Heel Pain in Asheville, NC

Plantar fasciitis is a condition that causes pain to the sole of the foot, most often felt in the heel. It occurs when connective tissue known as the plantar fascia becomes irritated and inflamed. The plantar fascia is a tough, fibrous ligament that connects the heel bone to the front of the foot.

Plantar fasciitis pain is usually close to the heel. It is often the worst first thing in the morning, after a long period of rest or after exercise. Women, runners, people who stand for long periods throughout the day and people with certain foot and leg anatomy features like high arches or tight calves are at greater risk for plantar fasciitis than others.

Potential causes of plantar fasciitis heel pain may include repetitive stress on the foot, such as excessive running or standing, tight calf muscles, improper footwear, and high-impact activities. Other factors that can contribute to (or exacerbate) heel pain may include obesity, aging, and foot mechanics issues like flat feet or high arches.

There are several symptoms of plantar fasciitis that may signal the need for treatment, including:

• Pain when walking
• Pain when waking up in the morning
• Discomfort in the heel after sitting for long periods of time and then standing
• Pain after exercise

If you experience any of these symptoms near the heel of your foot, we encourage you to schedule a consultation at our facility for further evaluation.

About 9 out of 10 cases of plantar fasciitis clear up on their own. That doesn’t mean people have to suffer for months while waiting for it to do so, however. Typically, plantar fasciitis is treated without surgery.

Nonsurgical treatment methods can include:

• Stretching
• Rest
• Ice
• Steroid injections

The evidence is mounting for platelet-rich plasma (PRP) injections as a viable treatment option for plantar fasciitis. If you are experiencing heel pain that hasn’t been relieved by more common methods, but you’re not ready for surgery, PRP may be able to help.

There has been clinical research in recent years to suggest that PRP is a viable treatment for plantar fasciitis, on par or even better than steroid injections, especially long-term. One of the most convincing comes from 2014, published in Foot and Ankle International.

Two groups of patients were treated; one group with corticosteroid injection and the other with platelet-rich plasma injection to the plantar fascia. Both groups showed improvement at three months, but only the PRP group demonstrated sustained relief at six months, 12 months, and beyond.

“I have been most impressed by the durability of the treatment,” said study author Raymond Rocco Monto, MD. “I had expected the results to degrade over time. In the early results, the cortisone patients did very well, but after an initial follow-up, their scores began to recede, and at six months the difference was significant. At 12 months, many of the patients who received cortisone had returned to their baseline, whereas the PRP-treated patients had retained most of their improvement.”

A more extensive 2017 meta-analysis published in Medicine comes to a similar conclusion. This analysis looked at nine studies with data from a total of 430 people. The data, when taken together, suggest that PRP and steroid injections are equally as effective for plantar fasciitis pain after four weeks and after 12 weeks. However, PRP was more effective than steroid shots after 24 weeks.

If you are experiencing heel pain that won’t go away, request an appointment with ARO. Dr. Lehman uses the latest advanced diagnostic techniques to determine the course of your heel pain and will come up with a treatment plan that’s right for you.

How soon can I return to physical activities after PRP treatments for plantar fasciitis or other heel pain?
Your ability to return to physical activities or strenuous exercise may vary based on how your body heals and how quickly your pain dissipates. In many cases, patients can resume light exercises after a few weeks and regular activities after about a month. You may also want to consider multiple PRP sessions over time for the possibility of lasting results.

Will I ever need surgery for plantar fascia pain or other kinds of heel pain?
Probably not. Your heel pain or plantar fasciitis can be treated safely and with fewer risks with nonsurgical methods such as corticosteroids or PRP injections. In particular, research into PRP techniques indicates that it may be an effective tool for treating chronic plantar fascia or heel conditions as a long-term solution.

Will PRP injections for plantar fascia pain be painful?
You may feel some discomfort during the PRP treatment. However, this is a brief sensation. Afterward, you may also feel pain in the treated area for a couple of days, but this is a sign that the treatment is beginning to work. Healing and lower pain are generally gradual from that point forward.