So you’ve tried the 9 home remedies… but what if you’re still not better?
It’s time to seek professional help from a podiatrist. If you wait too long (say, after three months) to see a doctor, plantar fasciosis can set in. It’s always more problematic to treat dying cells than ones that are just inflamed and healing is virtually impossible in this case without professional medical assistance. If the self-treatments fail to improve your condition after a month or so, go see a foot doctor right away.
Your foot doctor normally goes through these steps for your diagnosis.
1. MEDICAL HISTORY
Your foot doctor will note your symptoms, such as where the pain is and what time of day your foot hurts the most. Be prepared to answer questions about your medical history and daily activities as well. These give your foot doctor more clues to help figure out what is really wrong with your heel and suggest immediate changes to your routine, if necessary.
Your foot doctor will then check your feet, examine how you stand and walk, and also look at your structure, specifically for misalignment. If you have a thin heel pad, the heel bone can easily be felt and it may hurt when the doctor presses on it. Another thing a doctor will look for is a tight calf muscle (or equinus).
Before any testing is done, the doctor will probably check the level of blood flow into your feet and for signs of nerve entrapment in and around the heel.
Diagnostic Ultrasound: A professional examination should include a high-resolution, diagnostic ultrasound of the heels.118 With ultrasound, a doctor can determine the thickness of your plantar fascia (which normally is 4 millimeters thick, as opposed to 7-8 millimeters when afflicted with plantar fasciitis). To monitor a patient’s progress, I use ultrasounds once every 4-6 weeks. Look for a doctor who uses ultrasounds to evaluate your case.
IV. NON-INVASIVE VS. INVASIVE PROCEDURES
Professional treatments are separated into non-invasive and invasive categories. Like the 9 home remedies, there are generally 9 solutions used by doctors to treat heel pain. Remedies #1 – #5 are non-invasive, meaning a procedure that does not involve entering the body. The next four methods (#6 – #9) entail injections and surgery.
Your initial treatments typically consist of: custom orthotic devices, taping, prescribed anti-inflammatories, stretching exercises, and physical therapy.119 Your foot doctor should offer a comprehensive and gentle plan for the best recovery.120
V. IT MIGHT NOT BE PLANTAR FASCIITIS/FASCIOSIS!
If the 9 home remedies haven’t worked for you, it is quite possible that you do not have plantar fasciitis or heel pain, but some other condition, such as a stress fracture, tumor, bone cyst, nerve entrapment, or arthritis!
1. Stress Fracture
The heel bone is a “sponge” bone; it needs to absorb shock so, like an egg, it has a hard shell on the outside, but is soft on the inside. Therefore, if you put a tremendous amount of pressure on the heel it could crack inside, causing a stress fracture. This happens most frequently to people who experience a sudden increase of intensity in their activity; just like a soldier marching 10-15 miles a day when he’s never marched that far before. You need a bone scan and/or MRI (magnetic resonance imaging) to confirm a stress fracture.
2. Tumor or Bone Cyst
A bone tumor is an abnormal growth within the bone, while a bone cyst is a hollow or less-dense area that is clearly demarcated. Both of these can attribute to the cause of heel pain.
An MRI is helpful in sorting this out and other difficult problems in the heel and foot. Whereas x-rays only show the bones, an MRI reveals details like soft tissues, joint integrity, and bone density. An MRI is able to take layered photos, so you can explore the structure of the foot.
Consult a foot doctor in your area for more information on heel pain and other foot ailments, such as Charcot foot, bunions and more.