|
Heel Pain
Q: Why does my heel hurt more when I wake up in the morning and less when I am standing at work? A: This symptom – pain after a period of rest – is common to all types of bursitis. Bursitis is an accumulation of fluid in a joint or at a point where a muscle or ligament attaches to bone. When it occurs in the foot, the first step in the morning is very painful because you are placing weight on the swollen bursal sac on the bottom of the heel.
Q: My doctor says I have a “heel spur.” Why didn’t it show up when I took an X-ray of the foot? A: Pain in the bottom of the heel that is worse after resting begins with excessive tension on the arch ligament (the plantar fascia) where it attaches to the heel. The body protects the area with a bursal sac, and the spur of bone forms only after a long period of time. Despite the occasional lack of a spur on X-ray, we classify all of the cases as “heel spur syndrome.”
Q: How can this problem be treated? A: First, the painful bursitis is eliminated with anti-inflammatory medications, injections, or stretching exercises. Then, the tension of the ligament is eliminated with custom inserts, night splints, or surgery. The pain can sometimes be eliminated with a relatively new procedure involving shockwaves directed at the painful area.
Q: Isn’t surgery the only way to get rid of the problem permanently? A: No. In fact, at least 90 percent of heel spur patients achieve a great improvement or cure with non-surgical treatments.
Q: If I do need surgery, how is it done? A: There are many procedures available today. Most involve a small incision and cutting of the ligament with the use of a camera and small scalpel. The spur of bone may or may not be removed. In most cases, the patient can walk on the area right away.
Q: What should I do if I experience “after rest pain” in my heel? A: Go and see a foot and ankle specialist. Be aware that many other conditions can cause heel pain, including a stress fracture of the heel bone, a pinched nerve in the back or lower leg, and arthritis. X-rays and a full exam are needed to properly diagnose and begin treatment for this very disabling condition.
|