So how exactly does one treat heel pain?  To answer that question, you need to know what is causing the heel pain.  So make sure to have your podiatrist thoroughly examine your feet and ankles to find the exact cause of your heel pain.

 

Non-surgical treatments:

 

Stretching Exercises
Physical Therapy 
Ice Treatments
Taping or Strapping Fascia
Orthotics 
Night Splints 
Anti-inflammatory Injections
NEW! enPuls shockwave therapy
Diowave Laser therapy

 

Non-surgical treatments are usually all it takes to relieve heel pain and get you back on your feet again.  Of course, though it will be equally as important to rest your feet while they heal just as with surgery.  

 

Our in-office surgical suite is also here for those patients where surgery is needed. 
Endoscopic Plantar Fasciotomy
Traditional (open) Heel Spur Resection and Plantar Fasciotomy
Open Resection of Retrocalcaneol Spur or Haglund's Deformity

 

 

 

Laser Treatment

Study Assesses Laser Treatment For Plantar Fasciitis | Podiatry Today

 

Issue Number: Volume 28 - Issue 10 - October 2015

Author(s): Brian McCurdy, Managing Editor

 

Lasers may number among the effective treatments for chronic plantar fasciitis, suggests a recent study in the Journal of Foot and Ankle Surgery.

The randomized, double-blind study concerned 37 patients with chronic plantar fasciitis who were treated with low-level 635 nm lasers and 32 who had placebo treatments. Patients received treatments twice a week over a three-week period. At the final follow-up visit at eight weeks after treatment, the study notes the laser patients demonstrated a mean improvement in heel pain with a Visual Analog Scale score of 29.6 in comparison with a mean improvement of 5.4 in the placebo patients.

In addition to being non-invasive, low-level laser therapy is a form of regenerative medicine as the modality’s mitochondrial stimulation initiates a low-grade inflammatory cascade of events that can stimulate revascularization of the thickened fascial tissue, according to study co-author Kerry Zang, DPM, FACFAS. He notes lasers work synergistically with other forms of regenerative medical therapies.

As Dr. Zang notes, lasers are preferential to cortisone injections, which act as suppressants and temporarily stop the pain but also stop any inflammatory healing response, putting the plantar fascia at risk for further degeneration or rupture.  

For the past eight to 10 years, Lisa M. Schoene, DPM, ATC, has been using class III and class IV lasers for acute and chronic musculoskeletal conditions including plantar fasciitis. Dr. Zang notes the mechanism of action for class IV lasers is heat and true low-level lasers function by initiating biostimulation, producing no heat.

Low-level lasers are effective in treating both acute plantar fasciitis and degenerative fasciopathy, according to Dr. Zang, who is in private practice at the Arizona Institute of Footcare Physicians. He says six to eight treatments are necessary for chronic plantar fasciitis while three to four treatments are necessary for acute plantar fasciitis if treatment begins six to eight weeks after the onset of symptoms. He says lasers are cost-effective in comparison with other non-surgical modalities.

“I would use low-level laser therapy as a first-line therapy,” says Dr. Zang, a consultant for Erchonia Corp. “It can be used as a stand-alone treatment or in conjunction with other regenerative medical therapies. It is the only non-invasive treatment available that will stimulate an internal response.”  

Dr. Schoene notes the importance of patients with plantar fasciitis combining many treatments, including strapping, stretching and night splints. She advises patients not to run, jump or go barefoot. She also encourages patients to wear a higher heel profile to reduce the discomfort associated with the injury to the plantar fascia.

If one of Dr. Schoene’s patients comes back after one visit and is not at least 70 percent better, she will add a splint, ultrasound, laser treatment and possibly deep tissue massage. After a second visit with less than 70 percent improvement, if diagnostic ultrasound determines any tearing or loss of echotexture and increased thickening, she will perform deep tissue therapeutic massage, needling with a Traumeel (MediNatura) injection and will continue laser therapy.    

“This protocol takes chronically damaged, thickened or torn tissue, and creates an ‘uptick’ in the inflammatory cascade via the controlled irritation to the tissue to get it to become microscopically ‘acutely’ inflamed so the immune system can now jump in and turn on the inflammatory cascade to start the repair process,” says Dr. Schoene, a Fellow of the American College of Foot and Ankle Surgeons and the American Academy of Podiatric Sports Medicine.

- See more at: http://www.podiatrytoday.com/study-assesses-laser-treatment-plantar-fasciitis#sthash.BwdwimDE.dpuf

 

 

enPulse Shockwave Therapy

 

A projectile accelerated in the handpiece generates a mechanical pressure wave, which is transferred to the human body by an applicator head and which radiates out in the tissue.

The mechanical energy is absorbed by the tissue and decreases as the distance from the application site increases. The mechanical stress triggers reactions in the tissue that have a positive influence on a wide range of orthopedic and neurological conditions.

The method is used by therapists all over the world with great success. With the enPuls Version 2.0, Zimmer MedizinSysteme now offers a system that bundles all the advantages of the application in a compact form with the lowest downstream and operating costs that is easy to operate and apply with maximum flexibility and mobility.

 

Direct effects:

Zimmer enPuls: Medical effects

• Normalisation of the muscle tone through stimulation of the muscle spindle and the Golgi apparatus of the muscle tendon

• Pain overlay based on the gate-control principle (Melzack and Wall) with parallel endorphin release by the stimulation of the skin's pressure and touch receptors

• Stimulation of cellular activity and changes in cell-membrane permeability caused by direct mechanical stress in the cell wall

• Internal cellular building processes for reinforcement of the mechanical structure as a consequence of the mechanical stress at the limit of stress capacity

Indirect effects:

• Increased cellular metabolism due to changes in the membrane permeability, e.g. by opening the glutamate channels

• Release of substance P, a neurotransmitter and pain mediator, into the tissue with subsequent nerve habituation and with that reduction of the pain threshold

• Release of AGF and VGF (growth hormones) with corresponding cell reaction

• Increased cellular activity via gene expression