Southern Nevada Foot & Ankle Center • Dr. Ada Vera,DPM, FACFAS
Advanced and effective care you can trust. Foot & Ankle Doctors in Las Vegas, Nevada

HEEL PAIN

Heel pain is very common, and can most commonly be identified as a heel spur or a condition, called “plantar fascitis”.

A heel spur is a calcium deposit on the underside of the heel bone. On an X-ray, a heel spur protrusion can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as “heel spur syndrome.”

Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot.

Treatments for heel spurs and associated conditions include exercise, custom-made orthotics, anti-inflammatory medications, and cortisone injections. If conservative treatments fail, surgery may be necessary.

Diagnosis
A heel spur can be seen on an X-ray as an extension of bone in front of the heel. Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain – especially while walking, jogging, or running – if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.

Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning: a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

heel-pain

Non-Surgical Treatments for Heel Spurs

The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night’s sleep, the pain may feel worse as the plantar fascia suddenly elongates, which stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking. If you have heel pain that persists for more than one month, consult a health care provider.

Conservative treatments may be recommended, such as:

  •  Stretching exercises
  • Shoe recommendations
  • Taping or strapping to rest stressed muscles and tendons
  • Shoe inserts or orthotic devices
  • Physical therapy

Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid may be done to relieve inflammation in the area.

Surgery for Heel Spurs
If conservative treatment fails to treat symptoms of heel spurs, surgery may be necessary to relieve pain and restore mobility. Surgical techniques include:

  • Release of the plantar fascia
  • Removal of a spur

In most cases, plantar fascia release — with or without heel spur removal — has proven effective. But pre-surgical tests or exams are required to identify optimal candidates, and it’s important to observe post-surgical recommendations concerning rest, ice, compression, elevation of the foot, and when to place weight on the operated foot. In some cases, it may be necessary for patients to use bandages, splints, casts, surgical shoes, crutches, or canes after surgery.

Possible complications of heel surgery include nerve pain, recurrent heel pain, permanent numbness of the area, infection, and scarring. In addition, with plantar fascia release, there is risk of instability, foot cramps, stress fracture, and tendinitis.

Without Treatment
The pain due to the plantar fasciitis that causes the heel spur can become progressively more severe, in some cases damaging the tissue.

  • Dr. Vera really knows her stuff when it comes to diabetic foot care, it is a very serious matter and she is so detailed and makes sure I follow all of the instructions I am given. The staff always is so welcoming and I actually don’t mind having to go see the Doctor.

    Anonymous
  • Dr. Vera and her staff are wonderful, they took great care of my daughter, nice office and the whole visit was a pleasant experience.

    Ms. Ruiz
  • Can’t say enough about Dr. Vera, my husband had terrible foot problems and Dr. Vera was able to resolve all of his issues. The staff was so friendly and explained all of my insurance questions to me in detail. I would recommend Dr. Vera to anyone who needs a great Podiatrist.

    Sandy T.
  • Sent my friend to Dr. Vera for a ankle problem, they got her in that same day did x-rays and determined there were no breaks and all she needed was a boot, my friend was able to go back to work that same day thanks to Dr. Vera seeing her so quickly.

    SM Las Vegas