Heel Pain (Plantar Fasciitis & Heel Spurs)
Heel pain is a debilitating condition that can significantly affect an individual’s quality of life and is best managed through early specialist diagnosis and intervention. Research has shown that people who work in occupations where they stand for most of the day are most at risk, but the condition can also affect competitive athletes, and those who have recently put on weight. Patients commonly experience heel pain related to an overuse condition of the plantar fascia known as plantar fasciitis, from a heel spur, or from both conditions in combination.
At Perth Podiatric Surgery, our specialist podiatric surgeons Dr Andrew Knox and Dr Burke Hugo are able to assess this condition holistically and provide a comprehensive range of non-operative and surgical treatments to remedy the condition. Assessment of this condition typically includes a physical examination in conjunction with imaging such as x-ray and ultrasound which can be done on-the-spot on the day of your consultation. Following a diagnosis, our specialists will discuss what options are best for your condition based on the severity, duration, and prior treatment history. In approximately 80% of cases, heel pain can be managed successfully through non-operative treatment including custom-made orthotics, guided-cortisone or Amniofix (stem-cell) injections, footwear changes, and stretching exercises. These treatments can be provided in-house at our clinic.
In approximately 20% of patients however, heel pain can become chronic and may require surgical treatment. Surgical treatment is best performed early in patients who do not improve following standard care, and may involve surgical release of the plantar fascia and/or resection of the heel spur if present. In patients who have particularly flat feet, we often recommend consideration is given to adjunctive procedures which can help stabilise the foot such as the HyProCure procedure as this helps to reduce the risk of plantar fasciitis or other mechanical foot problems arising. A description of plantar fascia release and heel spur removal are provided below for reference.
Plantar Fascia Release
This procedure is performed for isolated cases of plantar fasciitis without a heel spur present. It can be performed through a limited open approach, or it can be performed percutaneously through the skin under imaging-guidance. The procedure involves release of the medial (inside) band of the plantar fascia, which bears approximately 1/3 of the load of the foot and is usually the band patients tend to experience symptoms in. Patients usually obtain immediate improvement in their symptoms following this procedure, however there is a period of restricted weightbearing following surgery to allow for normal wound healing to take place. Generally patients are still advised to return to wearing orthotics once the surgery site has healed in order to help reduce the risk of recurrent fasciitis.
Heel Spur Removal
Heel spur removal is often performed in patients that have chronic pain at the site of a calcaneal spur, and may be associated with concomitant plantar fasciitis. Generally, patients with a symptomatic heel spur describe a sharp stabbing sensation at the central heel pad area which is thought to occur from irritation of the soft-tissues from the sharp bony spur. In patients who do not obtain relief from standard conservative treatments, heel spur removal can be performed.
Our specialist Dr Andrew Knox performs a minimally invasive heel spur removal which is relatively straightforward and has significantly less downtime and risk than the traditional ‘open’ surgical procedure. This is performed within hospital under a general anaesthetic and involves shaving of the spur under live-x-ray guidance, with release of the medial band of the plantar fascia. For further information on minimally invasive heel spur removal in Perth, please refer to our website dedicated to this unique approach: https://www.1300keyhole.com/heel-spur
This website is intended for general information purposes only. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For more information, follow the link to make an appointment to see our specialist podiatric surgeons Dr. Andrew Knox & Dr Burke Hugo.