try a night splint instead of a steroid injection for heel painIn my Houston podiatry practice, I see a lot of patients who are experiencing heel pain. Heel pain is most often caused by plantar fasciitis, which is also known as heel spur syndrome. Plantar fasciitis is a painful inflammation of the ligament that extends from the heel to the toes. In other instances, pain in the back of the heel may be due to an inflammation of the Achilles tendon.

How Heel Pain Manifests

Heel pain can begin very intermittently, but, over time, become more consistent, more intense, and can even spread to the other foot.  For this reason, early intervention is best when it comes to treating heel pain.

There is some good news when it comes to heel pain: plantar fasciitis generally responds well to conservative, non-surgical treatment, including stretching exercises, medications, padding and strapping, orthotic devices, night splints, and physical therapy. In fact, a recent study in the Washington Post showed that plantar fasciitis patients being treated with non-invasive exercises were 1.6 times more likely to be cured than those patients receiving cortisone injections! So that means you probably won't need a steroid injection for heel pain. As long as you come in to see me early on in your pain journey. 

What About CBD for Heel Pain?  CBD or steroid injection for heel pain

I love how CBD can help your feet feel better. In fact, that's why I carry the CBD-infused ModPod line of foot care products in the office. (The Soothe CBD stick is a great choice if your feet are tired and sore at the end of a long day. But can these products heal your plantar fasciitis pain? 

First, let me give you a quick review. CBD is one of over one hundred active chemicals we find in cannabis plants. Unlike THC, another cannabis extract, it can't make you high and it is legal to use. (As long as your extract has less than 0.3% THC concentrations.) Now, why do people like CBD for heel pain? Well, this compound seems to have anti-inflammatory properties. So it could help address the inflammation that's causing your discomfort.

Still, I'm a science guy. And the research is mixed when it comes to CBD's ability to cure heel pain. For that reason, if you want to manage plantar fasciitis more naturally than with a steroid injection for heel pain, I'll probably steer you away from CBD. And I'll let you know more about the regenerative medicine treatment options I now offer in the office. 

Steroid Injection for Heel Pain: What the Research Says

Many of our patients come into the office wanting a quick-fix for heel pain. And, if they've had a steroid injection in the past that made them feel better? That's the go-to request. But here's a little fact that you may find surprising. This study followed 180 adults with heel pain caused by plantar fasciitis. Some of them were given exercises to speed recovery. Others wore a heel cup. And still others got a steroid injection for heel pain. But guess what? At the end of the study period, there was no clinically measurable difference in the recovery achieved by patients in each group. And that suggests there are better ways to treat your heel pain. Including...

PRP Injections: Can They Help Your Heel Pain?

Recently, I've been giving a different kind of shot to help my patient's heel pain. It's called a PRP injection for Plantar Fasciitis. And it really works! In fact, a recent study comparing PRP and steroid injections for heel pain proved that fact. Because, in the weeks following treatment, PRP patients had thinner plantar fascia than patients who received steroid injections. And that matters, because a thicker band of tissue is a classic plantar fasciitis symptom. 

Clearly, PRP relives heel pain. But it does so very differently from a steroid injection. Now, just like a corticosteroid shot, I deliver PRP treatment with an injection into your injured plantar fascia. But treatment actually begins before the shot, when I draw your blood and spin the sample in a high-speed centrifuge. This process separates your blood, allowing plasma to rise to the top of the vial for easy collection. Once that happens, I draw this portion of your blood into a syring and prepare your injection.

But why does your plasma help resolve heel pain at a faster rate? Here's the deal. This portion of your blood is packed with platelets. (Those are special cells that contain growth factors to fuel faster healing.) When we inject your injured tissue with PRP, it speeds up tissue repair naturally. Plus, the platelets recruit other reparative cells to help them out. The result? A shot for heel pain that delivers faster results. Without injection foreign substances in your body. Instead, it simply supports and boosts your body's ability to heal itself. 

Why You Can't Leave Heel Pain Untreated

As we've just explored, the pain of plantar fasciitis should resolve with proper, minimally invasive treatment; the healing process may be slow, but the problem does eventually improve or go away completely. But, for some patients, their heel pain is not reflective of plantar fasciitis—it can be the symptom of a far more serious problem.

Why is that the case? Well, let's get back to that study I mentioned at the beginning of this post. Remember, Dr. Rick Positano's research gave us a sweeping study on heel pain. And, after looking at the feet of 175 people who had been diagnosed with plantar fasciitis, 34% of those people actually had a torn ligament.

Now, that's scary enough on it's own, but the facts get even worse if we keep digging. How could that be, you wonder? Well, another 15% of those 'plantar fasciitis' patients actually had a type of benign growth known as a plantar fibroma. And, though neither condition is life threatening, they should each be treated very differently. In fact, a wrong treatment could actually make some of the conditions worse. (For example, doing plantar fasciitis stretches on a torn ligament will only exacerbate the injury.)PRP injection for heel pain vs steroid injection for heel pain


Injection for Heel Pain? Treating Plantar Fasciitis in Houston, TX 

When you see study results like that, you’ll understand why I always begin heel pain treatment with a diagnostic exam. Even if I think I know what's causing your pain, I want to ensure that I treat the correct injury. Then, only after securing an accurate diagnosis do I begin working towards a repair. And even after that, I start with the least invasive treatment possible for my patients. It is only if conservative treatment fails that I will try more invasive procedures, like injections or shockwave therapy, to reduce heel pain. What’s great about shockwave therapy for heel pain is that it aids in eliminating the inflammation of plantar fasciitis without surgery. As a result, only a very small percentage of patients in my practice require surgery to resolve their heel pain.

As with almost every foot condition, early treatment will make a huge difference in the types of therapies that will be effective for your treatment plan. If you are experiencing heel pain, schedule an appointment with Dr. Andrew Schneider today!

Dr. Andrew Schneider
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A podiatrist and foot surgeon in Houston, TX.