Seattle’s Heel Pain Specialists – Effective Relief of Plantar Fasciitis and All Types of Heel Pain

Dr. Huppin and Dr. Hale are experts in the effective treatment of heel and arch pain. Pain in the heels and arches is the most common problem treated in our clinic and we have become the regional referral center for treatment of even the most difficult and longest lasting cases of heel pain. We are usually able to help patients who have already seen numerous other practitioners.

Since heel and arch pain is such a pervasive complaint, a decade ago we established a specific protocol based on the best available research, to address the needs of our patients suffering from this ailment for months and even years, without relief. There’s no need to suffer this ongoing pain when most heel and arch issues respond to a properly prescribed and conservative treatment plan.

Anyone suffering from plantar fasciitis or other causes of heel or arch pain is a candidate for our Heel and Arch Pain Protocol and we even have specialized protocols for patients with special needs including:

  • Patients with previous treatment failure
  • Athletes
  • Arthritis patients
  • Pregnant patients
  • Children

If you are suffering from heel pain, contact us today for an appointment in our Seattle foot and ankle clinic.

Plantar Fasciitis: The Most Common Cause of Heel and Arch Pain

The most common cause of heel and arch pain is a condition called plantar fasciitis, although there are many other causes of heel pain. Plantar fasiitis is an inflammation and/ or degeneration of a thick band of tissue that runs along the arch of your feet from your heel to your toes and aids in stabilization of your arch while you walk and run. Symptoms involve two areas – the arch and the inside heel area (the latter being the more common). It can cause severe pain, especially in the morning when you get up. Common symptoms of plantar fasciitis include:

  • Pain in the morning when you first get out of bed.
  • Pain and stiffness when you start to walk after sitting for a while.
  • Increasing pain in your heel or arch towards the end of the day.
  • Tired feet at the end of the day.

Other causes of heel and arch pain include nerve entrapment (Baxter’s nerve), inflammation of the fat pad, arthritis, infection, fractures and sprains or even certain systemic diseases. Due to Because of the multiple possible causes, you should see your podiatrist for a thorough evaluation if you are experiencing heel or arch pain.

Plantar Fasciitis Treatment Goals: Pain Relief and Preventing Recurrence

Our goal is to provide relief as rapidly as possible that will be long lasting using the most conservative treatment option possible and that will prevent the pain from coming back. Because there are many underlying causes of heel and arch pain, the first thing we do is evaluate the cause of your pain and then develop a program to get you back to full activity as soon as possible. When treated correctly, surgery is almost never necessary. We can’t emphasize that enough – surgery is almost never necessary to treat heel pain. If it has been recommended that you have surgery, see us for a second opinion first.

Both Dr. Hale and Dr. Huppin are experts in diagnosis and treatment of foot and arch pain using including conservative treatments such as specialized orthotics for plantar fasciitis and Shockwave Therapy. Surgical options are available if all conservative treatments fail, but both doctors emphasize exhausting conservative treatments before considering surgery.

Our Heel Pain Treatment Protocol Explained

Although plantar fasciitis is the most common complaint of patients in our clinic, we find that well over 99% of the time it responds well to our specialized treatment program. Surgery is almost never required. Our treatment program focuses on three main areas:

  • Identify the underlying case
    We will discover the underlying cause of your heel pain and devise a personalized treatment plan to not only relieve your pain in the short run but also prevent it from reoccurring. We will evaluate your feet, walking pattern (gait), shoes, activities, exercise methods and other relevant information and then devise a treatment plan unique to you.
  • Reduce tension on the plantar fascia
    Many studies have shown that the most common underlying cause of plantar fasciitis is tension on the plantar fascia. These studies show that foot orthotics that conform extremely close to the arch of the foot are the most effective method to reduce tension on the plantar fascia. These are called “total-contact orthotics”. Some patients will do well with quality prefabricated orthotics and others require custom orthotics. We will help you find the most effective orthotic for your condition at the least cost.
  • Relieve the inflammation/degenerative changes
    We want to relieve your pain and get you back participating fully in the activities you enjoy. To this end, we try to relieve the inflammation/degenerative change which is causing your pain. This may involve exercises, physical therapy, anti-inflammatory medications, heel cups, over the counter arch supports, custom total contact orthoticsor a combination of these therapies.

Non-Invasive Treatment Options for Stubborn and Persistent Heel Pain

For cases of arch and heel pain that do not respond to our standard treatment protocol, we have two options to help you avoid surgery:

  • Shockwave Therapy – This is a well-studied non-invasive, non-surgical treatment option for intense, persistent heel pain associated with chronic plantar fasciitis. Read more about shockwave treatment.
  • Percutaneous Ultrasound Guided Approach to Plantar Fasciitis – This procedure is known as “dry needling” and has been shown in some studies to have a 95% success rate for patients with stubborn pain. It involves numbing your foot and then irritating the plantar fascia to cause minor bleeding which encourages healing. Read more about dry needling treatment.

Effective Treatment for Morning Heel Pain

Do you wake up in the morning and have sharp, stabbing pain in your heel? This is a common complaint we hear at the Seattle Heel Pain Center. Pain first thing in the morning is a very common problem and occurs most often in people suffering from plantar fasciitis and other types of heel pain. The heel pain usually occurs when you first get out of bed and lasts from just a minute or two up to half an hour. The pain may also occur after sitting for a period of time.

Morning heel pain is a sign of inflammation in your heel due to plantar fasciitis or another heel condition. When you walk around during the day, the act of walking and muscles contracting and pressure from the ground pressing on the heel acts like a massage and prevents inflammation from building up in the heel. But if you lay down at night or sit down for a while during the day, you stop doing those actions that prevents this build-up.

Once inflammation builds up and you stand again, you get a sharp pain in your heel from inflammatory fluid in the area. After you walk around for a few minutes, the inflammatory fluid is pumped out of the area and you feel better – at least for a while. Our goal is to determine the exact cause of your pain, develop a treatment plan that will cure the problem, relieve your pain and prevent the problem from returning. Even if other podiatrists have failed to help you, we can likely help you to be pain-free.

Conservative Treatment Options First: Surgery Should be the Last Resort for Treatment of Plantar Fasciitis

When treated correctly, surgery on the heel is almost never necessary. In fact, we advise you not to let anyone perform surgery on your heel unless you have seen us first for a consultation. There are rare cases of arch and heel pain which do not respond to conservative treatment. If surgery should be necessary, we will provide you with comprehensive, state-of-the-art care. You should, however, always give conservative treatment at least 6 months to work. Conservative treatment should include several of the following: total contact foot orthotics, proper stretching, walking boot, night splint, taping, home therapy, dry needling, anti-inflammatory medications, exercises and shoe recommendations.

A Second Opinion You Can Trust for Your Heel Pain

If you have chronic heel pain that isn’t responding to treatment with your current doctor or if invasive treatment such as heel surgery has been recommended to you, make an appointment to see our doctors at the Seattle Heel Pain Center for a second opinion. Second opinions are always a good idea to help ensure you have all the information necessary to ensure you are able to cure your heel pain. Even if we agree with your current course of treatment, we can usually provide some additional insight to help you heal quicker and prevent the heel pain from returning.

Your second opinion appointment will include:

  • Complete medical history and examination
  • In-depth evaluation of any orthotics or arch supports
  • Shoe evaluation
  • Detailed and easy to understand explanation of our findings and treatment options
  • Recommendations on a specific treatment plan

When you come to your second opinion, please bring with you:

  • Any current foot x-rays
  • Current CT, MRI or bone scans of the feet along with the radiologist’s report
  • Notes from current and past foot specialists who have treated your heel pain. You can download a records request form here and fax it to your doctor(s).
  • Orthotics and / or arch supports
  • A sample of shoes you usually wear
  • A written summary from your perspective of your treatment so far can also be helpful

After a complete history and evaluation, we will provide you with all of the available options for treatment of your heel pain, whether it is due to plantar fasciitis or another condition. Our opinions are based on the latest research on heel pain and our own experience over the past 20 years. Contact us today for an appointment at the Seattle Heel Pain Center.

FAQs About Plantar Fasciitis / Heel Pain and Treatment Options

How long will it take for my heel pain to get better?

The most common cause of heel and arch pain is plantar fasciitis. We find that plantar fasciitis is often not treated correctly or is under-treated, leading to a problem that lasts months or years longer than it should. When treated correctly, most patients start to see significant relief within several weeks. In order to achieve the most rapid relief, we will develop a treatment plan designed specifically for your feet. The sooner treatment is started, the easier the problem is to treat.

What causes plantar fasciitis?

It is usually the result of faulty biomechanics (walking gait abnormalities) that place too much tension on the plantar fascia, causing inflammation and pain. Themost common cause of this increased stress is a condition known as “over-pronation” which means that your feet roll inward too much when you walk. As they roll inward, the arch of the foot flattens and the arch lengthens increasing tension on the plantar fascia.

What is involved in treating plantar fasciitis?

Plantar fasciitis occurs when the foot flattens too much, leading to a lengthening of the arch and increased tightness in the plantar fascia. Our first mission is to reduce the tightness in the plantar fascia. If this does not happen, treatment will likely fail.
Step 1: Decrease tightness on plantar fascia

  • By ensuring you are wearing the correct shoes (bring some sample shoes with you to your appointment)
  • By using custom or prefabricated orthotics to support the arch
  • By using special taping or a “walking boot” to allow the painful area to rest for a couple weeks

Step 2: Reduce inflammation/degenerative changes and pain

  • By using ice
  • By prescribing prescription or over the counter anti-inflammatory medication
  • By administering steroid injections with needling
  • By prescribing physical therapy

Step 3: Prevent the pain from returning

  • Using custom orthotics or OTC arch supports

Can orthotics relieve my arch and heel pain?

Studies have shown that custom foot orthotics were effective both short-term and long-term in treating pain from plantar fasciitis, stating that “..foot orthosis is the best choice for initial treatment of plantar fasciitis.”1-3 Also, a 1997 study showed conclusively that orthotics should be prescribed with very specific wedging for the best results.4

How do orthotics help treat plantar fasciitis?

It is critical to support the arch and prevent it from collapsing to avoid continued tension on the plantar fascia and ongoing pain. Several studies have shown that the most effective way to accomplish this is to use custom foot orthotics that conform extremely closely to the arch of the foot.5-6 These are known as total contact orthotics. Many, if not most, of typical orthotics fail to completely eliminate the problem because they do not hug the arch of the foot tightly enough.
This lets the foot flatten and increases tension on the plantar fascia. We see many patients come into our office who have had orthotics made that simply do not provide enough support to cure plantar fasciitis. Dr. Hale and Dr. Huppin are both experts at prescribing, casting and troubleshooting all foot orthotics, including total contact foot orthotics. Comfort of your orthotics is 100% guaranteed.

Will prefabricated orthotics help my arch and heel pain?

Although custom orthotics, if correctly made, work the best to reduce tension on the plantar fascia, not every patient requires a custom orthotic for pain relief. Many patients will do fine with a prefabricated arch support. We will help you determine the best choice for your feet

How do custom orthotics help with plantar fasciitis?

In more difficult cases of plantar fasciitis, you may have custom functional orthotics prescribed for you. Research indicates that in cases of mechanically induced heel and arch pain the most effective treatment is quality prescription orthotics. Orthotics for plantar fasciitis are prescribed specifically to help take tension off of the plantar fascia.

In order to ensure best outcomes we first perform a detailed examination, including slow motion video analysis, of how you walk and how your big toe joint works. A laser mold of your foot is then taken in a very specific position and the orthotic devices are prescribed in a manner to ensure best function of your feet.

Dr. Larry Huppin and Dr. Doug Hale are specialists in orthotic therapy and teach orthotic therapy to other doctors at seminars throughout North America. We take great pride in providing our patients with the best possible orthoses for their particular problem. Quality of orthotic devices varies considerably and depends on many factors. We guarantee our patients that their orthoses are the finest quality and biomechanically accurate.

Trust the Experts at the Seattle Heel Pain Center of the Foot and Ankle Center

Plantar fasciitis and other causes of heel pain are the most common conditions treated in our Seattle clinic and the experts at the Foot and Ankle Center in Washington can offer you rapid and long-lasting relief from your heel and arch pain. Each type of heel pain has its own treatment protocol. Because it’s such a common complaint, we’ve devoted an entire division of our practice – The Seattle Heel Pain Center – to treatment of all types of heel pain.

We are the regional referral center that other doctors use for their patients with the most stubborn heel pain. We have a special interest in treating patients who have not had success with treatment from other doctors and therapists. We have a better than 95% success rate and can usually cure even the most long-lasting heel pain. Don’t live with heel pain. Most patients see relief within just a few weeks. Make an appointment now to see us in our Seattle office.

Medical Literature on Orthotics for Plantar Fasciitis

1JE Martin, JC Bosch, WP Goforth, et al, “Mechanical Treatment of Plantar Fasciitis,” Journal of the American Podiatric Medical Association, 91(2) (Feb 2001): 55.
2KB Langdorf, Am Keenan, RD Herbert, “Effectiveness of Foot Orthoses to Treat Plantar Fasciitis.” Archives of Internal Medicine, 166 (2006): 1305.
3E Roos, M Engstrom, B Soderberg, “Foot Orthoses for the Treatment of Plantar Fasciitis,” Foot & Ankle International, 27(8) (2006): 606.
4G Kogler, FB Veer, SE Solomonidis, “The Influence of Medial and Lateral Placement of Orthotic Wedges on Loading of the Plantar Aponeurosis,” Journal of Bone and Joint Surgery, 81A (1999): 1403-1413.
5PR Scherer, et al, “Heel Spur Syndrome, Pathomechanics and Non-surgical Treatment,” Journal of the American Podiatric Medical Association, 81 (1991): 68-72.
6WP Lynch, J Goforth, R Martin, R Odom, et al, “Conservative Treatment of Plantar Fasciitis, A Prospecitic Study, Journal of the American Podiatric Medical Association, 88 (1998): 375-380.Prospecitic Study, Journal of the American Podiatric Medical Association, 88 (1998): 375-380.

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