Are you experiencing heel pain? According to Dr Ed Davis, a podiatrist based in San Antonio, there are six questions you should ask yourself when seeking treatment to avoid mistakes along the way.

1) Do I have the correct diagnosis?

Get an accurate diagnosis from a specialist trained to recognize all the causes of heel pain. According to Davis, there are several causes of heel pain. Plantar fasciitis is the most common cause but often the easiest to cure. The plantar fascia is the large ligament-like structure that attaches to the base of the heel and to the bases of the toes. Pain is often worse upon arising in the morning. If plantar fasciitis treatment does not appear to be working, there may be a different cause.

2) Am I wearing the correct type of shoes?

More than 700 years ago it was discovered by shoemakers that shoes should not twist or bend in the middle but should be flexible in the ball of the foot. They invented the steel shank to prevent damage to the plantar fascia and joints of the arch. The shank is rigid and is placed between the midsole and outsole of the shoe. Shanks can be made from materials other than steel, such as fiberglass, graphite, or Kevlar. The plantar fascia is strong in tensile strength but is prone to damage by twisting or torsional forces.

3) Am I getting symptomatic treatment or curative, definitive treatment for my heel pain?

Plantar fasciitis can be acute, which is basically a strain or sprain of the fascia, which may come from overuse or poorly supportive shoegear. It is OK to treat this with rest, ice, massage, stretching and possibly non-steroidal anti-inflammatory drugs. Many cases of plantar fasciitis are chronic, so treatments for acute plantar fasciitis will have minimal effect. Chronic plantar fasciitis, left untreated, can progress to plantar fasciosis, in which degeneration of the fascia occurs.

4) Am I getting cortisone shots as a treatment for heel pain?

The term “cortisone” refers to a class of drugs known as “catabolic steroids.” Catabolism refers the breakdown of tissue. Cortisone, when mixed with a local anesthetic, is used in injections to provide relief of pain and inflammation. While it is OK for use in acute pain, it is important to understand that cortisone is not a cure. In fact, when overused, it can worsen certain conditions. Occasionally, overuse of cortisone can cause rupture of the plantar fascia.

5) Have prescription foot orthotics been offered as a treatment option?

Chronic plantar fasciitis is caused by the mechanical action of chronic repetitive strain of the fascia. True custom foot orthotics made from a corrected mold of the foot at a professional foot orthotic laboratory to the specifications of a doctor trained in the biomechanics of the foot can eliminate the faulty foot function leading to plantar fasciitis.

6) What treatment options are being considered for tough cases of heel pain or plantar fasciosis?

Cases of plantar fasciitis that have been untreated or undertreated for long periods of time can go on to plantar fasciosis, which is a degenerative process of the fascia. That is best determined by examining the heel with diagnostic ultrasound. Conventional plantar fasciitis treatments may not be effective for fasciosis. Treatments specifically for plantar fasciosis include extracorporeal shockwave therapy (ESWT).

[Source(s): Dr Ed Davis – San Antonio Podiatrist, PR Newswire]