Heel Pain / Plantar Fasciitis

Heel pain is one of the most common problems in the foot. Our feet can take on a great deal of stress, but too much stress from sports activity or improper footwear can cause heel pain.

Heel pain often affects the plantar fascia, a long, thin ligament that runs along the bottom of the foot, connecting the heel to the front of the foot. The plantar fascia also supports the arch of the foot. When the plantar fascia takes on too much stress, it becomes inflamed. This is called plantar fasciitis.

Causes and Symptoms of Plantar Fasciitis

There are several factors that may make you more likely to develop plantar fasciitis. Tight calf muscles, obesity, very high arches, or new or increased activity can make you more susceptible to plantar fasciitis. This condition is also common among runners and other athletes—the repetitive impact of running puts additional stress on the plantar fascia.

Plantar fasciitis causes pain on the underside of the heel. Pain is often worse after a period of rest or after physical activity. Bone spurs may also be present in the heel, but are not usually the cause of the heel pain.

Plantar Fasciitis Treatment

In the majority of cases, surgery is not required to relieve patients’ symptoms. However, if a patient’s symptoms do not resolve after several months of nonsurgical treatment, there are surgical options available.

Nonsurgical Treatment

Patients with plantar fasciitis will need to decrease or stop any activities that make heel pain worse, including running and other athletic activities. Nonsteroidal anti-inflammatory medications like ibuprofen or naproxen can help with pain and inflammation. Ice can also be effective in reducing pain and inflammation. Patients may be advised to apply an ice pack or roll the foot over a cold water bottle for 20 minutes at a time, 3 to 4 times a day.

Stretching the plantar fascia can also be quite effective. If tight calf muscles are contributing to plantar fasciitis, your doctor may suggest stretches for the calves as well. Shoes with thick, cushioned soles or heel inserts can help to reduce strain on the plantar fascia.

In some cases, your doctor may recommend cortisone injections in the plantar fascia to help reduce inflammation. Platelet-rich plasma (PRP) injections can also be helpful in helping the plantar fascia heal. PRP injections use a patient’s own blood, which is placed in a centrifuge to separate out the platelets. Platelets contain proteins called growth factors, which help with the healing of injuries. The increased concentration of platelets is combined with the remaining blood and injected into the plantar fascia to promote healing.

Extracorporeal shockwave therapy (ESWT) is another non-invasive treatment method that can promote healing in the plantar fascia. During an ESWT procedure, high-energy shockwaves are applied to the skin above the plantar fascia to stimulate the healing process. These nonsurgical treatments can be performed on an outpatient basis in any of the Spring Branch Podiatry locations.

Surgical Treatment

Surgery is only considered if nonsurgical treatment does not relieve symptoms. There are two surgical options available, depending on the cause of the plantar fasciitis: gastrocnemius recession and plantar fascia release.

During a gastrocnemius recession, the calf muscles are surgically lengthened. This procedure may be helpful for patients who have tight calf muscles, despite regularly performing calf stretches. When the calf muscles are lengthened, it increases motion in the ankle, taking stress off the plantar fascia.

If there is a normal range of motion in the ankle, a plantar fascia release may be recommended. During this procedure, the plantar fascia is partially cut to relieve tension in the tendon. If there are any bone spurs in the heel, they may be removed as well.

Plantar Fasciitis Treatment in Houston, TX

Spring Branch Podiatry offers both surgical and nonsurgical treatment options for plantar fasciitis, using the most advanced techniques available. Our doctors work with patients to develop a plan of action that meets the patient’s individual needs. To learn more about treatment options for plantar fasciitis or schedule an appointment, contact our office at (713) 461-1010.