Heal the Heel

Ok kids time for a little word association. Tell me the first thing you think of when I say - plantar fasciitis. If it starts with an F no need to articulate the sentiment, but you might want to read on.

Here’s an interesting story for you. On a recent Tuesday as I was walking a lovely patient into the operating room for her bunionectomy, she limped forward and remarked: “I wish you could do something about my plantar fasciitis.”  Well, little did she know she was talking to just the right NYC foot doc. For those of you who just brought your feet home from the foot store and have no interest in the vicissitudes of professional athletes, plantar fasciitis, colloquially known as heel spurs, is a painful inflammatory condition that manifests as heel pain, usually worse in the morning and progressively painful throughout the day.

Contrary to popular belief, blogosphere wisdom, athletic panic, and generalized yenta talk, it is a very treatable condition in almost all cases. In my NYC practice I typically start with a regimen of stretches, comfortable shoes preferably with custom orthotics, and a cortisone injection. Fear not the cortisone injection as it’s a potent anti inflammatory agent that goes right to the core of the inflammation and is therefore so much more than just a temporary bandaid. If that fails physical therapy - available right in the office - is next. Next step is shockwave therapy - more about that soon. And if all that fails, the last step, as my patient learned, is a surgical release of the plantar fascia, usually under endoscopic guidance, also called an endoscopic plantar fasciotomy or EPF to us busy doctors. This is an evidence based, time tested procedure that cuts part of the fascia, thus relieving the pressure, and ending the pain - no fascia means no fasciitis. Patients typically walk the same day, wear an ugly surgical shoe for three days, and after a few weeks of soreness, are permanently relieved of that pesky heel pain, with great long term outcomes and no effect on the structure or stability of the foot.

So if that nasty heel pain is keeping you from running, walking, or even getting to the loo in the morning without hobbling, don’t just give up or live with the pain. Just try to let me know in the office, before we get to the operating room.

See you in the office.

Ernest Isaacson

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