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Misconceptions and Facts About Heel Pain

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Heel pain is one of the most common foot conditions I treat in my clinic every day. Surprisingly, it is also one of the conditions patients have the most misconceptions about – both its cause and its treatment. Many patients believe heel pain is associated with a bone spur when, in fact, heel pain has a variety of causes including: being overweight, poor foot mechanics, a change in activity levels, wearing improper footwear, aging, trauma and even poor ground conditions. One of the difficulties in treating heel pain is that patients think they only have to support their condition while at work. In reality, when heel pain is symptomatic it needs to be supported all day long, at home and at work.

When a patient with heel pain first comes to my clinic, I begin by conducting a thorough assessment of his/her current footwear as well as taking a detailed history. I then check the foot joints to ensure adequate movement and press along the bottom of the foot, noting any tender spots. After that I perform a gait analysis (I examine how he/she walks) and I conduct any necessary tests to fully understand the cause of the discomfort. Once I have a clear understanding of the cause and severity of the heel pain I provide treatment recommendations. Often these recommendations include wearing more supportive footwear and/or a custom made orthotic.

At my clinic we have an onsite lab so I can quickly cast and fabricate custom orthotics and get my patients started with their treatment as soon as possible. I hand make the custom orthotics my patients require using a variety of raw materials. It is a meticulous process as I create the orthotics to meet each patient’s specific needs. Occasionally adjustments may be required to make sure they fit and function perfectly.

As a custom orthotic is only as good as the shoes it is worn in, an important part of my job is educating patients about proper footwear choices. At the clinic we have an array of shoes that have excellent orthopaedic benefits. Using these shoes as examples I show my patients what features to look for when they are purchasing footwear to help their condition.

Although patients with heel pain are eager to ease their pain, one of the biggest challenges I face is getting them to wear supportive shoes and their orthotics all the time, even at home. Sturdy work shoes along with a pair of indoor supportive sandals can make all the difference in a treatment plan.

When patients follow our treatment plan, heel pain is highly treatable and it is very rewarding to see them back on their feet and pain free. I once treated an elderly woman with severe heel pain. She followed my advice and wore custom orthotics and supportive shoes all the time. The treatment was successful and she happily told me she felt like her orthotics had given her life back.

By Shawn Duench, C. Ped (C), Kitchener, ON

 

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