·         Q: What causes so many people to have heel pain?

·         Q: Why do I have severe heel pain in the morning but not in the evening?

·         Q: Will I need surgery for my heel pain?

·         Q: Who typically gets heel pain?

·         Q: How do we diagnose heel pain?

·         Q: How can orthotics help your heel pain?

·         Q: How can you avoid heel pain?

·         Q: How long does it take to recover from heel pain surgery?

Heel pain is a very common condition treated in our podiatric office.  Patients come in complaining of pain to the bottom of their heel, sometimes radiating into the arch area and are seeking effective treatment. Dr. Weinert often speaks with patients who thought their heel pain would just go away on its own. However, with conditions such as heel spur syndrome or plantar fasciitis, this often is not the case.

If heel pain is not treated properly, symptoms will only get worse for the patient and can result in further pain and disability. This can happen not only in the foot, but in the ankle, knee, hip, lower back and even up in to the shoulder areas as well.  The foot is the foundation for the whole body system and if the foot or the heel hurts, then you can feel pain all over. Foot health starts with knowing the causes of heel pain and symptoms to look out for. Early intervention will prevent further damage to the feet and Dr. Weinert offers several treatment options to help his patients suffering with heel pain.
 

Causes of Heel Pain
Many things can cause heel pain.  Most commonly seen at our Troy, MI office are heel spurs, which are small growths on the heel bone. Heel pain can be caused from heavy activities and increased weight that put extra pressure on feet.   Dr. Weinert often treats heel pain in athletes, runners and women who are pregnant. There are other cases where Dr. Weinert has related a patient’s heel pain to arthritis, stress fractures, fractures, bone tumors, cysts, achilles tendonitis and Haglund's deformity.

The main cause of heel pain is usually a biomechanical problem in the foot and it’s, in a nutshell, having a foot out of alignment.  There are numerous conditions.  One of the most prevalent is called talotarsal dislocation syndrome.  This happens when you have a misalignment of your ankle on your heel and as you bear weight you get a collapse of the ankle on the heel causing the foot to be out of alignment. So the plantar fascia, bones, joints, and ligaments receive constant stress. This stress occurs at the point where the plantar fascia (the major tissue that connects your toes to your heel) meets the heel.  Many patients explain the pain as being in the middle of the inside of the heel.

As a patient bears weight, they get the collapse of the foot and that ligament pulls.  And if you think of a rubber band constantly getting pulled on that area of the insertion on the heel, you eventually start getting some micro tears in that ligament and causing inflammation and pain specifically right there in middle area of the heel.

Plantar fasciitis is also a common source of heel pain. The plantar fascia, a band of tissue that runs from your heel to your toes, can become strained and inflamed due to overuse and wear and tear. This band of tissue can only withstand so much pressure and when it gives way, the pain can be severe and requires immediate and effective treatment.
 

Symptoms of Heel Pain
Usually when a patient comes in they’ll explain that they have severe pain in the heel.  It’s usually worse during the first step in the morning when they get out of bed.  Many people say if they walk for a period of time, it gets a little bit better.  But if they sit down and get back up, the pain will come back and it’s one of those intermittent come and go types of pain.  Heel pain patients will say it feels like a toothache in the heel area or even into the arch area.  A lot of times it will get better with rest and then it will just come right back.  So it’s one of those nuisance type things that just never goes away.

Many of Dr. Weinert’s patients complain of similar symptoms. The following are common signs of heel pain and plantar fasciitis:

·         Pain that is worse first thing in the morning

·         Pain that develops after heavy activity or exercise

·         Pain that occurs when standing up after sitting for a long period of time

·         Severe, toothache type of pain in the bottom of the heel
 

Treatment for Heel Pain
Using our state-of-the-art equipment, Dr. Weinert is able to provide a full work up for the heel, including gait analysis. Digital imagining gives him and the patient a full view of the foot and injury to help formulate the best treatment plan possible. There are numerous treatment options available to help with heel pain and plantar fasciitis:

·         Anti-inflammatory medications

·         Digital custom orthotics

·         Physical therapy

·         Diagnostic and ultrasonic guided injection therapy

No one should ever resign to living with foot pain. If you have heel pain, visit Dr. Weinert for effective treatment and live pain-free once again. Call our Troy office today at (248) 362-3338 or visit our Patient Education section on our homepage for further information on foot and ankle conditions.

 

Frequently Asked Questions about Heel Pain

Q: Why do I have severe heel pain in the morning but not in the evening?

A: A good analogy is that if you think of a rubber band, you have a ligament on the bottom of the foot that’s sort of starts at the heel area and then it goes all the way up into the forefoot area.  And what happens is if you think of it as a tight rubber band, as you put weight down and that stretches, you get a constant stretch and a pull on that ligament, which we call plantar fascia.  And what happens is because as you bear weight and you get this extra malalignment in the foot, you get that extra pull on that ligament and it causes little micro tears in that plantar fascia band. This typically occurs where the fascia meets the heel.  That’s also where you will experience the pain and inflammation. 

So the constant pulling, eventually, with time will cause these symptoms and is very, very common.  These symptoms usually show up after some time.  Usually, middle aged patients are affected with this problem.  It is a condition where the problem will come and go and you will feel excruciating pain, sort of like a toothache type feeling, in the heel.  It’s one of those things that always comes back.  But if it’s addressed early on, surgery can be avoided.

Q: What causes so many people to have heel pain?

A: There are many reasons why people experience heel pain.  Based on what we see in our office, heel pain affects, probably more than one in every four people. A lot of this is caused from conditions within the foot. These conditions could be related to hyper pronation, which is where you get a collapse of the foot or even a high arch of the foot called cavus foot. The underlying cause is something internal, within the bone structure. These problems are usually something you will have all your life.

Hyper pronation is a hereditary issue where you can get an under development of a particular bone, usually in the ankle, and it causes a dislocation or a misalignment of the ankle on the heel.  It throws off, not only the foot with the bones, joints and ligaments of the foot, but also the bones in the ankle. It affects the internal rotation of the knee, hip, back and causes issues within those areas as well.  Hyper pronation is a pretty common, but very under diagnosed condition, and that’s why Dr. Weinert will treat you with comprehensive care.

Q: Will I need surgery for my heel pain?

A: At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it’s very imperative that you not only get evaluated, but receive care immediately.  Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct your foot.

Orthotics are sort of like glasses for the feet.  They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues. Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something that you should talk to us about.

Q: Who typically gets heel pain?

A: Heel pain is the most common problem seen at our office. About two out of four people will suffer from heel pain. A reason for this is because heel pain can happen to anyone.

Usually, in children, heel pain occurs from something known as Sever’s Disease.  This occurs when a growth plate andAchilles tendon becomes inflamed. This creates a pulling action, but it’s actually the growth plate that gets inflamed and causes pain, not on the bottom of the heel, but more in the back of the heel. 

For adults, heel pain can be a result of plantar fasciitis, heel spurs and will occur frequently in female and male athletes. It is very common in runners, dances and a wide scope of patients.

Q: How do we diagnose heel pain?

A: We do a full examination on all of our patients. We do a gait analysis to see the biomechanics of your foot, which is a big part of this problem. We also have a fluoroscopy unit that we utilize.  This device shows us the foot in a dynamic way, which means we can see how your foot moves mechanically.  As you put weight down, we can see how the bones shift and we can pin point any disturbance in your movement.

We are also able to take normal x-rays to view a static picture of the foot. The nice thing about our fluoroscopy or mini C-Arm unit is that we can have you put full weight on the foot to see any misalignment of the foot. Another nice feature is that the patient can see it up on our computer screen so they can see it with their own eyes. This helps you understand your condition.

Q: How can orthotics help your heel pain?

A: Depending on your diagnosis, different treatment options are available. The ultimate solution is to correct what really causes the heel pain. By correcting the origin you can prevent the problem from reoccurring. One great way of treating the source of the problem is by prescribing custom orthotics.

We do digital custom orthotics here in our office, which are a hundred percent accurate.  These devices go into your shoe and the put both your right and left foot, in a proper neutral position, which your feet should normally be in.

Q: How can you avoid heel pain?

A: Wearing real good, supportive shoes are a great way to avoid heel pain.  Usually, New Balance is a good shoe to wear, just for everyday shoe gear.  By wearing proper footwear and performing thorough stretches, athletes can help prevent frequent heel pain.

If you are starting to get a little discomfort or pain in the feet or heel, know that pain is not normal. So if you are having pain, you should be proactive and visit our office. If you let heel pain get out of control you could run into several other problems. It is always suggested to visit a podiatrist whenever you are experiencing pain.

Q: How long does it take to recover from heel pain surgery?

A: With the advancements in technology and treatments, if you do need to have surgery for the heel, it is very minimal incision that’s done.  And the nice thing is your recovery period is short and you should be able to bear weight right after the surgery. This means you can get back to your weekly routine in just a few weeks.

Recovery is a lot different than it used to be and a lot of it is because of doing a minimal incision and decreasing trauma to soft tissues, as well as even the bone.  So if you need surgery, then your recovery period is pretty quick.