What To Do About Heel Pain That Won’t Heal

It’s marathon season in NYC, and no, I’m not talking about binge watching entire seasons of Orange is the New Black or House of Cards on Netflix. It’s time for the big one, the #NYCmarathon, and my current and potential patients are gearing up.  Among the big fears New Yorkers harbor about the marathon, along with falling onto a subway platform and getting hit by a crane, is the dreaded plantar fasciitis, or heel pain that just won’t heal despite what can be months or even years of treatment.  Fear not, brave NYCers, hope is just over the horizon.

We have discussed heel pain many times previously in the hallowed halls of this blog.  As a quick review, the plantar fascia is a tight band of tissue that runs along the bottom of the foot from the heel to the toes.  The pressures and pulling of everyday life, trauma, or exercise can cause the fascia to pull off the heel bone, creating inflammation, pain, and a calcification that looks like a spur on X-ray.  Treatment consists of proper shoe gear with a good orthotic, stretching exercises and cortisone injections.  If that fails, physical therapy is a great option (and available in our office).  If that fails, patients tend to start to lose patience.

It is at this point that I often see cases of intractable, seemingly hopeless heel pain limping into the office.  Patients can be just about at the end of their rope, feeling that the heel pain will never resolve.  It is important to know that the majority of cases will heal even without any treatment, and the worst cases are still treatable.  After failing a course of conservative therapy for heel pain, surgery may be necessary.  The surgery is a straightforward procedure, in which part of the fascia is released from the heel bone in an endoscopic procedure with a very small incision, minimal downtime and a very high success rate.  In fact, most patients who undergo this procedure question why they waited so long.

So, if you’re training for a marathon, or limping through your first few steps in the morning and wondering if there is any hope, don’t give up.  Chances are you will cross the finish line, or the threshold to the bathroom, after a few visits to your friendly New York City podiatrist.

See you in the office.

Ernest Isaacson