Dr. Vladimir Zeetser, DPM, FACFAS
America's Premier Foot & Ankle Surgeon
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Heel Pain, Plantar Fasciitis and Heel Spur Syndrome
This general category results in pain to the inside (medial aspect) of the heel which can occur suddenly or have a gradual onset. It occurs from excessive tension on the plantar fascia, the tendon attaching on the bottom of the heel bone, which results in microtearing and inflammation. With time and continued stress, the muscle pulls at its attachment to the heel bone and eventually produces a calcified spur visible on x-ray.
Typically described by patients as a very painful sensation upon arising in the morning and trying to make the first step of the day. After anywhere between 10-30 minutes, the pain subsides and the day progresses with a dull aching constant pain. Upon relaxing and being seated the pain tends to go away and then when the patient arises again to start walking the cycle starts all over again with very painful first step. Conservative treatment typically consists of injections, anti-inflammatory medications, stretching exercises, orthotics and sometimes physical therapy. For the 5-10% of patients that do not completely improve with conservative care, additional options remain. Prior to considering open surgery, a successful treatment called Extracorporeal Shock Wave Therapy (ESWT), first introduced as Ossatron, has been used for decades safely to procedure up to 92% success rates with one treatment.