Heel Pain Center

The Heel Pain Center is a nationally-recognized leader in the treatment of heel pain.

There are many methods in treating various forms of heel pain, but one of the most exciting to become available in recent years is Extra-corporeal Shock Wave Therapy (ESWT), a non-surgical alternative for the treatment of foot pain associated with plantar fasciitis. Experts now say that New Shock Wave Therapy is an alternative treatment before resorting to surgery, which has a lengthy recovery time and carries the risk of complications. Shock wave therapy has been used since the early 1980's for the treatment/break-up of kidney stones. The application of shock wave therapy to soft tissue body parts continued in Europe in the 1990's and has recently received FDA approval in the U.S. Dr. Michael Horwitz is a member of the American College of Foot and Ankle Surgeons and is certified to deliver this treatment.

During the treatment, shock waves are focused on the point of maximal tenderness on the heel as it is bombarded with high intensity sound waves. Patients do not feel any pain because the area is anesthetized with local anesthesia. The theory is that the sound waves break up the scar tissue and inflammation, which allows normal healing tissue to repair the injury and alleviate the pain.

The ultrasound imaging system provides a live ‘picture’ of the inside of your foot to indicate the exact treatment site where shock waves are being delivered. The shockwave therapy system produces the actual shock waves, which are delivered outside your body through the therapy head’s water-filled cushion. The therapy head is attached to the end of an arm-like device on the system. This articulated arm moves easily so that the therapy head can be lined up closely to your foot.

The Doctors at The Heel Pain Center are among the handful of Podiatric Surgeons in Missouri who are trained to perform this innovative new procedure. Patients resume normal activity and wear regular shoes the day after the procedure.

Shock wave therapy is not for everyone and should not be used on people with bleeding problems, those taking medication that interfere with blood clotting, or for children or pregnant women. The therapy cost is covered by many of the major insurance companies.

The Podiatric Physicians at The Heel Pain Center like the fact that the treatment is low risk and noninvasive. In studies in Europe, when shock wave has been administered for over 10 years, patients with chronic plantar fasciitis rated a 80% successful outcome with just one treatment. More recent studies show an even higher success rate.

Achilles tendonitis and spurs have a non-surgical treatment that works.

If you have pain in the back of your heel and are thinking about having an invasive surgical procedure - STOP.

There is a proven treatment that works for permanently relieving the pain using sound waves.

The sound waves actually are shock waves and now using the same technology that dissolves kidney stones, your heal can be treated in one 20 min treatment.

This technology is proven. With literally 100's of articles that support cure rates of 70 to 95% published in the past 10 years, there is no disputing this technology and its results.

How does it work?

The machines produce high intensity shockwaves that are delivered into the back of the heel. In a single treatment session, 3200 shocks are delivered. The patient does not feel pain during the treatment. (local anesthesia is used) The treatment takes 20 min. The patient walks out of the office and can walk normally the next day in regular shoes.

What is happening here?

The Achilles tendon hurts when too much stress is put on it. Stress can come from overuse, or lack of stretching resulting in tightness of the tendon. The pain can exist at the insertion of the tendon or slightly higher. In either case, a spur can be located at the insertion. An x-ray can be used to see if you have a spur.

What does it mean if you have a spur?

Spurs are a sign that there has been excessive pulling on a bony insertion over a long period of time. Sometimes spurs are very large and sometime small. Sometimes spurs are located on the bottom of the foot and the back of the heel. This is because a tight Achilles tendon can pull back on the heel helping to actually create plantar heel pain (plantar fasciitis) and sometimes flattening the foot.

Stretching can help, but this often aggravates Achilles tendonitis.

Resting can help and should be tried as a conservative treatment.

Is there any other NEW treatment that can help this problem?

YES

PEMF pads are electromagnetic therapy pads that can be worn at night or during the day. These really work well at improving blood flow.

Is there any NEW surgical information or alternatives?

YES

The Endocspic Gastrocenemious Recession is fast becoming a procedure of choice for the treatment of Achilles tendonitis and plantar fasciitis in patients with over tight leg muscles. Often, the tight gastroc is overlooked by the foot professional at a primary cause of foot deformity and pain. Testing for this is very simple: dorsiflex the foot with the knee extended. If you do not have at least 10 degrees of dorsiflexion, then you are tight.

The EGR is simple to perform (less than 15 min) and is done under local anesthesia. It is performed through two very small 1 cm incisions in the back of the leg. As an endoscope is place into one of the incisions, a special blade is used to separate the aponeurotic band that joins the gastroc muscle to the tendon. See Photo.

The advantages are numerous: small incisions. Fast healing time to most activities in 3 weeks. Walking right away in surgical boot for 1-2 weeks and then tennis shoes.

Many other biomechanical advantages are obtained with EGR surgery. These include less forefoot pain, slows down deformity of forefoot bunions and hammertoes. Improves many forms of flat foot.

The EGR is now performed in place of Achilles tendon lengthening procedures closer to insertion. This is because of the lengthy healing time (6 months) for the Achilles tendon and increased risk of post op traumatic tearing with procedures performed close to the insertion.

Can the ECSW non-invasive shock wave procedure cure Achilles tendonitis without surgery?

YES

The ECSW is much better at treating insertional tendonitis vs high tendonitis. But it does work for tendonitis. See illustration for identification of high tendonitis vs insertional tendonitis.

What type of person usually gets insertional tendonitis of the Achilles?

Usually heavier people with have larger spurs on the back of the heel. But many different body types have this problem.

Why Feet for Life Centers?

Dr. Michael Horwitz performes more of these procedures than anyone in the Midwest. Averaging 5 EGR's a week on children and adults. Knowing what to look for and how to perform this procedure non-traumatically takes practice. Dr. Horwitz is a true leader in the treatment of heel pain. Feet for life Drs have performed over 450 ECSW procedures in the past 5 years and lead the country in the treatment of heel pain with this modality.