Treating Heel Pain Series
Heel pain is one of the most common reasons that our patients come to see us at Blue Ridge Foot and Ankle Clinic. Since it is a big concern for so many patients, we have decided to do a blog series on different types of heel pain and how they are treated. We will start with this post on the general treatment of heel pain and then starting next week we will cover one specific type of heel pain & a treatment plan for it each week.
Between the structural complexity of the heel, its biomechanics and the pressure we put on it when we engage in pretty much any activity, it is clear why the heel is not invincible (as much as we wish it could be!). Most athletes and runners complain of heel pain at one time or another, and it is important that this pain is diagnosed early and accurately for quick and successful recovery. Because of the multiple causes of heel pain, the individual physiology of each foot, and the varying amounts of stress that each person puts on his or her feet, it is important that heel pain is individually diagnosed and a treatment plans are individually tailored. Consult Dr. Murray and Dr. Chang for an accurate diagnosis and treatment plan.
To understand the underlying cause of your heel pain, your podiatrist will examine your foot, consider your medical history, and in certain cases conduct diagnostic imaging studies such as X-rays or MRIs.
Treatment may vary or be a combination of surgical and non-surgical methods. Your podiatrist will most likely recommend immediate treatment to comprise of RICE: rest, ice, compression and elevation. Limiting activities is important so that your heel has the proper time to rest and rebuild the impaired tissue. Ice packs should be applied, with a thin towel between the ice and the skin, for twenty minutes at a time, several times a day in order to reduce inflammation in the affected area. Your podiatrist will point you toward the proper wrapping or splinting method for your injury, providing you with a removable walking cast or other forms of immobilization to allow your injury the time, immobilization and support required for it to heal. Lying on the couch with your foot elevated up to 15 inches above your heart is a great way to reduce additional inflammation and swelling.
NSAIDs, or non-steroidal anti-inflammatory drugs, such as Ibuprofen, Aleve and Advil, will block enzymes that stimulate swelling responses in your body, thereby reducing pain. These should be taken as indicated on the packaging label or recommended by your doctor, but always with plenty of water as NSAIDs taken in excess or not properly flushed out of your system can have harmful effects on the kidneys. If NSAIDs fail to work after a number of weeks, your podiatrist may suggest injection therapy, of corticosteroid injections, to help reduce the inflammation in your heel and to relieve pain.
Your podiatrist will most likely recommend other techniques for padding and shoe modifications, and will suggest that you avoid going barefoot as shoes can help you relieve strain from your heel and affected area. Discuss which supportive shoes with good arch supports that are appropriate for your individual foot physiology and injury or condition would be best for you to wear. Your foot doctor will also supply you with and show you how to use padding for your shoes and how to strap or tape the injured area if necessary. Over the counter and custom orthotics are often important for long-term injury prevention, especially if your injury is a result of biomechanical abnormalities (with the way you walk, or your gait, for example). Finally, you can purchase a night splint from Blue Ridge Foot and Ankle, which helps you to stretch your plantar fascia as you sleep, reducing overnight swelling and making the first steps out of bed in the morning less painful.
Non-surgical treatment may include a regimen of exercises that range from stretching to strengthening, and will usually involve work with a physical therapist. You physical therapist will work with you to stretch your calf, which will relieve strain on the affected area and assist with blood flow, which will help you recover faster. Physical therapists may also use massage techniques to increase the blood flow in the affected areas.
If all other treatment methods fail, surgery may be a viable option. Surgical methods depend on your individual condition and its severity. Consult Dr. Murray and Dr. Chang to discuss surgical treatment options.
Heel pain is hard to deal with in the long-term, because the underlying causes that led to your injury may be difficult to resolve. For a runner, the problem may be the miles you are logging, the surfaces on which you are running, your rest schedule, or even a workout that you did weeks ago. It’s possible that your running shoes are worn out, or that the problem is the shoes you wear or activities you pursue outside of running. Plantar fasciitis, for example, can be aggravated by even the most unexpected stresses, such as how you sleep or pressing the clutch in your car.
However, the good news is that most heel injuries are preventable with dedicated work – be sure to wear supportive shoes, always warm up before exercise, cool down and stretch afterward, and most of all, listen to your body. When you experience heel pain, visit Dr. Murray and Dr. Chang of The Heel Pain Center of Central Virginia. With their years of experience working with the Charlottesville and Waynesboro community, they can help you get back on your feet and on the road to recovery.Read the rest of this entry.