Heel or Arch Pain

A common cause of heel and/or arch pain is irritation along a structure which attaches from the heel to the toes. This is called the plantar fascia. Often times it becomes irritated with prolonged periods of weight bearing. We refer to this as "plantar fascitis" A common symptom with plantar fascitis is pain when first stepping down on the foot after a period of rest (eg. first thing in the morning). It usually settles down after a while only to become painful again after a period of weight bearing. The cause is usually biomechanical or put simply the way the foot is positioned during walking. Sometimes there is a bone spur present on the heel. In the majority of cases non-surgical techniques are effective in relieving symptoms due to plantar fascitis. If conservative treatment does not relieve the symptoms after a reasonable period of time it can be treated by surgical techniques There are other less common causes of heel pain such as stress fracture or nerve entrapment and Dr. Sherris can determine this through a thorough examination.

Non-Surgical Techniques
Non-surgical l treatment  techniques for plantar fasciitis include selecting appropriate shoes with good firm heel, adequate padding in heel and arch area, performing specialized plantar fascia and heel cord stretching exercises provided there are no medical problems which would complicate this, good arch supports, or in some cases   Orthoses (custom molded shoe inserts). If symptoms continue other methods may be used such as a  plantar fascia night splint which is a device similar to a removable cast that is worn at night time while sleeping and during that time it maintains the plantar fascia and heel cord in a stretched position. Physical therapy modalities such as ultrasound or, whirlpool and massage therapy. If heel pain persists local injection therapy may also be helpful.

Surgical Techniques
Surgical treatment of plantar fasciitis is directed at releasing the painful segment of the plantar fascia from it's attachment at the heel. This relieves the tension and in doing so helps prevent further irritation. If there is a heel spur present it can be removed at the same time. A recent advancement is the use of endoscopic surgery for painful plantar fasciitis. The procedure is performed through a small endoscope. This results in a smaller scar and faster recovery time as compared to traditional techniques.