Revolutionary Treatments For Heel Pain



Posted: Tuesday, July 21, 2009

by Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute

You step out of bed and your feet scream in pain! You waddle (or maybe even crawl) across the room until the pain starts to subside. Your are active, you try to keep walking even through the pain, but the pain just gets worse. After several minutes, the pain starts to improve only to return again if you sitdown, laydown or even by the end of the day no matter what. Does this sound familiar? For many people this is a dialy occurance and is usually diagnosed as "Plantar Fasciitis".

Many people ask if this will resolve without treatment and often try to resolve it with some simple treatments at home like ice, stretching, arch supports or even changing shoes (goodbye flip flops). When the pain doesn't improve (sometimes it does), they start to look for other options to overcome this limiting problem. There are many treatment options.

Common treatment options include orthotics, night splints, cortisone shots, casting, boots or even limiting activities. As an runner and a sports physician, I don't consider it a good option to stop people from exercising, therefore I am constantly looking for options to resolve pain while continuing activities. Let me discuss some revolutionary treatment options for this painful condition:

1. Cold Laser --> This treatment option is painless and utilizes a type of Ultraviolet light (or low level photon energy) to penetrate in areas of pain to stimulate increased cellular metabolism in the areas of maximal pain. It will therefore produce increased cell migration to area and increased circulation to ultimately reduce swelling, reduce pain and produce healing of a painful plantar fascia.

The advantage of this treatment includes complete absence of pain during treatment and FDA approved safety. The biggest disadvantage is the need for multiple treatments (8-12) with 2-3 treatments required per week to get best results. It has been shown, however, to be quite beneficial.

2. APC (Autologus Platelet Concentrate) or Platelet Rich Plasma injection --> Another relatively new treatment that concentrates the cells most beneficial in healing as taken from the patient and reintroduce these cells percutaneously into the inflammed plantar fascia. The idea is to stimulate healing through injection (the simple act of inserting a needle can stimulate healing) and further stimulate healing through use of healing cells injected into the desired site.

Advantages include improvement and resolution of symptoms often after a single injection, often much more effective than cortisone injections. The big disadvantage includes pain with drawing of the blood and injection. Care must be utilized to minimize infection.

3. Topaz Radiocoblation --> The newest treatment, a minimally invasive surgery called the mini-plantar fasciotomy, consists of the percutaneous insertion of a radiofrequency probe into the plantar fascia. The probe is locally inserted at varying depths through the percutaneous grid to treat the most painful areas of the heel (and plantar fascia). The insertion produces three results: 1) Mini tears in the plantar fascia to allow lengthening and reduce the retrograde pull from normal walking. 2) Stimulate neoangiogenesis (new blood vessel formation) to reduce swelling and allow migration of necessary cells and mediators for healing the plantar fascia. 3) Growth factor migration to the area to stimulate collagen fiber regrowth and complete healing of the inflammed plantar fascia.

Advantages of this treatment include the usual resolution of pain longterm from solving the problem, not just treating the symptoms. The surgery is also quick (usually less than 20 minutes) and allows return to regular shoegear within days of the procedure. One disadvantage of this procedure is the possible fact that the surgery may require 2-4 weeks for complete recovery.

Now with these state-of-the-art treatments, we often recommend combinations to produce the highest results. Most recently, we have combined the Topaz Radiocoblation with Platlet Rich Plasma (PRP) to utilize the advantages of each and produce the highest results. So as you hobble to the bathroom at night or in the early morning, consider some new treatments that may get you back to normal quickly.

Copyright (c) 2009 Mountain West Foot & Ankle Institute

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Brandt R. Gibson, DPM, MS is a podiatrist from American Fork, Utah that is constantly in search of new, effective ways to treat plantar fasciitis. He is located at Mountain West Foot & Ankle Institute. His goal is to educate people and help them "optimize what they were born with." For further educational information, visit his blog at http://myheelpain.blogspot.com/ or visit his website at http://www.UtahFootDoc.com .
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