New Heel Pain Treatments?

Recently, I read about two new treatments for chronic heel pain/plantar fasciitis. The first involved use of Botox injections. Some physicians have tried this to alleviate the pain. As you know, Botox is used for reducing or removing facial wrinkles. It works by paralyzing the underlying facical muscles to stop the skin from wrinkling. This is a temporary treatment and needs to be repeated over time. For heel pain, the reason that it may work is not known. It may have a paralyzing effect on the underlying tissue therefore stopping pain signals. More study has to be done this since Botox is a dangerous solution if not used in proper amounts. The second treatment is dry needling of the plantar fascia under ultrasound guided visualization with use of injection of steroid. The theory behind this is that by "damaging" the plantar fascia it causes a acute inflammatory reaction instead of a chronic one. Basically getting the healing process moving forward to healing of the tissue. Injection of steroids in not new but is used routinely to decrease inflammation and pain to the plantar fascia. Again, this technique need time to be evaluated to truly see if it works.

At this time, the overall most successful treatment for heel pain and plantar fascia is conservative care. Over 90% of heel pain responses to taping, icing, stretching, orthotics, injections, night splints and proper shoes. For those who do not responded to conservative care, other more proven treatments are used. These are the traditional plantar fasciotomy, endoscopic plantar fasciotomy (EFP), high energy shock wave therapy (ESWT), and Topaz plantar fascitomy which utilizes radio frequency waves to stimulate healing.