What is the best orthotic for me?

Well, let's start by first explaining what an orthotic is and is not. An orthotic is a device you put in your shoe that helps to balance and stabilize your foot so that it can function normally. I often say that orthotics are like "glasses for your feet."
Now when it comes to orthotics there are many products that are called orthotics. The reality is a $10 gel insert you get at the grocery store IS NOT an orthotic. It is a foot cushion. All it does is add a thin layer of cushioning to your foot. If you happen to be a very frail elderly person or if you are on long-term steroid medication, you may need this. Most people do not need a gel insert. Don't believe the advertisements.
Bottom line, if the product you buy is soft enough that you can bend it with your hands or wring it out like a dish towel, it is not going to help you.
If you have foot pain, specifically heel pain, you probably need a functional foot orthotic. This is a product made of durable plastics. You can not bend an orthotic with your hands. The job of an orthotic is to change the position of your foot while you walk. In order to that is must be able to stand up to your weight. I weigh 195 pounds. There is no gel or pad or cushion that can possibly hold up to my weight step after step.
In order for a hard plastic device to be comfortable it must be custom made to your foot. If any of you wear contact lens you know that you really don't feel them after a short adjustment period. Think about it, you are putting a piece of plastic IN YOUR EYE! That does not sound comfortable, yet I have worn them for years with no problems. Orthotics are the same way. Because they are custom made to your foot they fit perfectly. Thus you don't even know you are wearing them after a short adjustment period.
OK, so what is the cost for a pair of orthotics? Well, it varies but you can expect to pay somewhere between $400 and $600 dollars for a custom pair of orthotics. The good news is they will probably last you 3-5 years and THEY WORK.
Bottom line, you can get $3 dollar glasses at the drug store but they will only help you if you need a little magnification. The same goes for orthotics. If you all you need is a little extra padding try the over the counter products. If your feet hurt every day, if you feel that sharp shooting pain in your heels when you get out of bed in the morning, you need a custom orthotic.

Dedicated to your health,

Craig Conti, DPM
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

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.

Brother with Heel Pain

Well, my brother is dealing with heel pain. He has had one injection, taping, night splint, icing, stretching, and Aircast Air Heel. Initally there was some relief but he over did with excessive standing and walking and using a shovel to did some holes. So now he has had an additional injection,taping, and casted for orthotics. He is also taking Aleve daily. If no improvement after 4-6 weeks, he may consider having surgery. The surgery he is looking into involves using RF (radiofrequency) technique using the Topaz unit. Recent articles are showing that chronic plantar fasciitis is very difficult to treat with the traditional methods and that RF may be the answer for those very resistant cases.

Children and Heel Pain

Just wanted to talk about children with heel pain for a second. We see many kids come into our practice complaining of heel pain. Most of the time it is "simple" calcaneal apophysitis or Sever's disease. This an inflammation of the growth plate at the heel. Getting the correct diagnosis involves a good history as well as xrays and possible diagnositic ultrasound. Treatment can be as easy at ice, stretching, change in shoe gear, NSAIDS, heel cup and rest. Consult your pediatrician or podiatrist for further evaluation and treatment.

Welcome

Welcome to Sarasota Foot Care Center blog on heel pain. Heel pain is one of the most common complaints we see in our practice. There are many causes of heel pain and along with that, many ways to treat heel pain. At Sarasota Foot Care Center , we utilize the latest diagnostic techniques and therapy, from in office xray and diagnostic ultrasound to high energy shock wave. Conservative care is the hallmark to initial treatment which may include strapping, padding, night splints, orthotics and injections. Each patient is individually evaluated and treatment is specific to that person. We look forward to sharing this blog with you.