This article was from the January issue of Canyon
and Country Times.
Heel Pain
Revisited
By: Michael Zapf, D.P.M., M.P.H.
I am happy to report that Marcie and her heel spur are doing fine. As
many of my Country and Canyon Times readers know, February is my month for
reporting on the saga of Marcie and her heel pain.
Marcie first came to my office five years ago complaining of severe heel
pain. It was the worst in the morning. She dreaded getting out of bed. As her
left heel hit the floor the pain started. As she started to walk she felt as if
a sharp spike was in her heel bone. After walking for awhile the pain became
more tolerable but would return when she stood up after resting or sitting.
Eventually the pain started to affect her performance as a nurse and she wanted
me to help her.
With the help of a few diagnostic tests and an X-ray I confirmed that she
had a heel spur. Marcie also had an irritation of a ligament that runs the
length of the bottom of the foot. This ligament goes by the name “plantar
fascia” and the irritation is called “plantar fasciitis.” To explain what is
occurring imagine the arch of the foot and the plantar fascia as a triangle. As
the foot flattens it also elongates. Unfortunately the plantar fascia does not
stretch much. A strong force trying to flatten the foot irritates the plantar
fascia especially where it attaches to the heel bone. If this goes on for a long
time the fascia becomes inflamed and a spur can develop.
I did not treat Marcie for her painful heel spur. Instead I treated the
abnormal flattening of her foot. I made for her a set of in-shoe orthotic to
control her foot flattening. They worked like a charm and
they continue to do so. As long as Marcie wears them in her shoes she does not
have pain in her arches. At first she wore them all the time by moving them to
her various shoes. Last week she reported that she can go for several days
without the orthotics. When the pain starts to reassert itself she just starts
wearing the orthotics again and it never gets as painful. She continues to be
happy with this non-surgical approach to heel pain. She still doesn’t like to
get up in the morning, but at least its not due to heel pain.
Dr. Zapf has a private practice in Agoura Hills and
Thousand Oaks
and teaches part time at the L.A. County/ U.S.C. Medical Center. For more information please call his office at (818) 707—3668.
