By Dr. Bruce Pinker
Pain in the bottom part of the heel and arch of the foot is a very common condition, known as plantar fasciitis. Typically, the plantar fascial ligament that spans the foot, originating in the heel and traveling down toward the toes, becomes aggravated or inflamed. There are several reasons why this occurs, and many effective ways to prevent and treat it.
In addition to plantar fasciitis, many individuals endure heel pain due to a heel spur, a spike that develops on the calcaneus (heel bone). This is usually caused by excessive force on the plantar fascial ligament which produces high tension levels at the origin of the ligament, causing a tearing of the bone, coupled with bleeding and calcification to produce a physical bone spur. Based upon many years of research, we know that the culprit is the increased stress on the plantar fascia. Therefore, most heel spurs do not need to be removed and can be treated conservatively via physical therapy and custom-made orthotics. Occasionally, cortisone injections may be of some benefit but usually produce only short-term relief. Ninety percent of all cases of plantar fasciitis and heel spurs can be treated non-surgically.
For those complicated cases, there is the Extra Corporeal Shock Wave Therapy (ESWT). This non-invasive approach to heel pain is FDA-approved and highly effective, typically yielding success in 90 of every 100 cases. The procedure is performed in our office in one visit as we own and operate the high-energy model (there is also a low-energy version that requires several treatments and we do not endorse it). ESWT is similar to the lithotripsy procedure that is performed to treat kidney stones. We have successfully utilized this treatment in our office for many patients over several years.
One of the best ways to prevent plantar fasciitis is to stretch your feet, legs, and lower back on a daily basis. In our September 2012 newsletter, we discussed proper stretching techniques and these can be found on our Facebook page here: Progressive Foot Care of White Plains NY, Pomona NY. The important factor for stretching is discipline. It must be performed every day, preferably right after one gets out of bed. The rationale is that while we sleep, our feet tend to fall downward naturally. As this occurs, the ligaments and tendons on the bottom of the foot tighten and shorten. This leads to increased pain upon stepping out of bed.
Unfortunately, simply wearing “good” shoes does not prevent pain. While supportive footwear is beneficial in providing orthopedic support, shock absorption and biomechanical control, it is often not enough. Many times, a custom-made orthotic is necessary to address the concerns of the foot. We prescribe and fabricate these in the office on a regular basis.
As we enjoy more temperate weather, we may choose to jog, walk or run. It is important to stretch out, wear proper footwear, and seek the advice of a podiatrist if foot pain occurs. Many foot issues can be treated conservatively, and if addressed quickly, can be resolved in a relatively short period of time.
Taking care of your feet can be your first step toward good health. Remember, your feet are the foundation for your body.
Dr. Bruce Pinker is a podiatrist with offices in Pomona and White Plains.