In the human foot, the heel bone, also known as the calcaneus, stands out as the largest among the 26 bones. It plays a crucial role in forming the heel, along with a thick layer of connective tissue beneath it called the fat pad and a fluid-filled sac known as the retrocalcaneal bursa sac located near the back of the heel. These structures reduce friction and aid in the smooth movement of the Achilles tendon over the bone where it attaches.
Common Causes of Heel Pain
Heel pain can stem from various conditions or injuries, including:
Plantar fasciitis. This condition arises due to excessive stress on the calcaneus and its connective tissues from physical activity, obesity, or inappropriate footwear. Plantar fasciitis occurs when the plantar fascia tissue, connecting the heel bone to the ball of the foot, becomes overly stretched, leading to pain and inflammation, especially during the morning.
Heel spurs. If left untreated, plantar fasciitis can progress into a chronic condition, possibly resulting in the formation of heel spurs on the heel bone. Heel spurs are calcium deposits that form in response to repeated stress, which may or may not cause pain.
Acute injuries. Injuries directly impacting the heel bone, like fractures or contusions, can induce intense pain, swelling, and challenges in putting weight on the injured heel.
Gout. Gout is a form of arthritis characterized by the accumulation of uric acid crystals in the bloodstream, which can occasionally develop on the heel bone, causing pain, tenderness, swelling, and redness, often worsening at night.
Gait anomalies. Distinct walking abnormalities, such as excessive pronation where the ankle rolls inward excessively, can exert undue pressure on the heel bone's ligaments and tendons, leading to heel pain.
Haglund’s deformity. This bony enlargement at the back of the heel often referred to as "pump bump," is frequently linked to wearing high heels and may play a role in causing heel discomfort.
Achilles tendinitis. This situation arises when the Achilles tendon, which links the muscles of the calf to the heel bone, experiences unusual stretching or tearing, leading to pain and inflammation where it attaches to the heel bone.
Bursitis. Inflammation of the bursa sac, which acts as a cushion between the Achilles tendon and the heel bone, can lead to painful symptoms.
How a Podiatrist Diagnoses and Treats Heel Pain
Heel pain can be diagnosed by a podiatrist through a comprehensive examination and, if necessary, imaging tests. The treatment methods vary based on the severity and type of condition and often encompass conservative approaches such as
- Taping or strapping
- Extracorporeal shockwave therapy
- Changes in footwear
- Orthotics
- Physical therapy
- Steroid injections
- MLS laser therapy
Persistent heel pain, with or without signs like inflammation, redness, warmth, or swelling, warrants attention from a podiatrist. Ensure you seek proper diagnosis and treatment by scheduling an appointment promptly to address your condition effectively.
EPAT Shockwave Therapy
EPAT, also known as Shockwave Therapy (ESWT), is an FDA-approved, highly effective, non-surgical treatment for acute and chronic heel pain.
Extracorporeal Pulse Activation Treatment (EPAT), also known as Shockwave Therapy (ESWT) is the most advanced and highly effective non-invasive treatment method cleared by the FDA and is typically used to treat the pain associated with heel spurs, Plantar Fasciitis, Achilles tendinitis and other foot & ankle conditions.
Accelerate Healing With Pressure Wave Therapy
It is typically used to treat the pain associated with heel spurs, Plantar Fasciitis, Achilles tendinitis and other conditions.
Millions of patients worldwide have found relief through EPAT and over 80 percent report less pain or no pain after EPAT treatment.
How EPAT works
A podiatrist directs low-frequency sound waves, also known as shock waves, at the injured area through a hand held applicator. The shock waves penetrate deep into the soft tissues, stimulating blood flow, accelerating the body’s natural healing process. There are generally a few sessions needed in our office, each lasting approximately 15 minutes.
The benefits of EPAT
- No anesthesia
- No side effects
- No incision means no risk of infection
- No hospital stay
- Faster healing
- Immediate weight bearing
- A return to normal activity immediately.
EPAT THERAPY FAQ’s
What is EPAT?
EPAT is an acronym for Extracorporeal Pulse Activation Technology (extracorporeal means “outside the body”). It is a highly effective, non-invasive, office-based treatment that accelerates healing of injured tissues. EPAT has a proven success rate equal to or better than other treatment methods, including surgery, without the risks or long recovery. It is performed in our office without the need for anesthesia.
How does EPAT work?
EPAT utilizes a unique set of acoustic pressure waves delivered through a special applicator focused on the site of pain or injury. These pressure waves stimulate the metabolism, enhance blood circulation, and accelerate the natural healing process.
Is EPAT safe?
EPAT is a safe, FDA-approved treatment with virtually no side effects. It has been used to relieve the pain of millions of patients worldwide.
What conditions can be treated with EPAT?
EPAT can be used to treat many painful soft tissue injuries, Including Plantar Fasciitis, Achilles tendonitis, acute and chronic muscle pain and other conditions.
When will my heel pain subside?
Most patients will experience heel pain relief after 3 treatments, but some patients report immediate pain relief after only one treatment. Over 80% of patients report less heel pain or no heel pain after EPAT therapy. Treatment sessions take approximately 15 minutes per injured area, but may vary depending on the injury. Usually three treatment sessions are necessary and are performed once every 7-10 days. If you are improving after the first three treatments but are not yet pain-free, up to 5 treatments may be necessary.
How is EPAT performed?
Ultrasound gel is applied on the skin of the area to be treated. The pressure waves are then delivered using a special applicator tip which is moved over the injured area.
What are the possible side-effects of EPAT?
EPAT is a non-surgical treatment with virtually no risks or side effects. In some cases patients may experience some minor discomfort which may continue for a few days and/or the skin may become bruised or red after treatment.
Is EPAT safe for pregnant patients?
EPAT has never been tested on pregnant patients, so EPAT is best avoided by expectant mothers. If you are a new parent, you should wait to be treated for at least 3 months after delivering your baby, as your foot pain may subside after weight loss and when your hormone levels return to normal.
What are my aftercare instructions?
All patients receiving EPAT therapy should avoid all anti-inflammatory medication for at least two weeks prior to the procedure and four weeks afterward. This includes over the counter medication such as Ibuprofen (Advil, Motrin), Naproxen (Aleve) and aspirin. Your doctor will provide you with detailed aftercare instructions.
Who should not have EPAT?
EPAT should not be used in patients who have deep venous thrombosis or malignancy. It is also best to avoid the procedure if you are taking blood thinners.
Will my insurance pay for EPAT?
Unfortunately, insurance companies do not pay for EPAT, though the cost of EPAT can often be reimbursed from a qualified health savings account.
Where Can I Get More Information About EPAT?
Please call the office of Hamilton Foot and Ankle Associates for any further inquiries or to schedule an appointment today! Chicago: (312) 641-2999.
