After weeks, months, or years of persistent heel pain, you’ve finally decided to visit Dr. Mitchell Wachtel and his staff for treatment. What happens next? Once you’ve taken that first step to allow us to help you with your foot and ankle pain, there are procedural steps that we take. Here are a few of the different procedures and treatments that you can expect us to consider, depending on your diagnosis.
An X-Ray is a diagnostic imaging tool that sends x-ray beams through your body. Depending on the thickness of the tissue in the area, the beam will be absorbed at varying amounts. You can think of it like a Polaroid camera. In the areas where there is nothing blocking the beam, the film will be completely exposed, turning black. But in areas where the tissue is the thickest, such as bone, the film will remain nearly white. A bone’s surface is smooth and continuous. With x-ray technology, a physician can see areas in the bone that have an interruption in what should be a continuous line. This is how a broken bone and a bone spur can be visualized. A bone should also have consistent density throughout. When the bone shows areas that are darker than others, this is a sign that extra calcium has been deposited. This is the case with instances like stress fractures and conditions like Sever’s disease where the bone has repetitively healed from micro-traumas. An X-Ray is an inexpensive way to assist in the diagnosis of heel pain.
Cortisone therapy is a treatment that includes injecting cortisone into an effected area with a needle. Cortisone is a type of hormone that your body produces naturally and helps with inflammation. This hormone does not help with pain, but it significantly helps swelling and inflammation.
Cortisone therapy is often not the first choice treatment for conditions like plantar fasciitis and Achilles tendonitis because it is an invasive treatment that can have side effects. However, if other treatments fail, it serves as a great anti-inflammatory treatment. It works quickly to stop the pain that one is feeling at the site of injury and can allow patients to use more aggressive physical therapy treatment without the associated pain from the injury.
Ultrasound (evaluate fascia for rupture) all uses in fasciitis and for correct location of cortisone shot
Ultrasound is another imaging technique that is similar to an X-ray, but is used to visualize soft tissue like muscle, fascia and tendons. In the case of tendonitis and Plantar Fasciitis, it can be used to visualize where the tear (injury) of the tissue is located. It is also a wonderful way to see exactly where the needle is being placed for cortisone therapy so that the delivery of the shot can be targeted to the precise location of injury. This allows for the cortisone therapy to be as effective as possible.
Laser therapy is a non-invasive procedure that increases circulation to the injured area or to thickened nails. The laser works by increasing cellular ability as well as stimulating growth and repair. This stimulation helps to heal the tissue causing lasting positive effects. The laser is set at a particular wavelength to ensure optimal healing. The K laser heals the affected area quickly getting you back up and going faster than other treatment plans. For heel pain, the K laser is effective in treating Achilles tendonitis and plantar fasciitis.
Surgery (topaz procedure for heel pain)
Surgery is a last resort therapy that is only utilized if all other non-invasive techniques fail. One procedure that is used for heel pain is the TOPAZ procedure. This technique utilizes a minimally invasive technique that uses shock waves to treat the tendons and fascia. The chronic inflammation is treated and becomes an acute inflammation. Acute inflammation is treated more readily by our body and allows for healing of your tendons or fascia to occur and prevent future injury.
Schedule an appointment with Dr. Wachtel today by connecting with us via the Contact Us page, or calling our office: (978) 794-8406.