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Posts for category: Heel Treatments

September 04, 2015
Category: Heel Treatments

  YES!  It is true.  There is a very good chance that if you have plantar fasciitis - the very bad pain on the bottom of the heel that starts hurting in the morning and acts up whenever you sit down and get back up on it - your pain will probably get better if you lose a little weight!  Now - by no means am I saying that ALL people with heel pain are overweight.  There are people who are very thin that have heel pain.  But the vast majority of people with pain on the bottom of the heel will see at least some pain relief, and many will see a LOT of relief, by losing a little weight.

   Plantar fasciitis is caused by a tightening of the ligament on the bottom of the foot that runs from the heel to the base of the toes.  When it becomes painful, it is due to a chronic inflammation, and sometimes small tears within that ligament or fascia.  Anything that causes more pressure on the foot - sports activities, long periods of walking or standing, flat feet, very high arch feet with weight concentrated on the heel, and excess weight - can make it worse.  While people of normal weight DO get heel pain, a large number of people where this condition is long-standing and very difficult to treat are...well...LARGE.  I once saw a woman get a single steroid injection into her heel, lose just 10 pounds (and the woman was just very slightly overweight to start) go for 14 YEARS without pain.  The really odd thing is that when she came back to me for a second injection, she said she had recently gained that weight back.  I've seen people have gastric bypass surgery after having uncontrolled diabetes, cardiovascular disease, AND heel pain - where after several unsuccessful to slightly successful treatments for heel pain LOST 80 to 100 pounds (and these were BIG people to start)...see their heel pain resolve COMPLETELY, the need for diabetic medication go WAY down or even eliminated.  Of course their blood pressure many times stabilizes as well.

A few years ago I bought an old house and decided I would "rehab" it.  That's basically fixing it up, and in my case spending more money on the supplies and labor than I did on the house!  To keep expenses from getting totally out of hand, I agreed to pick up some of the materials needed at Lowe's and Home Depot, and have them ready for the contractor to put in.  I have knee arthritis, so going up and down the 20 or so stairs at the front of the house was no fun anyway.  But just carrying cans of paint up those steps caused my knee pain to become excruciating.  If that wasn't bad enough, carrying kitchen cabinets up was even worse.  A few extra pounds made a hug difference in my knee pain, and it does the same to the heel.   

   Not every one will see heel pain resolve completely as a result of losing weight, but if you or someone you love has had heel pain for a year or more, it has not responded well to treatment, and you may just be carrying around a few extra pounds, give it a try!   Losing a little weight may just make a BIG difference in your level of pain.


Richard S. Eby, DPM


7348 East Brainerd Road

Chattanooga, TN.  37421


November 30, 2014
Category: Heel Treatments

HEEL PAIN is one of the most common problems seen in the Podiatry office.  The problem is that pain in the heel is often not related to what shows up on an x-ray of the foot.  There are TWO places on the foot where a "spur" is commonly seen.   The most common is on the bottom of the foot and is referred to as a Plantar Heel Spur.  The other, located on te back part of the heel is called a Retrocalcaneal Spur.  There are a few similarities in these spurs, and a number of differences.  The first thing to be aware of is that PAIN on the BOTTOM of the heel has NOTHING TO DO WITH THE SIZE OF THE BONE SPUR!  At one time, surgery was done on the bottom of the heel when a very large spur was present.  Baseball great, Joe DiMaggio had surgery on the bottom of his heel through a very large incision and it is felt by many that his baseball career ended because of that!  The presence or absence of a spur on the bottom of the heel is NOT a good indicator of what should be done to treat the heel.  Many spurs on the bottom of the heel have NO PAIN associated with them, and in infact PAIN ON THE BOTTOM OF THE HEEL IS FROM PLANTAR FASCIITIS (a mechanical tightness and subsequent pain that develops from mechanical causes) and has NOTHING TO DO WITH THE PRESENCE OR ABSENCE OF A SPUR!  It is true that MOST people with Plantar Fsciitis also have a spur, but many people with a spur on the bottom of the heel have NO pain.  If the decision IS made to do surgery on the bottom of the heel, removal of the spur is not even necessary.  It is cutting of the plantar fascia or tight ligament that leads to resolution of pain when surgery is done.    Pain in the back of he heel SOMETIMES is from the presence of a spur on the back of the heel.  It is also true that MOST of the time, the larger the spur on the back of the heel, the more likely it is to hurt.  I would also say that the larger a spur on the back of the heel is, the more likely it may need to be surgically removed.  Not all large heel spurs on the back of the heel are painful, and when they are, conservative treatment should always be tried first, but it is true that if there is a large painful spur on the back of the heel, and it has been painful a LONG time, it is more likely to need surgery.  There is little soft tissue protection between the back of the heel bone and the skin, so a large spur becomes very prominent and pressure causes pain.  Additionally, cortisone or steroid injections, which are often used on the bottom of the heel to relieve pain, cannot safely be used on the back of the heel.  A big part of the problem with the back of the heel is the Achilles Tendon.  This is the LONGEST and STRONGEST tendon in the body, but also very vulnerable to injury.  Steroid injections can cause a spontaneous rupture of the Achilles tendon.  There are still many ways to treat either type of heel pain.  These included over the counter arch supports and insoles, custom orthotic devices,physical theapy, shockwave treatments, night splints, stretching exercises, PRP (Platelet Rich Plasma), several other NEW alternative treatments such as Ozone and Stem cell injectons, and...if all else    The FIRST thing, is to be seen  a specialist to ge an accurat diagnosis, and then treatment can be started.  One of thmost important things when dealing with heel pain is to BE PATIENT.  Sometimes the first treatment will get alleviate all of the pain, but in many cases a multifacted approach is needed. 


Richard S. Eby, DPM

(423) 622-2663

October 22, 2012
Category: Heel Treatments

Heel pain is very uncomfortable for everyone. Millions of people suffer from chronic heel pain, especially in the morning.  Heel pain is also known as Plantar Fascitis. During rest, the Plantar Fascitis tightens and shortens. When body weight is applied, the Fascia must stretch and quickly lengthen, causing micro-tears in the Fascia. Over stretching of the Plantar Fascia is more likely under the following conditions:


1. Excessive pronation ( flattening of the arch)

2. Walking on hard surfaces for long periods of time.

3. Excess weight or pregnancy

4. Tightening of the calf muscles

There are several different options for this issue. There are custom made orthotics, cortisone injections, some meds and last resort is surgery.