HEEL PAIN &
Heel pain can be caused by stress fractures of the heel bone, plantar fasciitis, achilles tendonitis, or a combination of different conditions. Most often these conditions will resolve on their own with conservative treatment such as daily stretching, icing, physical therapy, corticosteroid injections, custom orthotics, and anti-inflammatory medications. In some chronic cases, surgery or other more advanced treatment modalities is indicated. It is important to seek a foot and ankle specialist early in the disease process to reduce the chance of a chronic condition.
Pain Under Heel:
Stone bruise- a bruise to the fat pad of the heel secondary to acute or chronic trauma.
Plantar fasciitis- is described as pain in the bottom of the heel during weight bearing or walking. Patients often say the pain is worse in the morning and improves throughout the day. This pain is caused by chronic tension at the insertion of the plantar fascia that causes inflammation. Plantar fascial tension is usually a direct result of thigh calf muscles or ankle equinus.
Heel Spur- a spur of bone can form due to chronic tension and inflammation at the insertion of the plantar fascia on the heel bone. In certain cases, this can be the direct cause of the patients pain and may require surgical
removal (exostectomy) of the spur.
Pain Behind Heel:
Achilles Tendonitis - Achilles tendonitis is described as pain in the tendon either at its insertion on the heel bone or middle of the Achilles tendon.The cause is primarily a degeneration of the tendon. Most patients describe a gradual onset of pain and swelling behind their heel or around the Achilles tendon without specific injury. Typically, the pain is noted after activity alone, but becomes more constant over time. The pain is made worse by jumping or running and especially with sports requiring short bursts of these activities. There is tenderness directly over the back of the heel bone and often there is a bone prominence at this area. Achilles tendonitis pain is due to the chronic inflammation from these causes and is drastically improved with immobilization. If that fails, treatment includes physical therapy, biologic injections, and potentially the need for surgery in severe cases.
Custom orthotics are devices that are worn to correct foot and ankle problems without surgery. Treatment may begin with less expensive over the counter orthotics and progress to a custom orthotic if the diagnosis and symptoms require it.Custom orthotics may correct or prevent foot abnormalities or deformities.
Custom orthotics are custom-molded to the patient’s foot. Dr. Hook utilizes new and innovative digital technology to fabricate custom foot orthotics. A three-dimensional scanner is utilized to capture a three-dimensional model of the foot and orthotic is created with precision and accuracy.
Typically, there is a period of adjustment required for any new custom orthotics. An appropriate period of “breaking-in” should be allowed for a new insert. If it causes pain or pressure to the foot, Dr. Hook can make adjustments to improve the fit. Adjustment and proper fitting of the orthosis is included in the service provided.
Most commercial insurance programs will pay for custom orthotics. If they are not covered under your health care plan, there are cash price options available at Dr. Hook’s office. Sometimes, they may be a covered medical expense under a Flexible Spending Account. Medicare does not currently cover custom orthotics unless patient has an approved diagnosis of diabetes and related conditions.