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Foot Problems: Heel Pain / Spurs

Heel pain originates deep within the foot, directly on the heel bone or within the foot's connective tissues called the fascia. A very common ailment, is that you may feel pain on the bottom or on the inside edge of your heel. The pain may be sharp when you get out of bed or when you stand up after sitting for a while. You may feel a dull ache in your heel after you've been standing for a long period on a hard surface. Running can also cause a dull ache. If a nerve is irritated, you may feel burning or a shooting pain in your heel.

Wearing shoes with poor cushioning can irritate the tissue in your heel (plantar fascia). Being overweight or standing for long periods can also irritate the tissue. Running, walking, tennis and other sports that put stress on the heels can cause tiny tears in the tissue. If your lower leg muscles are tight, this is more likely to occur. When you feel pain in the bottom of your heel, the plantar fascia is most likely inflamed. Overuse or excess body weight can cause the tissue to tear or pull away from the bone. The tissue then becomes inflamed and painful. Sometimes the inflamed plantar fascia also irritates a nerve, causing more pain. A Heel spur is a projection or growth of bone and can grow where the muscles of the foot attach to the bone. While some heel spurs are painless, others that are determined to be the cause of chronic heel pain may require medical treatment or surgical removal.


Orthopedic Extracorporeal Shock Wave System
Approximately 25% of the American population suffers from pathological bone and joint conditions, calcification and diseases of the tendon. The OssaTron orthopedic extracorporeal shock wave system provides a non-surgical, non-invasive alternative (orthotripsy®) for patients suffering from heel pain.

What is extracorporeal shock wave (ESW) treatment?
"Extracorporeal" means "outside the body". Shock waves are created by very strong acoustic (sound) energy. Your ESW treatment will be performed with a device called the OssaTron.

The OssaTron is a shock wave generator, very similar to the shock wave devices used to treat kidney stones without surgery. The shock waves are created by a spark plug that is enclosed in a soft plastic dome filled with water. During ESW treatment, this dome is placed closely against the heel so that the shock waves pass through the dome to the heel. ESW treatment has recently been found to be effective to treat chronic proximal plantar fasciitis, a condition that causes pain in the heel of the affected foot and is sometimes called "heel spurs".

Other Non-Surgical Treatment

If self-care measures do not relieve the pain, our podiatric physicians may recommend various treatments to reduce the inflammation which may include prescription oral non-steroidal anti-inflammatory medications, cortisone injections, or foot taping and padding.

Other options include:

  • Physical Therapy: Our podiatrists may treat heel pain with ultra sound, electrical stimulation, or hydrotherapy. Each of these methods may help reduce the inflammation.
  • Custom Orthotics: A foam or plastic orthotic (custom made to fit the foot) can often relieve the strain on the tissues and permit the heel to recover.

Surgical Treatment

If non-surgical treatments fail and pain persists, surgical treatments can be performed on an outpatient basis in less than one hour. Endoscopic Plantar Faciotomy (EPF) can be performed to separate the connective tissue from the heel bone. After the tissue has been detached, our podiatric surgeon will remove any spurs, leaving the heel bone smooth.