Heel Pain

Most soft tissue heel pain is caused by a condition called Plantar fasciitis. It is caused by strain in the plantar fascia. The plantar fascia is a tendon that extends from the Achilles tendon to the toes.  When either tendon is too tight, the Achilles tendon pulls the plantar fascia (which is the weaker of the two) when the foot is stretched, as it is when walking.  When the plantar fascia is not being pulled, it starts to heal and the pain decreases.  Once a step is taken, the plantar fascia is strained again and hurts.  This is why the first few steps in the morning after sleeping all night can be very painful.  After the first few steps, the plantar fascia stretches enough to decrease pain.  As the day goes on, the soft tissue of the heel becomes more inflamed and usually hurts by the end of the day.  Over time, capillaries in the plantar fascia break from the strain, which decreases the blood flow, and causes collagen fibers in the tendon to thin out from lack of nourishment.  This worsens the problem.  In 80% of cases, conservative treatment is all that is needed to stop the heel pain.

When you come in to be evaluated for plantar fasciitis, we may take X-rays and ultrasound images of the foot.  The X-ray is to assess bone problems (not plantar fasciitis) that may be causing or worsening heel pain, such as stress fractures in the heel or bone spurs.  When heel spurs are present, you will usually be evaluated for plantar fasciitis.  Bone spurs are not usually painful; in fact, many people have spurs and never feel pain.  The pain comes from a tight plantar fascia being stretched over the spur.  Plantar fasciitis treatment is a far less invasive procedure than removing the spur and often produces better results. If the spur continues to cause pain, you will be evaluated for bone spur removal.

The topaz radiocoblation starts with making small incisions in skin over the plantar fascia on the bottom of the foot.  The radicoblation wand is then inserted into the incisions and makes incisions of varying depths in the plantar fascia.  This stimulates growth of collagen and blood vessels.  The plantar fascia is then injected with platelets to further encourage growth. We recommend staying off your feet for two days before returning to normal activities and the tendon should be fully healed within 2-4 weeks.