heel & arch pain

YOUR FIRST STOP FOR HEEL & ARCH PAIN in San Antonio & South Texas

HEEL & ARCH PAIN Frequently Asked Questions

If you suffer from heel or arch pain in your feet, you probably start your day like many others with the same pain—convincing yourself to “get it over with” and to put your feet on the floor for the first time that morning.

This is often when pain is the worst for those suffering with chronic foot pain, and many people have simply accepted that this is now part of their morning routine.

Heel and Arch pain can be caused by anything from:

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. Heel and Arch Pain

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

Do not admit defeat!

Conquering your Heel & Arch pain is as easy as taking the next step toward happy feet and scheduling today!

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quick links:

Heel and Arch Pain

heel & arch pain

treatment options

Do your heels scream with pain first thing in the morning? At Next Step Foot & Ankle Clinic, we encounter people every day who have assumed—or been told—that there is no hope for their heel and arch pain.

Dr. Silvester and his team take great pride in the fact that they do not just offer effective treatments and therapies; they offer hope to those who have been told that pain will be a part of their life indefinitely.




Find out the difference between custom orthotics and arch supports and if they may be right for you.



Click the video below to see how Dr. Silvester recommends some at-home stretches. Stretching helps loosen your ligaments, increasing the elasticity and helping them heal.



Dr. Silvester shows you and our patient with chronic heel pain how to put her night splint on.

Provides a gentle stretch on the ligament causing the heel pain (plantar fasciitis)

In studies it works about 65% of the time without doing anything else. 



This is an option, but at Next Step Foot & Ankle Clinic we use these as “treatment options” last and if needed.


Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessary, advanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your heel & arch pain, such as:

Learn More >

Shockwave therapy if appropriately applied has been shown to be as effective as surgery.

It does not interrupt your activities of daily living, has a very quick results in general, and can help  induce long-term healing to the tissues.

Shock wave has been shown to be as effective as surgery for plantar fasciitis.

Learn More >

Nerve Decompression Surgery

When other non-operative treatments fail and compression of the nerve is playing a role in the nerve dysfunction, surgery may be the best option. Sometimes nerve disease is like sleeping on your elbow wrong. You wake up and your hand is numb or tingling. The nerve is just always being compressed.

Nerve decompression surgery allows the surgeon to open the tight area through which the nerves pass by dividing the anatomical structures that encase the nerve. Surgical procedures can be performed in the comfort of our Olympia Surgery Center.

Dr. Silvester and Dr. Larsen have additional certifications in nerve surgery. He has undergone specialized training in the treatment of painful nerve conditions. The organization called The Association of Extremity Nerve Surgeons (AENS) provides advanced training in the medical, physiological, and surgical treatment of nerve conditions. Through this organization and other ongoing medical education, Dr. Silvester chose to specialize in the treatment of these difficult and perplexing conditions. Dr. Silvester achieved adequate surgical experience and demonstrated proficiency in the procedure, and is now a Fellow of the Association of Extremity Nerve Surgeons.

Learn More >

Injectable extracellular matrix is used to help you heal faster.  Frequently, if the heel pain has been present for a long time or is significant degeneration in the ligament (plantar fascia).

This treatment can provide a structural repair model for the tissue to heal itself. This is often used in conjunction with shockwave therapy.


We occasionally use amnion injections to help tissue heal.

Sometimes, nothing else works so surgery is necessary.

We use many different types of surgical approaches to heel pain one of them that is very helpful is a percutaneous procedure where the incision is about as wide as a pencil lead.  This results in a very quick return to work and activity

We have the gold standard in laser therapy.

Our MLS Laser Therapy is a robotic computerized laser that provides multiple benefits: Anti-inflammatory, analgesic, accelerated tissue repair, and improved vascularity are just a few.

success story

"When I started walking again...I don't have any more heel pain.."

(hover mouse over to learn more)

Click the video to hear our patient, Leah's, testimony with Dr. Silvester and Next Step Foot & Ankle Clinic treating her severe and chronic Heel Pain.
Success with: Injection Shots - Shockwave Therapy - in/out surgery, NOW PAIN FREE!


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to happy feet!

Click the links to request your appointment or learn more about what Next Step Foot & Ankle Clinic can do for you.

Where will take you?

Dr’s Educational Presentations

Blog Articles on Heel and Arch Pain


Videos on Stretches for Heel and Arch Pain



If you are ready to wake up with pain-free heels and arches without problems, Next Step Foot & Ankle Clinic has a solution for you.

Contact Our Office Today to Set Up Your Consultation Appointment!

Browse our website to learn more about our services, or contact us directly at 210.375.3318 to schedule an appointment.

Related Areas:

Achilles Tendonitis

Plantar Fasciitis