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    San Antonio Podiatrist, Dr. Ed Davis, States That Heel Pain Has Many Causes

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    There are numerous causes of heel pain so obtaining an accurate diagnosis is important.

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    Dr. Eddie Davis, a Board Certified Podiatrist practicing in San Antonio, Texas states that heel pain is one of the most common concerns that bring patients to the offices of foot specialists. It is often assumed that heel pain is caused by plantar fasciitis, an inflammation of the ligament emanating from the heel and spanning the arch of the foot. There numerous causes of heel pain despite the fact that plantar fasciitis being the most common cause.

    Davis states that he often sees patients who claim to be suffering from plantar fasciitis “for years,” but, upon closer examination, have heel pain caused by other issues. A thorough examination is required to discover and treat those causes. The list of causes is long but here are some of the more common ones:

    1) Plantar fasciosis: This is a degenerative process of the fascia as opposed to an inflammatory one. Plantar fasciosis was once termed “intractable plantar fasciitis” as it appeared to be plantar fasciitis that failed to respond to treatment. Surgical treatment for this has been replaced by newer technologies focused on the area of degenerative fascia to include injection of stem cells, platelet rich plasma, high energy pressure waves also known as extracorporeal shockwave therapy, the Topaz procedure and the Tenex TX Procedure. There is a discussion of these procedures on Dr. Davis' Heel Pain Blog, http://sanantoniopodiatrist.typepad.com

    2) Rheumatologic or arthritic conditions such as gout, rheumatoid arthritis, anklylosing spondylitis and Reiters disease.

    3) Neurologic causes: Tarsal tunnel syndrome is an entrapment of the nerve on the inside of the ankle that provides sensation to the bottom of the foot, a condition similar to carpal tunnel syndrome in the hand. Baxter's neuritis involves entrapment of a small nerve under the heel bone which has symptoms similar to plantar fasciitis but can cause pain even when one is off the foot.

    4) Trauma. This can refer to acute trauma such as fractures, contusions and stress fractures but also chronic repetitive strain which can lead to ruptures or tears of the plantar fascia. Ruptures of the plantar fascia can be caused by excessive use use of cortisone injections which weaken the fascia and provide temporary pain relief to the injured or inflamed fascia.

    Heel pain can occur with overuse but if the condition persists, one should obtain a professional evaluation.

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    Dr. Eddie Davis



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