Thursday, March 04, 2021

Heel Pain Causes and Relief: Myths and Misconceptions

As a podiatrist, I’ve treated people for a wide range of foot pain problems for years. For a large percentage of my patients, pain in the heel and arch is caused by heel spurs. There are a variety of treatment options for heel spurs in Brooklyn, with no single best treatment. I approach each patient’s condition individually, creating a treatment plan tailored to their symptoms and how they respond to each option. There is no golden rule in treatment, so I carefully monitor progress and adjust as needed.

Common Causes of Heel Pain  

There are five common causes of heel pain I see in my practice:

1.    Pronation, or flat feet. This is sometimes referred to as having fallen arches.
2.    Significant weight gain or loss.
3.    Prolonged standing, particularly for repeated periods.
4.    Overuse or overexertion of the heel, which can lead to stress injuries.
5.    Wearing shoes with little or no arch support.

Treatment Options for Heel Pain

Treating heel pain depends on what kind of injury or inflammation is involved, what is causing the discomfort, and how advanced the damage or trauma to the foot is. Each patient’s response to specific therapies also comes into play. Standard treatment options may include steroid injections, wearing orthotics, stretching exercise, radiofrequency nerve ablation, extracorporeal shockwave therapy, using class 4 MLS laser, and, eventually, heel spur excision surgery.

About 25% of individuals suffering from heel pain caused by heel spurs don’t respond to conservative, non-invasive treatments. I often see these patients after they’ve seen another podiatrist and have been disappointed in the results. Injections, physical therapy, and orthotics have had disappointing results, and they are frustrated and tired. Many of them have been given misinformation based on myths and misconceptions.

Common Myths and Misconceptions Regarding Heel Spur Treatment

Patients often ask questions based on information that is outdated or inaccurate. I’ve outlined the most common questions here, including my response to them, to help clear up some of the misconceptions people have about heel pain relief:

1. Is it true that I have to be treated for heel spurs conservatively for at least six months before I can have surgery?

Answer: No. Although conservative treatment may be initially recommended, there is no justification for six months of suffering.

2. Is it true that I won’t be able to walk after heel spur surgery?

Answer: No. How quickly you will be able to walk depends mainly on the procedure your surgeon chooses. After calcaneal osteotomy, you will not put weight on your foot for some time. On the other hand, after percutaneous heel spur excision, you will be able to walk almost immediately.

I personally prefer performing percutaneous heel spur excision with plantar fasciotomy so that my patients can recover quickly and get back to their everyday routines. Using fluoroscopy to pinpoint the heel spur ensures the procedure is safe, simple, and effective and allows the individual to walk normally right away.

3. What is the healing time for heel spur surgery?

Answer: Depending on the procedure, anywhere from ten days to six weeks.

4. Can you guarantee that the heel pain will go away?

Answer: No. Any surgeon who guarantees heel pain relief isn’t being honest. Although most of my patients obtain full or dramatic pain relief, a small percentage will continue to feel some pain. This is usually related to a different underlying issue such as local tissue inflammation caused by the surgery, scar tissue, cuboid syndrome (pain on the lateral side of the foot), or chronic pain not related to the heel spur.

Overall, conservative and surgical treatments of chronic pain caused by heel spurs effectively reduce or eliminate discomfort. If you have additional questions or concerns, I will be happy to discuss your heel spur treatment options.  

This is a guest blog entry.

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