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Heel Pain and Plantar Fasciitis   Heel pain is one of the most common conditions podiatrists treat. It accounts for approximately 15-20% of The North Shore Podiatry Group’s practice. Most patients with heel pain find that it is most painful with the first few steps in the morning and after prolonged sitting. The condition can occur in anyone, but is most common in athletic or overweight people. Feet that flatten excessively are also more likely to develop it.   A strong ligament called the plantar fascia (Figure 1) extends from the heel bone to the toes. When the foot flattens, the plantar fascia becomes taut. It stretches, and begins to pull away from the heel. This causes pain. Over time, the pulling stimulates the heel bone to produce a heel spur (Figure 2). The heel spur itself is usually not the cause of the pain.    Treatment Most of our patients gain relief from conservative treatments which include: Icing and stretching exercises performed daily. Taping the foot in a manner that relaxes the plantar fascia by controlling pronation (flattening). Orthotics (custom supports) to relax the plantar fascia by controlling pronation. Modification of exercise routines. Changing to shoes with good support and heel cushioning. Other conservative treatments include: cortisone injections, oral anti-inflammatory medications, physical therapy, and night splints.   Extracorporeal Shock Wave Therapy (ESWT) This revolutionary new treatment was approved by the FDA in July, 2002 for treatment of chronic heel pain that is unresponsive to conservative therapy. ESWT is a non-invasive, non-surgical procedure that administers high intensity shock waves to the precise area of inflammation, which is the point where the plantar fascia attaches to the heel bone. The shock waves increase blood flow to the area and stimulate a healing response. ESWT uses the same technology and instrumentation as lithotrypsy has for many years to break up kidney stones.   ESWT is performed by the doctors of the North Shore Podiatry Group under local anesthesia. The procedure takes about 20 minutes. The patient can immediately return to a supportive shoe and may drive home from the procedure. Normal walking is permitted, but athletic activity should be eliminated for about four weeks. Complete relief of heel pain has been obtained by approximately 90% of the patients who have been treated with ESWT by the North Shore Podiatry Group.   Surgery ESWT has practically eliminated the surgical treatment of plantar Fasciitis and heel spurs in our practice. When it is necessary, however, the doctors of the North Shore Podiatry Group perform Endoscopic Plantar Fasciotomy. The procedure is performed through two incisions, each the diameter of a drinking straw. A miniature television camera (the endoscope) is placed into one incision.  In the other, a small blade is inserted. The surgeon sees the plantar fascia on a television screen. It is easily and precisely cut. The heel spur is not touched. If you are a candidate for Endoscopic Plantar Fasciotomy, your doctor will give you a detailed explanation of the surgery and its post-operative course.   If you have questions or would like to discuss the treatment of heel pain and plantar fasciitis, please contact The North Shore Podiatry Group.   The North Shore Podiatry Group Glenview · Lake Forest · Gurnee Phone: (847) 729-9580 · Fax: (847) 729-9480 The information provided in this website is not intended to be a substitute for medical attention, diagnosis or treatment. The material is provided for information purposes alone. Visitors should not exclusively rely on answers provided in this website. Specific questions should be directed to your own health care provider. The North Shore Podiatry Group makes no claims, expressed or implied as to the accuracy and timeliness of any advice, services, or other information referenced in the website. Additionally, North Shore Podiatry Group is not obligated to follow-up or contact visitors to this site, nor is it liable in any manner for the decisions of visitors whose actions are based on information found in this website.