It can develop slowly, and slowly become disabling. It can be a persistent condition such as plantar fasciitis or of unknown origin. Bunions, heel spurs or arthritis can also cause heel pain. Before our clinicians can treat the aching foot, we need to do a little detective work and find out what’s causing the problem. If the pain is related to nerve impingement (nerve entrapment), muscles, tendons or ligaments may be squeezing the opening through which nerves pass. This happens when muscles become chronically inflamed, or tendons or ligaments become swollen. The pressure on the nerve then causes pain.
Nerve entrapment may cause the pain to radiate along the foot or the leg, and impart a burning or tingling sensation. Some patients with nerve impingement feel a numbness in the heel or toes.
Heel pain can persist for years unless it’s diagnosed properly and treated. Moreover, it directly affects the patient’s daily activities, making it difficult to do such mundane things as shop for groceries or walk the children to the bus stop. More than one person has given up activities that she or he loved— golf, for instance, or shopping— because of this nagging pain. And although the type of shoes worn may exacerbate the pain, simply changing shoe styles does not guarantee a cure.
While heel pain is sometimes caused by a specific injury, more often it’s the result of chronic stress. Most adults have some damage to the nerves, muscles, ligaments and tendons, especially if they do a lot of running, walking, or standing, just due to the load we impose on our feet through the years.
The doctor will first exam your foot and ask about your lifestyle, shoewear, general health, medical history and other factors. She may order x-rays or other imaging studies. The objective is to narrow the diagnosis from a whole host of possibilities, which include:
- Tendinitis (Achilles or other tendon)
- Fractured bone
- Peripheral neuropathy (common in diabetic patients)
- Stress fracture
- Pinched nerve
- Thinning heel pads
- Rheumatoid arthritis
- Tumor in the heel bone
The first step is call one of our clinics in Dallas, DeSoto or Sunnyvale to schedule an exam and a diagnostic visit. The longer the problem is neglected, the more difficult it can be to treat some cases.
Radio wave therapy delivers relief for heel pain
Exercise, anti-inflammatory drugs and physical therapy are helpful for some patients with chronic heel pain, depending on the source of the pain. The doctor may prescribe special footwear to relieve pressure on the heel area.
Another option is Radio Frequency (RF) therapy. This treatment employs an electrical current to disrupt nerve function. Mild heat from the electrical current interrupts the transmission of pain signals from the nerve, thus relieving the pain. No damage is done to the nerve during the treatment. The treatment can be applied in the clinic; no hospitalization is needed.
The doctor inserts a needle or needles into the foot to deliver the radio waves, which then heat the nerve to 80-90 degrees celsius. You may feel a slight soreness, numbness or weakness after the injection, but these symptoms are temporary and usually disappear within a few weeks.
RF therapy has become an important option for patients with plantar fasciitis, which in the past was considered one of the more stubborn types of heel pain. This condition occurs when the band of tissue extending from the toes to the heel becomes irritated and then inflamed. It seems to occur in patients who have overly flat or high arches. Patients who stand on hard surfaces wearing non-supportive footwear are especially prone to plantar fasciitis. We can treat this condition with corticosteroid injections, surgery and physical therapy but RF therapy has become an important adjunct to these treatment options. RF therapy has the added benefit of not causing any injury to tissues. We can repeat the treatment until the problem is resolved.