utilizing the information provided by Functional Foot Typing every patient, a custom Foot CentringTM is casted, prescribed and dispensed that removes the predisposing biomechanical factors that created the problem in the first place. Fortunately more than 95% of all heel pain patients that we treat are improved with these non-surgical therapies.
ESWT (Surgical Shockwave)
The remaining 5% (usually overweight and non-compliant) can be cured utilizing another non-invasive treatment called Shock Wave. Shavelson placed the first high intensity shockwave unit in New York City and LifeStyle Podiatry remains on the cutting edge of Extra Corporeal Shock Wave (ESWT) treatment.
ESWT is patterned after the shock wave therapy machines that have been used for 15 years to break up kidney stones. In the foot, ESWT is performed under intravenous and local anesthesia. During the treatment the device is aimed at the heel and thousands of otherwise painful shocks are directed at the painful area for 15-20 minutes. Post op soreness and pain controlled by Tylenol for a few days is expected but in numerous studies 80% of the ESWT patients who use post op custom orthotics are back to regular activates with less pain in 2 to 4 weeks and permanently cured.
Note: More and more insurance plans are covering ESWT and at LifeStyle Podiatry we take the time to get insurance precertification but this service may not be covered by insurance and is not often suggested for that reason.