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Sunday, February 4, 2024

Plantar Fasciitis, Heel Spurs, Running Shoes, Arch Supports and Custom Orthotics #HeelPain #HeelSpur #PlantarFasciitis


Heel Spurs and Plantar Fasciitis



I am a Podiatrist who happens to have suffered from heel spurs and plantar fasciitis in the past. I know first hand how painful it is. Plantar fasciitis is a common, painful problem. Heel spurs are associated with plantar fasciitis. Patients describe the pain as sharp or stabbing and it is generally worse when you first get up in the morning. After taking about 10 steps, it eases up. But it always comes back after any rest and can be much worse with activity, standing in one place, like at the kitchen sink, or at the end of the day. The pain can be covered up by oral anti-inflammatory medicines like Naproxen, Motrin or Mobic, but the relief is temporary and my have side effects like stomach pain, stomach ulcers or kidney damage. Diabetic patients tend to be more susceptible to side effects and should avoid long term use of this class of medication. For some patients, stretching, Physical Therapy, local cortisone injections and custom orthotics may provide long term relief. But steroid injections make blood glucose numbers rise and should be avoided in patients who are diabetic. As a last resort, surgery is an option, as long as general health is good and there is adequate circulation to allow healing.
Assessing the patient's shoes first is a good starting point, making sure they are getting the basic support they need.  Naturally, they look to see which shoes I'm wearing. My feet are not necessarily the same as theirs, but I wear Saucony brand  or Brooks running shoes for various reasons. One is the price. They have quality shoes that vary in price from under $60.00 to over $200.00.  The Brooks shoes tend to be slightly more expensive than the Saucony brand. The more expensive styles are geared for competitive runners and are not necessarily what the average person wants, needs or can afford. Regardless, they are all well made and provide good cushioning, stability and support. They come in a wide range of colors and styles that are attractive and functional. They all come with a removable insole known as a sock liner that can be replaced by either an over the counter arch support or a custom orthotic without making the shoe feel tight. Power Step arch supports are a good choice. They are in the range of $50.00 a pair and come in a variety of styles for the different arch heights, from flat feet to high arches. 
Custom orthotics, made by a Podiatrist, who will either take a mold of your feet or do a digital scan, will last much longer. Since they are custom made, they are more expensive, but may be worth it if the cheaper arch supports helped but not completely. I prefer the mold technique because it captures your foot in a functional position rather that at rest, sitting in a chair with your feet up. Custom orthotics cost $400.00 to $500.00 dollars, but will last for many years. I have just one pair I wear for work, golf, running, walking and just day to day comfort. They are now 20 years old and have never been refurbished.  To me, that's a pretty good investment.
If you do develop heel pain that is not going away by itself, do yourself a favor and make an appointment with a Podiatrist near you. X-Rays will be taken to make sure that is no stress fracture or tumor in the bone. The sooner you get evaluated the better chance you have of avoiding long term pain that interferes with your day to day activity and lifestyle.