Heel Pain – Advanced Options

In our final third installment of our blog regarding heel pain we will be discussing two minimally invasive surgical techniques that are proven methods of treating chronic plantar fasciitis. First let’s recap the previous techniques that we have discussed. Extracorporeal Shock Wave Therapy (ESWT) is a technology that utilizes energy to stimulate healing and regeneration in the body at sites that are injured. The energy stimulates cells that produces bones and also stimulates cells that regrow cartilage, ligaments, and tendons. Next we discussed platelet rich plasma or PRP. Whereby blood is drawn from the patient and then placed in a centrifuge where the blood components are separated out and the PRP is harvested. Platelets are primarily responsible for the clotting of blood but they also contain numerous growth factors which aid in the healing processes of the body. The next step is adding Ozone to the mix. Ozone helps increase the metabolic activity of your cells thereby helps to regenerate healthy tissue. This increased metabolism causes a significant increase in the oxygen level of the tissues as well which also helps the healing process.

Finally we have two minimally invasive surgical techniques that we utilize to help heel chronic plantar fasciitis. First we have Topaz debridement. This technique utilizes radio frequency ablation to break up scar tissue using a device called a Topaz Microdebrider. This instrument is pushed through the plantar fascia at the sites of insertion of the medial, central, and lateral bands of the plantar fascia. When the Topaz device is placed into the plantar fascia it dissolves any inflamed scar tissue and creates an acute reaction that the body will start to heal. The Topaz wand is typically used in the areas of maximal tenderness. The surgeon palpates this area of the heel and marks it with a skin marker. This ensures maximum relief after the body has healed the area of ablation. PRP can also be utilized to stimulate the healing process of the plantar fascia as well and is often times combined with Topaz debridement. After the procedure the patient is able to walk out on their own with minimal discomfort. Topaz debridement is a quick, easy, and a minimally invasive way to treat chronic plantar fasciitis.

Cryotherapy is the final technique we will be discussing. Cryotherapy is a specialized technique where the surgeon uses a hand controlled probe that can achieve extremely low temperatures to destroy pathological tissue. This destruction of chronically inflamed plantar fascia then begins to heal itself naturally utilizing the bodies own growth factors. The process takes minutes to complete and no sutures are required. The point of maximum tenderness is marked on the foot and that is where the cryoprobe is placed. Minimal local anesthesia is utilized to minimize discomfort to the patient. Studies have shown that up to 90% of patients who suffer from chronic plantar fasciitis have relief after cryotherapy. This minimally invasive technique is highly effective and has a minimal recovery period of 72 hours. Patients can walk immediately after the procedure but are advised not to perform any intense physical activities.

Heel pain is one of the most common problems seen at Advanced Podiatry and that is why we have several options for our patients when developing appropriate treatment plans. ESWT, PRP, ozone, Topaz debridement, and cryotherapy are all highly effective methods in which chronic plantar fasciitis can be treated utilizing minimally invasive techniques. The patient can consider the various techniques and choose which would best fit their needs while also meeting the doctors recommendations. As stated before we can also combine therapies in order to enhance the healing process. All the methods mentioned above require no stitches and patients are able to walk immediately after the procedure. At Advanced Podiatry we approach heel pain as a team and together we can help relieve the pain of plantar fasciitis. If you have any questions regarding your options in treating heel pain, please feel free to call the office of Advanced Podiatry.

Best Regards, Dr. Jairo Cruz Jr