Have a question about your heel pain? Click on your question
below and get your answer:
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Q: What causes so many people to have heel pain?
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Q: Why do I have severe heel pain in the morning but
not in the evening?
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Q: Will I need surgery for my heel pain?
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Q: Who typically gets heel pain?
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Q: How do we diagnose heel pain?
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Q: How can orthotics help your heel pain?
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Q: How can you avoid heel pain?
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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:
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Pain that is worse first thing in
the morning
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Pain that develops after heavy
activity or exercise
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Pain that occurs when standing up
after sitting for a long period of time
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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:
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Anti-inflammatory medications
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Digital custom orthotics
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Physical therapy
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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.