Heel and Arch pain can be caused by anything from:

• Arthritis

• Fractures

• Nerve Irritation | Nerve Entrapment

• Heel Spurs

• most commonly, it is caused by Plantar Fasciitis

Probably the most important thing that a podiatrist can provide you with is the correct diagnosis.

In our office we use diagnostic ultrasound and x-rays to evaluate the patient and make the correct diagnosis.

In about 10% of the patients that come into our office, the plantar fascia is not involved in the patient’s pain.

The protocol we use for making the diagnosis of plantar fasciitis includes a 6 point exam on your lower extremity.  We also use of x-ray as well as the ultrasound to make the correct diagnosis. Virtually half the patient’s we examine have more going on than just plantar fasciitis and about 20% of them do not have plantar fasciitis at all.

If you DID NOT get an ultrasound with your doctor exam for heel pain, you may not have the correct diagnosis. 

Short answer, yes! One of the most common childhood complaints, heel pain is often caused by Sever’s disease.  Sever’s disease is the result of the growth plates in the heel growing faster than the Achilles tendon, which causes irritation and pain as the tendon and other muscles tighten. Dr. Silvester can help treat symptoms effectively and economically with shoe inserts and therapy.

Learn more: Sever’s Disease and Heel Pain

Children suffer from many other foot conditions. If your child complains about their feet “being tired” or hurting, please visit our Pediatric Foot Care page to learn more. You may just save them from years of pain.

As with all conditions, heel pain is much easier to treat when it is caught early. If you have had pain for 4-6 weeks  get an appointment with a good foot doctor (we like us) :).

Most of our heel pain patients are 80% improved in one week after seeing us. They might not be cured but they sure feel better.  Healing the damaged tissue takes time.

If you have had heel pain for  one year it is going to take more effort than if you have had it for one month. 

The wrong diagnosis or an incomplete diagnosis. I am shocked when patients come to see me for a second opinion with heel pain and they have been given the diagnosis of plantar fasciitis.

When I asked them how the doctor arrived at that diagnosis I often hear “I don’t know, I just went in and told that doctor I had heel pain and he told me that I have plantar fasciitis”.

When I asked if the doctor did a careful exam on the foot I frequently here “no, he didn’t even touch my foot”. There are several causes of heel pain. And a successful treatment plan needs, first of all, the right diagnosis.

Most doctors treat heel pain by prescribing medication and physical therapy.  Although these can be helpful, the usually do not solve the problem.  Especially since most people have had heel pain for months by the time we see them.  Also, they take time.  Prescribing medication and physical therapy is 1940s medicine.  It can work sometimes.  But frequently, the patient just gives up and lives with the pain.

We use a injections  to help control the pain of the plantar fasciitis. We use techniques to make them more tolerable.  

The vast majority of our patients state they have felt significantly less pain with our injections than injections they got elsewhere.

Injections for plantar fasciitis have shown a very strong short term effect. They can get you over the pain quickly. They are not enough to solve the problem but they are a piece of the puzzle.

Don’t worry about the horror stories too much. Yes, it can hurt but we try and make it as easy as possible. Also, the injection should be guided by the ultrasound to make sure the medication is getting in the right place.  

There are several clues that help to make the diagnosis of plantar fasciitis (PF) as opposed to the other causes of heel pain.  They are not 100% but taken together they do help.

1: Location of pain:  PF usually hurts on the plantar medial aspect of the heel. This  is on the inside of the heel.  Pain can also extend into the arch.  If the whole bottom of the foot is sore it may be something else. 

2: Timing of pain:  PF usually hurts more the first steps of the morning as you get out of bed. It also usually does not hurt when you get off your foot.  If you have pain after laying down that lasts for more than a few minutes it is more likely to be nerve pain. 

3: Relief with a few steps.  In the early stages of plantar fasciitis the pain subsides after being of the feet for a few minutes.  As the tissues get stretched and warmed up the pain decreases.  When it gets more severe the pain persists.

1:  Get some good running shoes with a thick heel cushion. Try and wear them most of the time.  Avoid barefoot on hard surfaces.  

2: Get good arch supports if you have a normal foot. (We sell some great ones at our office for heel pain).  Don’t spend  more than 50 dollars. STAY AWAY FROM RETAIL “ORTHOTICS” THAT ARE JUST OVER THE COUNTER ARCH SUPPORTS AND COST HUNDREDS OF DOLLARS.  

3: Stretch your achilles tendon gently 2 minutes three or four times a day for 2 minutes. There are lots of ways to do this.  Look on line.

4:  Stretch your plantar fascia frequently. Don’t over do this. You can aggravate the problem with too aggressive stretching.