By Susan J. White
NorthShore University HealthSystem
Heel pain is one of the most common conditions people seek relief from when visiting a podiatric specialist. In fact, three out of four adults will experience some level of heel pain over the course of their life, estimates Howard Stone, DPM, a NorthShore University HealthSystem (NorthShore)-affiliated, board certified podiatric surgeon.
This common problem can occur in men and women of all ages, but is most prevalent in people who regularly exercise, especially runners, or in overweight people. Those with flat feet are also very susceptible to chronic heel pain, explains Dr. Stone.
The muscle and tendon complex in the calf that include the Achilles tendon, begins to shrink with aging and without regular stretching, can lead to pain in the bottom and back of the heel. The plantar fascia—a strong ligament extending from the heel bone to the toes—becomes tight when the foot flattens, and as it stretches it begins to pull away from the heel, says Dr. Stone. The stretching and pulling of the plantar fascia over time can cause pain and can stimulate the heel bone to produce a bone spur.
Many people gain relief from the painful condition known as plantar fasciitis with conservative treatment options including rest, ice, and stretching exercises; over-the-counter anti-inflammatory medicine; a night splint that holds the foot and ankle in a 90 degree position; an orthotic or custom support for shoes to help relax the plantar fascia; or possibly a cortisone injection.
If that first level of treatment options fails to provide relief, Dr. Stone often recommends patients work with a physical therapist to develop a more involved stretching routine and icing therapy, and sometimes to discontinue weight bearing exercise like walking and running in favor of activities like swimming or biking.
Recently, Dr. Stone and his colleagues have begun using a relatively new and exceedingly successful laser therapy to treat heel pain, which has virtually eliminated the need for surgery among his patients. “Surgery is always the last resort for patients struggling with heel pain,” says Dr. Stone.
The Class IV laser can penetrate deep into the soft tissues, and is a completely non-invasive and painless procedure to jumpstart the body’s own healing response, explains Dr. Stone. The mechanism by which the laser works draws water, oxygen, nutrients, and new blood flow to the affected area to begin the natural repair process of the damaged tissue.
The vast majority of plantar fasciitis patients find total relief in an average of six to eight laser therapy treatments, according to Dr. Stone. The treatments last approximately four and a half to five minutes and are generally given twice a week, he adds.
FDA cleared, laser therapy is now being used by some professional sports teams to help athletes heal a variety of muscular and joint injuries. In addition to heel pain, Dr. Stone uses the laser to treat patients with Achilles tendonitis and arthritic joints.
“This has really changed how I treat this condition. Patients love it and it is gratifying to help so many people become pain free,” says Dr. Stone, who notes that the only downside is that the procedure is not yet covered by most insurance, so patients are generally faced with a $500 to $700 total out-of-pocket cost for the therapy.
While laser therapy is becoming more common among athletic trainers, it is only available at select foot and ankle practices in the area, according to Dr. Stone.
