The Advanced Heel Pain Solutions
the complete guide toHeel Pain
Non-Surgical Heel Pain Procedure!
- no casts
- no crutches
- walk immediately after procedure
Shock Wave Therapy for Heel Pain
Improved Shock Wave Therapy
Shock Wave Therapy has a long history of being an alternative treatment for plantar fasciitis before resorting to surgery, which has a lengthy recovery time and carries the risk of complications. The Podiatric Physicians at Feet For Life 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. Currently, the Epos Ultra and Medispec provide a treatment modality that is more accurate and cost effective than competitive machines.
Important: See our video describing how we use EWST in combination with minimally invasive surgery to cover the critical factors necessary for success.
The video covers:
• How and why we use ESWT.
• How we accurately diagnose fasciosis (thickening of the plantar fascia) with Ultrasound.
• How we treat Baxter’s Neuritis with cyro. This inflamed nerve is often present with chronic heel pain.
• How we treat the tip of the plantar spur with FAST wand aspiration. This treats the most painful areas without the painful and lengthy recovery.
• In 30 years we have treated 1000’s of patients with these techniques and collected great reviews and success stories.
What Equipment Do We Utilize?
The Feet For Life Centers own the most proven and effective Extracorporeal Shock Wave Therapy (ESWT) machines. Dr. Horwitz has led the country in ESWT research along with Dr. Wolfgang Shoden in Germany. This began 25 years ago with his early acquisition of a Dornier Epos Ultra ESWT. Dr. Horwitz that performed 1000’s of ESWT treatments on achilles tendon, sesamoid pain, fractures and of course plantar fasciitis patients. Many problems commonly treated with surgery can now be treated effectively with ESWT, which is similar to the shock wave treatment that has been used for years to break up kidney stones (lithotripsy).
In fact, heel pain treatment without surgery is a reality and ESWT is far preferable to surgical treatments for Plantar Fasciitis and Dr. Horwitz is certified to deliver this treatment. He is Board Certified in foot Surgery by the American Board of Podiatric Surgery and a member of the American college of Foot and Ankle Surgeons.
Two of the machines used by Dr. Horwitz are the Dornier Epos Ultra, manufactured in Germany, and the Medispec ESWT, from Israel. Both devices represent the latest in FDA approved non-surgical options for treating plantar fasciitis in adults who have been treated by other methods, but have had little or no relief.
Extracorporeal Shockwave Therapy (ESWT) is a U.S Food and Drug Administration (FDA) approved non-invasive, non-surgical treatment option for intense, persistent heel pain associated with Achilles tendonitis and chronic plantar fasciitis.
What Are The Causes Of Heel Pain?
Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst.
Because there are several potential causes, it is important to have heel pain properly diagnosed. Our foot and ankle surgeona at Feet For Life are able to distinguish between all the possibilities and to determine the underlying source of your heel pain.
Please watch our videos on our YouTube channel:
What Conditions Can Be Treated?
Plantar Fasciitis — Plantar Fasciitis is one of the most common causes of heel pain. It causes a stabbing pain in the heel, usually happening when you wake up. Once the foot is warmed up the pain usually gets better, but it can return.
Plantar Fasciosis — Plantar Fasciosis has similar symptoms to Plantar Fascitis but it is caused by the degeneration and thickening of the plantar fascia. We offer a wide variety of treatment options for this as well.
Achilles Tendinitis — Achilles tendonitis is an inflammatory, acute, repetitive stress injury of the Achilles tendon, commonly affecting athletes and active individuals.
Achilles Tendinosis — Achilles tendinosis is a persistent or even chronic condition which lasts more than a few months and involves pain at the back of the ankle along the Achilles tendon.
Am I A Good Candidate?
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.
Since not all patients have insurance coverage, we offer the most competitive prices in the country for treatment of plantar fasciitis with the Epos Ultra.
Non Surigcal Approach to Plantar Fasciitis
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. 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.
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 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.
Once the process is complete, it renews blood supply to that part of your body and then your body takes over and does the rest by healing from the inside out! We have found that this treatment is 90% effective in relieving persistent heel pain. Those suffering from pain in the arch of their foot or their heel or have an established diagnoses of plantar fasciitis or Achilles tendonitis are candidates for this treatment.
Heel Pain: The Latest Answers
To best understand our Heel Pain Center, please read the following article by Dr. Michael Horwitz
You can choose to believe us or come in and have it proven to you. The fact is, our newest surgical procedure for Plantar Fasciitis and Achilles Tendonitis will get you back to work the NEXT DAY.
If I told you right now that I could cure your chronic heel pain with a 30 minute treatment, and have you back to work the next day, would you beleive it? Well you wouldn’t run because you can’t RUN, in either direction, (towards my office or away), if you truly have chronic plantar fasciitis.
Yes it’s true! I can cure your foot pain because I have the resources and experience to do it. In this article, I attempt to plainly spell out exactly how we cure chronic cases of heel pain at Feet for Life. I have even created a new video and website specifically to outline my ground breaking technique.
Unlike other articles, I will not give you a historic perspective of the problem first, and then begin a lengthy justification process in order to convince you of something that I would like you to believe. Instead, I plan on telling you how I will treat you, and then let you determine if it sounds like something you want. Chances are, if you are still reading this, you already have an idea of what your diagnosis entails, and you’re looking for some ANSWERS!
Simple. Fast. Effective.
Here is how we do it:
1. Get the Correct Diagnosis
Use a diagnostic Ultrasound to measure the fascial thickness and look for signs of chronic inflammation. When patients come in with chronic heel pain, they are often aware of the conventional methodsfor diagnosing, but many have yet to have a simple diagnostic ultrasound. This test is simple, fast, and effective. With this data, the diagnosis of “fasciosis” or chronic inflammatory change, can be made.
2. Getting the Treatment Right
Your feet are yours. They are part of a system that is so uniquely yours, that even if you had a twin sibling with the same problem, treating you both the same would be a mistake. This is because the condition we are treating is related to your biomechanics and activity / footwear preferences. So starting with a program greatly increases the chances for successful long term outcome. Your program should include at least 3 treatment stages – pre, intra and post treatment.
3. Pre – On Your Mark
This is the time to evaluate your existing footwear. Most of the time, chronic fasciitis is due to improper footwear use. Restrictive footware and improper use of orthotics are often the culprits. This is footwear that won’t let your foot function naturally. I often see patients who have become addicted to certain orthotics and footwear that they believe are helpful, but actually are hurting them. It is the loss of motion and strength of your arch muscles caused by restrictive footwear and orthosis that may be the source of your chronic problem. So during this “pre” treatment phase, we actually need to get you out of your foot prison. Don’t worry, if you want to go back to your problem footwear, you can after we cure your faciitis. We often also have to address your weekend footwear vs weekday footwear. See our website for more on this.
4. Intra – Getting Set
Here we cure you. That’s right. In the most straight forward, logical and simple way, we directly address your inflammation. Believe me when I tell you that we have figured this one out. It was not easy. It took about 15 years, but we have done it. We need 1 day out of your life. You must be willing to have something done for 30 minutes, because this is the time it takes to perform a small procedure on your heel that utilizes both ESWT technology and Radio Cobalation. After 15 years of using ESWT effectively, and 3 years of performing Topaz procedures, we have now got it so right, that I challenge any doctor in the world to come up with a better answer for chronic heel pain that will get a patient back to work and on their feet the very next day.
5. Post – Go
This stage comes at 4-6 weeks after your ESWT / Cobalaton treatment. Your are now ready to get back into life. Here you are introduced to everything your need to stay out of trouble and get back to high impact activity. Hopefully, during your post treatment period, you have read some materials and have a better understanding of how you got into a chronic state. Now that you are pain free, it’s time to start using your knowledge of proper footwear to your advantage. Some of you may even cure yourselves with just this vital information.
Best Game on The Planet
“It’s great to have that moment of complete recognition of what’s right.“
I see this every day of my life in the faces of my patients. After years of being treated the absolute wrong way, they come into my environment, get re-educated and leave believing that someone actually got it right. Often times I am barraged with “why” questions. “Why did I not get this treatment and information before?” “Why wasn’t I told this?” The answer is that every problem you can possibly have can be solved with the right knowledge of proper treatment. It took a best selling book, “Born to Run”, by Christopher McDugal, to truly look at conditions like foot overuse injury and strip away all of the barriers to seeing the problem for what it was, before the problem could be solved. It took me 20 years of treating heel pain, and the humility to see that I did not know everything I needed to know, that got me to the point of finding the truly minimally invasive procedure that is now curing patients and getting them back to full activity in one day.
A Closer Look at What Exactly We Are Doing
By now you are asking for an appointment to our Heel Pain Center or you are looking for all the answers right now.
It’s very simple, we treat the entire heel. We know that chronic heel pain is usually a condition with many sequela. Often, a patient will have prototypical plantar fasciitis for a few months and during this time will start to stand on the outsides of their feet – along to more stable lateral column. This takes the pressure off of the medial fascial insertion and transfers it to the calcaneal cuboid joint, the sural nerve and lateral musculature of the foot. That’s why patients will point to both the medial and lateral aspect of the heel. They have 2 different problems. One is related to the original plantar fasciitis and the other is one of the many compensation injuries that occurs because weight shifting. But lets not stop there, next often comes bouts with achilles tendonitis, and even back, neck and knee pain.
So when we perform the 30 minute treatment, we cover two main bases. First, we use high intensity ESWT and lots of it. 4000 pulses will cover all of the main areas that are tender including the cuboid articulations and as far into the arch an necessary. For this we use the Israeli Medispec ESWT machine with it’s wide focal diameter. Secondly, we have learned that cobalation of the plantar fascial insertion provides a hands on and very accurate micro fenestration / cobalation of the area that is often time the most tender in chronic cases. Using both of these is what we have found will get patients better fast.
The Topaz Evolution
Here is the point in this paper where any physician worth his salt will take this information and run with it. It would be useful for you to reference the original Topaz procedure publicized on our website. Here we used the wand to create multiple fenestration into the plantar fascia through multiple small stab incisions. This was effective as a treatment, but required 4 weeks of recovery before patients were back in footwear. So the opportunity cost was larger than ESWT, and it was an invasive procedure.
I created the new combination procedure to address both the post op recovery time and invasiveness by using only one incision.
Utilizing the topaz wand and ONE very small incision, we address the plantar fascia directly creating 5 or 6 fenestration points into the medial band of the fascia. The incision is so small that it does not need a stitch. So the trauma is minimal and the patient recovers from the procedure in hours and is ready to get back to regular activity the next day!
What Are We Actually Doing to Your Foot?
We are actually curing your condition! Everything in life is about flow. Chi is another word for this. When it comes to treatment of inflammation, creating flow is vital. The arthritic is the prime example of a no-flow situation. With no flow comes stagnation and crystallization, like ice – no flow.
With ESWT and Cobalation, we melt the ice. We meat tenderize the tissues to actually create a new blood supply. This isn’t simply warming up an area to create better flow, this is making tissue vital. At the same time we are getting rid of stagnant tissue factors that create pain and inflammation. The ESWT covers a large area and is very atraumatic. The Topaz allows us to pin point the treatment right into to area that is the most inflamed. The combination is spot on.
Please consider reading our FAQ on this treatment on our website. It will hopefully answer even more of your questions. Or, maybe you could come in and see me or one of our physicians. I would very much like to know if you read this article, so please mention it to me.
Plantar Fasciitis Diagnosis
Heel Pain Treatment
We Offer Individualized Treatment Options Specifically Tailored For Your Feet
Why Choose Feet For Life
Feet For Life Centers located in St. Louis and Chesterfield MO offer the most innovative and up-to-date solutions for Heel Pain. You can expect little downtime, fast healing, and minimal chance of complications when you choose to be treated at our Center. Read about our State-Of-The-Art Surgery Center Here.
Meet Dr. Michael Horwitz, Top Podiatric Surgeon in Midwest
Dr. Horwitz is the leading podiatrist in the country and top podiatric surgeon in Midwest. His commitment to professionalism through extensive research, innovation and practice along with providing the best possible care in a patient friendly medical environment has given him a great reputation and trust among thousands of his patients.
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