Where Does Your Heel Hurt?
Again, this is a symptom – one that can be caused by a variety of issues. The location for the more common conditions responsible for heel pain are:
- Plantar Fasciitis– If your pain is on the bottom of the heel, sharp, and most intense with the first steps of the day (or after rest), this is most likely the culprit.
- Plantar fibromatosis– If you see or feel lumps growing along the bottom of the Plantar Fascia, this is the “other” Plantar Fascia problem. These growths may be the size of a pea or marble and found right behind your big toe joint or in the arch area. The bigger the lump the bigger the pain.
- Insertional Achilles tendinitis– If your pain is in the back of the heel during or following physical activity (running and/or jumping), then you probably have inflammation, injury, or degeneration of the Achilles tendon where it inserts on the heel bone. The lump at the back of the heel is reactive and enlarged bone (also called a Haglund’s deformity or “Pump Bump”). Achilles tendonitis is slightly different and occurs above the heel.
- Sever’s disease– if your child is between the ages of 6-14 and experiences pain around the back and sides of the heel, he or she may be suffering from what we call “juvenile plantar fasciitis.” This same form the cause as adult Plantar Fasciitis but a growth plate gets damage instead of the soft tissue.
Less common sources of heel pain include tarsal tunnel syndrome, nerve entrapment, and stress fractures.
Heel Pain Relief
Fortunately, conservative (nonsurgical) therapies are highly effective. This approach is something you may appreciate because Dr. Leibovitz is committed to avoiding surgery. Our patients really appreciate it!
To address the pain, your treatment plan may include:
- Biomechanical control (correcting and/or restricting abnormal foot movement) When you hear hoof beats….think of horses and not Zebras. This is the most common cause as well as the easiest to address.
- Shoe selection. Not all shoes are equal.
- Cortisone injections (in extreme cases)
- Physical therapy to address a short/tight Achilles complex.
- Laser Therapy as an additional option to help speed up healing!
Heel pain is often related to underlying structural and biomechanical issues. The most common cause is flat feet, gait irregularities, and tight calves.
Typically the treatment plan will focus on changing the way the foot functions. Prescription orthotics are a treatment option that help many patients find the relief they’re seeking. These devices are effective in changing and maintaining faulty mechanics. Orthotics will include shoe selection to assist with biomechanical control. Here is a link about good and bad shoes for heel pain – click here. All the treatment options will include a specific stretching program for the Achilles complex.
During your recovery, our focus is to keep you as active as possible. Everyone will get better with rest. Getting you better with activity is the difficult part. Unfortunately, after recovery with only rest the original problem is still there. Here is a video on why heel pain keeps coming back like a bad penny – click here.
If you have chosen laser therapy to help supplement your treatment plan, you can expect one of two options. The first option involves a session a week for 6 weeks. The other is designed to help speed up recovery even faster if you need the additional help, with 2 sessions in the first week, followed by 1 session a week for 4 weeks.
While our goal is always to avoid surgery, there are rare times when the treatment options are exhausted without adequate relief. At this time a person may have this option to consider.
If that applies to you, Dr. Leibovitz will help you understand your options. He is highly skilled in foot surgeries and you can rest assured knowing your feet are in good hands. You will also be given detailed instructions so your recovery is as fast and effective as possible.