Heel Pain: You Don't Have to Live With It
Written By: Dr. Childs

Your heel pain may have started days, weeks or even months ago. Maybe at first you felt a dull ache that went away. Now, you may have intense pain every day. Maybe it is worst with your first step in the morning, or it may get worse as they day goes on. In any case, heel pain can make walking or exercising unbearable, but you don’t have to live with it.
Causes
Heel pain is a common problem that affects people of all ages. There are many causes including injuries, excess weight, or the way your feet and legs move. If your heel moves too little or too much, it can cause other parts of your foot or leg to function incorrectly. Over time, this stress from poor foot function can lead to tearing of ligaments or tendons in the heel. For some people, daily use is enough to weaken these tissues. For others, a direct injury or sprain can cause the problem. In all cases, being overweight or walking barefoot can aggravate these problems.  Treatment goals are designed to reduce this abnormal pull on the ligaments and tendons.
Plantar Fasciitis
Plantar Fasciitis is the most common cause of heel pain. The plantar fascia is a ligament that runs from your heel bone to the ball of your foot.  Inflammation of this ligament is what causes the pain. The bottom of your heel may hurt when you stand. The pain usually lessens after you walk a few steps, but may return over time. Over time, prolonged inflammation may cause tearing, scar tissue formation, and even a heel spur.
Treatment of this condition is designed to reduce the inflammation, pain, and swelling of the ligament. Initially, you may be prescribed stretching and icing exercises, medications, or special inserts for your shoes. The right footwear is important as well. Going barefoot and wearing flip-flops are major causes of heel pain. Generally running or walking shoes with laces and a rigid arch are best. You should also get rid of any shoes that are heavily worn down as they are often more harm than good. As part of your treatment plan, your podiatrist may suggest certain types of footwear or arch supports that are best for your foot type.
Plantar Fasciitis usually responds to conservative care, and less that 5-10 percent of people that have heel pain ever need surgery.  In fact, if your heel pain has not gotten better, it may be because you don’t have the typical plantar fasciitis. Other causes of heel pain include Achilles tendon problems, stress fractures, chronic instability of the ankle, and even nerve problems such as nerve entrapment syndromes. Check with your podiatrist if the pain persists to make sure you don’t have one of these other problems.
Chronic Heel Pain
Chronic heel pain is pain that has not gone away over 6 months. Usually when someone has plantar fasciitis for a prolonged period of time, or has had an injury from trauma or overuse, they often develop scar tissue like changes to the plantar fascial ligament. Runners are especially prone to this. In these cases, the patient no longer has plantar fasciitis, but in fact really has plantar fasciosis. In cases of plantar fasciosis, there is no inflammation present, but rather degeneration of the ligament has occurred. This is the point where many people are forced with the decision to either live with the pain or have surgery. However, there is another minimally invasive option.
A New Treatment Option: TOPAZ
If you have suffered with heel pain and thought you were limited to either being stuck with the pain or having  painful surgery, you may have another option called TOPAZ.  TOPAZ is a quick, simple and minimally invasive medical technique available for the trearment of tendons and fascia. The TOPAZ microdebrider utilizes patented Coblation technology designed to specifically treat tendons and fascia. The TOPAZ MicroDebrider is the only radiofrequency device indicated for the debridement of soft tissue and has been performed in over 85,000 cases. The procedure is a single application and requires no incision. The technique has been associated with quick return to daily activities allowing for significant improvement in patient outcomes.Since obtaining original FDA clearance in 2002 and expanded indications for tendonotomy in 2005, TOPAZ has offered a minimally invasive alternative for thousands of patients for the treatment of tendons and fascia.
If you are interested in discussing your heel pain or want more information about the TOPAZ procedure, call Orlando Foot and Ankle Clinic at 407-423-1234.