Most heel pain can be cured without surgery. Unfortunately, there is no magic bullet for heel pain. Many times heel pain treatment consists of many different types of treatments and each treatment contributes a little bit. Sometimes taping of the foot will relieve up to 40% of the heel pain. Using a nightsplint can often help about 20% of the heel pain. Injections, stretching and changing shoes, avoiding going barefoot, and custom or over-the-counter orthotics also relieve a significant amount of the heel pain. All these things together almost always cure heel pain.
But what about those cases where all the conventional, simple, noninvasive treatments don’t get rid of heel pain – or where it is taking a really long time to see any results?
Specialized injections of PRP (platelet rich plasma) can help. However, those injections can be very expensive. I’ve had patients complain of $1,400 bills for those injections and they didn’t work! There are treatments that are simpler and less expensive, though.
Shockwave therapy has had a good track record in curing resistant heel pain. Initially there was high-energy shock wave which required the foot to be put to sleep and the use of a very expensive machine. When insurances reduced payments for those machines they all but disappeared.
Today, we are using a low energy shock wave in our office which requires four treatments at weekly intervals followed by four treatments at biweekly intervals. This treatment is inexpensive and doesn’t require anesthesia. It works by increasing the blood supply to the plantar fascia and helping nature repair the plantar fascia.
What is exciting is the combination of the shockwave therapy with laser therapy. We are using a class IV diode laser which serves to increase the ATP (adenosine triphosphate) of the cell. ATP is the energy of the cell. By using the shockwave therapy to increase the blood supply to the plantar fascia then followed by the laser which increases the energy within the cells we are seeing remarkable results using a noninvasive, pain free treatment modality.
The shockwave and laser combination along with our comprehensive plantar fasciitis protocol has tremendously increased our success in curing the most stubborn heel pain!