LIGHTNING RELEASES (3/17/2014) – Heel pain is one of the most common reasons for patient visits to podiatrists. There are many causes for heel pain but the most common cause is plantar fasciitis, an inflammory condition of the plantar fascia, the band of connective tissue that runs from the base of the heel to the ball of the foot. Dr. Ed Davis, a Podiatrist in San Antonio discusses the various causes of heel pain in his Heel Pain Blog:
Plantar fasciitis may be caused by overuse, occupational considerations such as jobs which involve standing on hard surfaces for long periods of time, an increase in physical activity or shoes with inadequate support. Davis advises that shoes which feel soft generally feel better at first but “support always wins the day.” The most important part of the shoe is the shank, the area in the middle of the shoe that connects the heel to the ball of the foot. It is okay for the shoe to be flexible near the toe joints but the shank should be firm in order to provide proper support.
Common treatments for plantar fasciitis include stretching, ice massage, shoes with improved support, rest and anti-inflammatory medication. If plantar fasciitis symptoms persist for more than a few weeks then the pain can become chronic and more aggressive treatments are in order. There are reasons why heel pain caused by plantar fasciitis may become chronic, generally related to faulty foot and leg mechanics. Some causes of chronic plantar fasciitis include a tight heel cord (Achilles tendon), the back of the foot rolling in too much (subtalar joint overpronation) or the front of the foot rolling out too much (midtarsal joint oversupination). Podiatrists may prescribe foot orthotics, http://www.footorthotics.pro/ , changes in shoegear, physical or manual therapy or devices such as night splints.
There are a number of patients who have heel pain that seems to persist despite treatment. Such cases were termed “intractable plantar fasciitis” in the past. We now know that longstanding inflammation can lead to degeneration of the fascia and that process is termed “plantar fasciosis.” Treatments for plantar fasciosis were limited until about 15 years ago when the first modality targeted specifically for fasciosis was introduced: ESWT or extracorporeal shockwave therapy. There are several advance treatments currently available that Dr. Davis offers.
Extracorporeal shockwave therapy involves the use of sonic pressure waves, is non-surgical and is used in the office. Dr. Davis utilizes the Swiss Dolorclast: http://www.ems-company.com/en/medical/products/swiss%20dolorclast/ as the preferred method.
Topaz procedure or coblation therapy involves use of a “wand” that utilizes a radiofrequency energy to remove diseased tissue from the plantar fascia utilizing a minimally invasive approach: http://www.topazprocedure.com/
TenexTX: This is the lastest modality available and involves use of an instrument that removes diseased tissue utilizing a tiny wand with high energy ultrasound. The procedure is guided with sonography and can be performed in the office or in an outpatient surgery center. http://tenexhealth.com/
Minimally invasive procedures generally allow rapid return to activities and minimal discomfort.
Dr. Davis can be reached at http://www.southtexaspodiatrist.com/ or 210-490-3668.