One of the most common complaints I hear in private practice concerns heel pain. What we in the medical field call heel spur syndrome usually involves a painful heel. Sometimes pain extends into the arch and the back of the heel in the achilles tendon insertion. Achilles tendon pain is at times accompanied with heel pain.
Some patients describe their heel pain as severe in the morning and improving with activity. Others feel that pain increases with activity. Although the symptoms vary, the source of the problem is the same: imbalance due to the pulling of a group of fibers (known as the plantar fascia) which inserts in the heel bone at the area where the heel spur is noted.
Oddly enough a person can have heel spur syndrome without actually having a heel spur on x-ray. The explanation of this finding is complicated. One of the most beneficial and yet non-invasive types of treatment is the orthotic device that corrects the imbalance. This prescription device is an impression of the foot in its corrected position. The orthotic takes the strain off the heel spur region.
This conservative treatment to decrease heel pain has a success rate of about 98% in my practice. However, should conservative treatment fail, I feel the best surgical procedure is the Instep Plantar Fasciotomy which has proven to be extremely successful. I have seen patients years after this procedure and have been happy to report they still remain pain free. One of the benefits of this procedure is that patients can be in regular shoes soon after surgery and can walk immediately after the procedure.
