Healing Heel Pain Without Surgery

"I was in agony for years," said podiatrist David Geltzer. "In podiatry school, I was finally diagnosed. I can empathize with my patients."

The condition can hit anyone, but is especially linked with several risk factors, including anatomical flaws, such as high arches, “fallen” arches (flat feet) and tightness of the Achilles tendon or calf muscles; foot-use abnormalities, such as twisting or rolling the foot while walking; activities that involve hours of standing, walking or running on hard surfaces; and obesity or pregnancy, which add extra weight.

Relief from plantar fasciitis generally comes from long-term, persistent, but simple interventions such as shoe inserts, three-times-a-day stretching exercises, ice packs, night splints and over-the-counter pain relievers. For the small minority of patients who don’t respond to these treatments, the fallbacks may be a risky surgical procedure to remove part of the ligament or a new, expensive, largely unproven sound-wave threatment.

The plantar fascia protects the foot’s arch and the entire leg’s bones, muscles and nerves by absorbing shock. But the ligament may be too loose, too tight or torn, all of which produce inflammation and soreness. This inflammation is usually diagnosed through a foot exam and X-rays. The X-ray, which is used to rule out a stress fracture, usually reveals calcium-deposit “heel spurs.” Today, these are viewed as harmless.

"Twenty years ago, we used to always do surgery to remove the spurs," said Marlene Reid, a suburban Chicago podiatrist who gives interviews on behalf of the American Podiatric Medical Association. “Now we believe spurs do not cause the pain.”