Understanding Foot Pain

Our foot consists of an intricate network of bones, muscles, ligaments and tendons, all beautifully held together and designed to bear the weight of the body. Though our foot is a strong and stable structure, it too is vulnerable to injury, causing mild to severe foot pain.

Foot pain can affect any part of the foot, from the tips of the toes to the Achilles tendon at the back of the heel. Initially, foot pain usually starts as micro injuries on some of the structures of the foot; usually the plantar fascia or Achilles tendon, causing these structures to swell up and experience mild to extreme foot pain. Although mild foot pain can easily be treated at home, it will take time for the injuries to heal. But most often, mild foot pain can progress to chronic foot pain due to lack of knowledge on how to properly treat the early signs of pain.

Every time we hurt ourselves, it is quite normal to take medications for the pain. Unfortunately, taking pain killers for foot pain could actually make the condition worse. Pain is like a signal, telling you that there is something wrong with your foot and you need to give it some rest. When you take pain killers, you are masking the pain, allowing you to use your injured foot, hence causing more injury which could lead to chronic heel pain.

When you experience mild foot pain, allow your foot to rest for a few days. If your foot is swollen, it is advisable to apply cold stimuli to reduce the pain and swelling. Wrapping the foot is great in immobilizing the foot. A foot that is allowed to rest can heal faster. Also, elevating the foot above the heart is also an effective way to reduce swelling. You will know if your foot is ready when you no longer feel any pain when you step.

Treat Your Heel Pain With RICE!!!

The best time to go outdoors and have a lot of fun with your family and friends is the summer time. This is the best time to go to the beach, go camping or do all sorts of outdoor stuff. But if you feel pain on your foot, like for example heel pain when you take your first step when you wake up in the morning or heel pain when you step out of the car, this may mean plantar fasciitis.

The plantar fascia is a strong fibrous tissue found underneath the foot. It attaches at the calcaneus or heel bone to the balls of the foot. This structure is very important since it maintains the arch of the foot. The plantar fascia is under constant stress when walking, running, or when lifting weights. 

With every step, the first part of the foot that hits the ground is the heel bone and this area can be a source of irritation and inflammation that can affect not only the heel bone but the plantar fascia as well. Also, when the plantar fascia is over stretched, this can cause microscopic wounds which can cause pain.

Plantar fasciitis is commonly found among the elderly due to the natural wear and tear of the plantar fascia. This condition also affects athletes, more particularly runners.

If you are affected by this, don’t let your heel pain ruin your wonderful summer days. There are several ways to alleviate the pain caused by plantar fasciitis. One easy way is the RICE method.

Rest. Resting the foot is one way of stopping heel pain due to plantar fasciitis. If the foot is allowed to rest for an extended period of time, this can promote wound healing and may cure plantar fasciitis.

Ice. Cold stimuli can control pain and swelling. 

Compression. Wrapping the foot with elastic bandages can help control swelling. Remember not to put the bandages too tight to allow proper blood circulation.

Elevate. Rising the foot above the heart is the best way to reduce swelling. Raising the foot allows venous return.

Another alternative way to treat this type of pain especially if it’s already causing chronic pain is EWST or Extracorporeal ShockWave Therapy. This procedure uses shockwaves to allow the plantar fascia to heal naturally. This is a non-invasive procedure and lasts for just a few minutes per session. For most patients, pain relief is felt immediately after only one session.

Plantar Fasciitis One Of The Leading Causes Of Heel Pain

It is pretty common for adults to experience some kind of foot problem, especially on the heel area. Heel pain is one of the common foot problems of adults. This occurs because of the natural wear and tear of the foot. Sadly, daily exercise and activities that are supposed to be good for your health, can be stressful for the foot.

The calcaneus bone or commonly called the heel bone is largest the largest bone of the foot. This large bone is the first structure of the foot that hits the ground when walking or running. Under the foot, there is a very important structure called the plantar fascia. This is a very strong and tough connective tissue, it attaches to the calcaneus bone to the balls of the foot and it keeps the arch of the foot intact. Because of this the plantar fascia is under constant stress especially when carrying heavy objects. Due to the attachment of the plantar fascia below the heel bone, this area can be a source of irritation.

When these structure gets excessively stretched, this puts a lot of stress on the fascia and causes irritation making the heel area inflamed. This is called plantar fascia and this condition is probably the most common cause of heel pain. People who are into sports like runners, sprinters, football, basketball players are prone to develop plantar fasciitis. This occurs because of abrupt force delivered to the foot and irritating the plantar fascia. Certain conditions that can lead to plantar fasciitis are being overweight, having diabetes, or wearing tight or wrong footwear.

Symptoms of plantar fasciitis are heel pain on the first steps after getting out of bed in the morning or stepping out of a car. Pain gradually deceases after a few steps but pain could heighten up again during the day especially on long standing or climbing up the stairs.

A thorough physical exam and past medical history is expected for a podiatrist to properly diagnose foot pain due to plantar fasciitis. There are different causes of foot pain that can show similar symptoms of plantar fasciitis. A correct diagnosis is the key to proper treatment.

There are several approaches in treating heel pain and the goal is to relieve the forces that are causing the plantar fascia to be stretched excessively. At home, there are easy ways to relieve foot pain. Resting the foot is an effective way to stop the pain. If the foot is allowed to rest long enough, this can encourage healing of the plantar fascia. Ice packs or cold compress provide quick relief of pain and swelling. If pain still persists after these basic treatments, then a podiatrist is needed.

Understanding the Development of A Heel Spur

What is a heel spur?

A heel spur is a bony formation located at the calcaneous bone or heel bone that is evident through x-ray. Also called calcaneal spur, this condition is commonly associated with plantar fasciitis when the spur is located at the inferior part or at the bottom of the calcaneous bone.

Though these conditions are related, they are two separate disease entities. Plantar fasciitis refers to the irritation or inflammation of the plantar fascia, and this is sometimes accompanied by a spur. But not all patients with plantar fasciitis develop a heel spur and not all patients with heel spurs have plantar fasciitis.

Heel spurs are seen on patients who have chronic heel pain due to the inflammation of the plantar fascia. This is often seen on middle aged men and women or among active athletic individuals involved in sports like runners, basketball players and volleyball players.

Patient don't actually complain of heel spur pain but pain from plantar fasciitis. Most often, a heel spur can only be found or diagnosed through radiological findings where the pointy bony prominence is located at the attachment of the plantar fascia.

How do heel spurs form? About 70% of patients with plantar fasciitis will develop heel spurs. The plantar fascia, which is located at the bottom of the foot, is a strong fibrous tissue that attaches to the heel bone to the balls of the foot. It is responsible for the arch of the foot and plays a major role in the biomechanics of the foot. This fascia is also under enormous stress when running, walking or bearing weight.

However, this important structure is very prone to injury and degenerative changes. The natural wear and tear of this tendon can cause irritations and inflammation causing chronic heel pain. For some reason, the new bone growth is formed at the attachment of the plantar fascia to the heel bone probably because of the constant stressful pulling action.

Treating pain associated with heel spurs and plantar fasciitis can be done conservatively. Most often, the R.I.C.E. method which stands for rest, ice, compress, and elevate can effectively relive pain. Other treatments are foot inserts, pain medications and steroid injections.

A new treatment called ESWT uses multiple shock waves to naturally stimulate healing in the injured fascia. This is a holistic approach since it encourages the bodies own healing properties.

For more information about heel spurs and plantar fasciitis, please visit the Family Foot and Leg Center in Naples or Contact Dr. Kevin Lam at (239) 430-3668.

Shockwave Therapy: Will It Work For Me?

Shockwave therapy for the treatment of heel pain is a Non-invasive, PAINLESS procedure used to manage that nagging pain you feel that "you've tried everything for," and feel with every step you take!

That's right, no hospital, no operating room, no surgical blades, no bandages, no stitches, no PAIN!!

Shockwave therapy is performed by using a machine on which the heels are placed. It then expels high energy sound waves into your heel through the skin. These 'sound waves' move through the soft tissue structures and bone in your heel and break up some of the scar tissue that causes your discomfort. The special products in your body that heal tissue are attracted to the shockwaves, and a healing response occurs over time!

Heel pain is a common among patients treated at major health centers in the world! Many patients, young and old, are competitive and/or leisurely tennis and golf players. These individuals typically complain of pain in the heel(s) most intense with the first few steps taken during the competition that 'eases up' as the game goes on. At time the pain is felt in the arches, or even in the back of the heel.

Eventually, the pain becomes aggravating enough that it is felt with every step attempting to return a serve, or with every long drive down the fairway. When arch supports, custom orthotics, and cortisone injections fail, that is when shockwave therapy is introduced!

So¦.you're wondering what the recovery process is after shockwave therapy?

The procedure takes about half an hour per foot. Patients walk in, have the procedure, and walk out with a walking boot worn for an unspecified time period at your doctor's discretion, depending upon the origin of your heel pain (minimum of 24 hours, maximum of 2 weeks).

Patients report NO pain during the procedure and mild tenderness after the procedure for approximately 48-72 hours. You can walk, drive, go to the grocery store, sunbathe & swim, and go to dinner the evening of the procedure! Again, no hospitals, no operating room, no surgical blades, no bandages, no stitches, NO PAIN at all!!

How many treatments?

The number of treatments is dependent upon the type of shockwave therapy recommended for you, as well as your personal schedule and flexibility. To sum things up, there are two types of shockwave therapyHigh Energy and Low Energy. High energy shockwave therapy requires one treatment, and the sound waves are of a higher frequency level. Low energy is one treatment weekly for 5 weeks, and the sound waves are of a lower frequency level. Patients respond positively to both high and low energy shockwave therapy.

What are the disadvantages?

Unfortunately the majority of insurance companies do not cover the procedure despite shockwave's impressive beneficial results in the medical literature. Therefore, shockwave therapy is an out-of-pocket expense. The medical community is hopeful that shockwave therapy will be compensable by insurance companies in the near future.

Why should I choose shockwave therapy over a surgical procedure?

Because ESWT shockwave therapy has been found to be equally beneficial to an open surgical procedure, without the risks that open surgeries introduce (pronounced pain, swelling, infection, & the need for another surgery/revision).

Pain Caused by Plantar Fasciitis

One of the common causes of heel pain is because of an injury to the plantar fascia. The plantar fascia is a tough fibrous tissue located below the foot. It is actually a ligament and it attaches behind the heel bone to the toes of the foot. It is responsible for the arch of the foot and plays a very important role in the foot's biomechanics.

The plantar fascia is constantly under stress when walking or running. When we carrying heavy loads, the plantar fascia pulls all the bones of the foot together, pulling it tight to provide a solid structure for bearing weight.

At times, the plantar fascia can get injured. Plantar fasciitis is a condition wherein the plantar fascia undergoes a painful inflammatory process. This is fairly common in individuals who are active in sports particularly running. It is also common in elderly individuals in which the plantar fascia weakens due to degenerative processes.

Pain caused by plantar fasciitis is easily treated with the RICE method (rest, ice, compress and elevation. Giving the foot a rest is the most basic form of treatment. This allows to the foot heal.

Cold stimuli reduces pain and inflammation. Compression helps reduce swelling and also immobilize the foot. Elevating the foot above the heart also diminish swelling by preventing the pooling of blood on the affected foot and also assist in venous return.

If pain persists after these basic steps, it is advisable to visit a podiatrist to advice and assist you to make a proper diagnosis and give appropriate treatment.

For chronic heel pain that does not respond to treatment, shockwave therapy or ESWT for heel pain can be recommended.

Treatment Options for Achilles Tendonitis

Heel pain can be due to a lot of foot conditions. One of the most common cause of foot pain is Achilles tendonitis. This condition is due to inflammation of the Achilles tendon which is found behind the ankle.

Achilles tendonitis is more frequent among the middle-aged group, particularly those active in sports activities. Just like other tissues in our body, the tendons become weaker and less flexible as we age.

There are several approaches in treating Achilles tendonitis. It is best to treat the injury as soon as possible to prevent more severe outcomes.

Resting the foot is the primary management to control heel pain and inflammation. This will reduce the swelling and promote healing.

Applying ice packs to the Achilles tendon area relieves acute heel pain. Do not apply ice directly to the skin but instead wrap the it with a clean towel. Additionally, ice packs should not be applied on the skin longer than 30 minutes as it can also stop blood flow if left for too long.

Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen can help control inflammation and reduce foot pain. However, NSAIDS can cause stomach upsets so it is best to take the medication with a full glass of water.

Physical therapy and stretching exercises are very helpful if done under the supervision and instruction of a podiatrist or qualified physical therapist. Immobilization of the ankle is helpful in more severe injuries to quickly relieve inflammation. Leg casts or special orthotics can help in healing the tendon more rapidly.

Corticosteroid injections are rarely given as they have not been shown to significantly improve the condition and can have possible complications.

Surgical intervention is only considered if nonsurgical approaches have not provided relief. The procedure can involve tendon lengthening, debridement of the tendon, or moving the tendon attachment.

ESWT or Extracorporeal ShockWave Therapy is a modern approach to managing heel pain. This is an in office procedure that is a safe way to treat more complex heel pain conditions. Instant results are seen with cost-effective and painless management of chronic heel pain.

The Use of ESWT for Heel Pain and Other Joint Pains

Extracorporeal Shock Wave Therapy or ESWT is a new treatment used for heel pain, foot pain, various types of joint pains. This new medical device is approved in the US by the FDA for treating foot pain due to plantar fasciitis and tennis elbow. There are many more future approvals from the FDA with the use of ESWT for other health conditions like Achilles tendinitis, patella tendinitis and a lot more.

ESWT is a unique treatment because it stimulates the natural healing properties of the body and can cure chronic pain. There are two theories on how this device promotes tissue healing:

1. The shock waves produced by ESWT machine induces microscopic injuries to the affected area, creating new growth of vascularisation. Increased vascularisation means more blood flow to the injured muscle tissues, ligaments and tendons.

2. Since there are tiny injuries produced by shock wave, the body naturally treats the newly induced injuries and at the same time heals old joint injuries that the body has been ignoring or desensitized to. This makes ESWT very ideal for treating chronic pain.

Extracorporeal is a medical term which means that a medical procedure is done outside the body. It is a low-risk and non-invasive procedure with minimal or no side effects.

The procedure is simple and is very similar to ultrasound. First, the damaged tissue is located around the painful area of the body. Once the targeted tissue is found, multiple shock waves are introduced to create micro injuries which actually help to induce the natural healing process, creating new tissue growth and therefore repairing new or chronically damaged tendons.

This is all done in just 30 minutes and depending on the extent of damage, it may require successive sessions to treat the pain. Some patients feel mild discomfort after the procedure. For some, the pain relief is observed with a single treatment while for others, heel pain is relief is gradual with ESWT treatment.