Do you dread getting out of bed?

flat-feet1Learn about heel pain and what you can do about it

More than ten million Americans suffer from heel pain. “Heel pain affects both men and women equally, and it can be quite debilitating,” says Dr. Shah Askari, of the Arizona Institute of Footcare Physicians in Mesa. The pain is often explained as a sharp burning or shooting pain in the center of the heel. “You may first notice the pain after a long walk, but often it seems to appear out of no where,” says Dr. Askari. “Patients often don’t recall any specific injury to the area.”

Heel pain is caused by inflammation of the tissue that stretches from the base of the toes, along the arch, to the heel bone. “This condition is called, Plantar Fasciitis,” explains Dr. Askari.  Patients with plantar fasciitis will most often complain of pain when they first get up in the morning or after sitting for a period of time. When they start moving again the pain eventually eases, but never goes away.

There are many causes for heel pain such as improper foot function, poorly fitted shoes or an injury. Problems occur when too much stress is placed on the heel bone and the soft tissue around it. Dr. Askari explains, “When an imbalance in the foot is allowed to progress it can affect the heel, the tendon tightens and pulls against the heel bone. Many patients believe the pain comes from a spur, but it is actually coming from the surrounding soft tissue.”

The most helpful step in avoiding heel pain is wearing properly fitted shoes. It is also important to not wear well-worn shoes that have excessive deterioration on the heels or flip-flop sandals. Flip-flop soles offer no arch support and can also make foot motion worse, leading to inflammation and pain. Dr. Askari suggests wearing shoes that offer more support as well as stretching before exercising to help avoid heel pain.

“The good news is that conservative care relieves the pain for most people,” says Dr. Askari.  Treatment is aimed at reducing the inflammation with medication, injections or physical therapy and, at the same time, relieving the abnormal stresses on the soft tissues and the subsequent imbalance of the foot to alleviate the problem.

“Controlling foot movement is also important,” Dr. Askari says. This is done with orthotics.  These special corrective devices fit into shoes and can improve imbalances and provide significant relief. He adds, “The secret to making effective orthotics is accurately measuring the way a person walks, when they are walking. We have a great tool available that uses a computer to collect this information when patients are walking.”

When heel pain does not respond to conservative treatments, there are surgical options available, which allow patients a quick recovery and return to normal activities. There is no need to suffer from heel pain. Dr. Askari recommends visiting a podiatrist if the discomfort persists for more than two weeks.

Q&A with Dr. Kerry Zang

dr-zang-2-copyWhy Do My Feet Hurt?

Your feet are designed to handle the stress of everyday life and pain is an indication of a
problem. Ill-fitting or worn-out shoes, walking barefoot, changing activity level or gaining weight can aggravate conditions and cause pain and discomfort. Three of the most common sources of foot pain are bunions, neuromas and heel pain.

A bunion is an enlargement of the big toe joint caused by a mechanical problem or an inherited condition. So, if your grandmother had bunions, there is a good chance that you will too. If left untreated, they may become larger, unattractive and painful and may lead to hammertoes, corns and calluses. Surgery is indicated when pain continues or there is damage in the joint. Early diagnosis is beneficial to help relieve the pain and slow the progression.

Pain can also come from neuromas, a thickening and swelling of a nerve, usually caused by compression and irritation from repetitive activities or tight shoes. My patients say it feels like their feet are on fire, or they experience a cramping, tingling sensation, or even numbness.  Symptoms become more intense as the nerve enlarges and the temporary damage becomes permanent, so it’s best to seek treatment if discomfort persists for more than a few days.

Plantar Fasciitis is the most common cause of heel pain. It is an inflammation of the tissue that stretches along the arch to the heel bone. Patients report pain when first getting out of bed, which might lessen with activity, and usually reoccurs after periods of rest. The longer heel pain remains untreated, the worse it can become.

Early treatment for all of these conditions can help alleviate your pain and avoid or delay the need for surgery while increasing your chances of a successful outcome.

DID YOU KNOW?

According to the American Podiatric Medical Association, 72% of Americans say foot pain impacts their lifestyle by preventing everyday activities such as: exercising, standing for long periods of time, traveling, and playing with children and grandchildren. Changing shoes, resting and icing may help, but if pain persists, consult a podiatrist.

Put Your Best Foot Forward

iStock_000014728052XSmallDon’t let foot pain keep you from getting in shape for the New Year

2013 is upon us, and whether you would like to eat healthier, manage stress, take a trip,
or volunteer, one resolution at the top of everyone’s list is to ‘Get Fit.’ However, if your
feet don’t feel good, you don’t want to exercise. Before starting any exercise routine, it is
important to talk to your doctor. Dr. Mia Horvath with the Arizona Institute of Footcare
Physicians offers advice to keep your feet in tip-top shape for the New Year.

1. Start your workouts gradually. Increase your stamina little by little in order to prevent
overuse injuries. “There is no need to overdue it right away; be cautious so that you
avoid overuse injuries like stress fractures, tendon strains and ankle sprains.” advises Dr.
Horvath.

2. Before you start working out, make sure you have a well-fitting athletic shoe designed
for exercise or sport. “If you have been wearing the same pair of tennis shoes every day
for the past 6 years, it’s time to update,” says Dr. Horvath. A good pair of shoes will
support your arch and provide cushion for your heel. Dr. Horvath adds, “If you have
shoes that are not the correct size, you could cause injuries or irritate existing problems.”
Shoes that are too small can irritate the nerve tissue in between the toes and may lead to
numbness or a burning feeling, and if shoes are too big they may cause friction blisters or
jamming of the toe joints.

3. Use good technique when exercising. If you have incorrect posture, lift weights that
are too heavy, or misuse the exercise equipment, it can cause instability in the foot and
ankle, leading to a sprain or an injury. Working with a professional or personal trainer
can help you prevent injuries at the gym. “If you do hurt your foot, see a podiatric
physician for evaluation; don’t just ‘walk it off’ because it may make things worse,” says
Dr. Horvath.

4. Protect yourself from bacteria. Change shoes every other day so that they do not
become sweaty. Never go barefoot in public areas such as public showers, the pool deck,
or when using equipment as these areas of the gym can breed toenail fungus, viruses
that cause warts, and bacteria. “You want to have a barrier between your feet and wet
surfaces. If you have a cut, scrape, or crack in the skin, that can be an entry point for
bacteria, so make sure you cover minor wounds,” recommends Dr. Horvath.

5. Listen to your body. Foot pain is not normal and should not be ignored. Seeing a
podiatrist at the first sign of foot pain can increase chances of a quick successful recovery
and avoid further injury. When your feet feel good, you feel good, and they will help you
exercise and follow through with your new year’s resolutions.

What to do about dry cracked heels?

Have you ever experienced dry cracked heels? If so, you are not alone. In Arizona it is a
common but treatable problem due to the low humidity of the desert especially in the winter. Dry cracked heels can also occur secondary to other medical conditions like diabetes, thyroid dysfunction, nutritional deficits, or peripheral vascular disease. “Your feet are like the canary in the coalmine,” says Dr. Siegel from the Arizona Institute of Footcare Physicians. “As we age, they can detect other conditions going on in your body.

”It is also very common to have dry cracked heels if you wear flip-flops, especially after a long hot summer. Flip-Flops create repetitive micro injuries, by slapping against the bottom of your heel, creating further drying and cracking of the skin. “If you wear flip-flops or strap sandals, your feet are more prone to dry out from the loss of moisturizing oils, which causes rough, dry skin that is prone to cracking,” says Dr. Siegel.

If left untreated, these fissures or cracks can become infected and create further problems. If you have diabetes or another chronic condition, it is important to visit your doctor right away so you do not get an infection. Home treatments are not as effective and medications available over the counter are not quite strong enough to deal with dry cracked heals. If your condition does not respond to home care within 48 hours, or continues to worsen, consult your doctor.

Podiatrists such as Dr. Siegel can remove thickened calloused tissue on your feet and also recommend an appropriate local medication if needed. The Arizona Institute of Footcare Physicians also offers products that help alleviate this problem. Dr. Siegel recommends using a product called Sleep ‘n’ Heel available in the Education Center. “The sleeve is great for my patients because you wear it on your foot while you sleep and it helps your skin heal overnight.

”Dr. Siegel also advises that you wear proper shoe gear for the appropriate activity. “Flip Flops can be good for around the house or spending time by the pool, but if you are running errands or going to the grocery store, it is best to wear proper tennis shoes with good support.”

Dr. Siegel’s Tip: Look at your feet every day. “It’s good to check your feet for cuts or sores,” he says. “If you see that you have a cut or sore, it is best to schedule an appointment to have a podiatrist check it out right away.”