THIS IS TAKEN FROM AN INTERVIEW OF DR. COLON (ON HEEL PAIN):
Interviewer: What would you say are the most frequent symptoms that your patients are experiencing whenever they come in to see you when they're complaining of heel pain?
Dr. Colon: The most common symptoms of heel pain that I see in my patients is pain with the first step in the morning. As soon as they get out of bed, they step down on the floor and they have a sharp pain going right into their heel. A lot of times they describe it as it feels like they're stepping on a nail. It sometimes get relieved by walking around a little and later in the day the pain returns again.
The other thing that's very common is the patients come in saying they've had this pain for months. They've tried everything. They've tried Tylenol, over-the-counter anti-inflammatories, even prescription anti-inflammatories from their doctor and nothing is working and then they finally come in to see us.
Interviewer: What causes heel pain?
Dr. Colon: Heel pain has many different causes. It could be due to trauma. There could be a stress fracture in the heel. The most common things though that cause heel pain is an inflammation in the arch or the heel of the foot caused by biomechanical problems when the patient steps down on their foot and when the patient is walking because of the shape of their foot, and sometimes due to recent weight gain. But they're basically walking on the side of their foot instead of on the plantar part of their foot and they're putting a lot of strain and inflammation on their plantar fascial tendon. And so it gets inflamed, and that's called plantar fasciitis.
Interviewer: I see. And so plantar that means the bottom of the foot?
Dr. Colon: Yes. That's the bottom of the foot, all across the arch of the foot and into the heel is where the plantar fascial ligament is located. And any part of that plantar fascial tendon can be inflamed. The most common area is right where it inserts into the heel, right where your arch and your heel meet and once it gets inflamed, it can just radiate up the leg. It can go up into the ankle. It can go around the other side of the foot. But that's where it starts.
Interviewer: Is that the most frequent cause of heel pain that people have when they come in to see you?
Dr. Colon: That's right.
Interviewer: Okay. And are there other things that maybe would cause heel pain as well?
Dr. Colon: Yes, there are other conditions. There's different types of arthritis. A patient can have a nerve entrapment there similar to carpal tunnel in their wrist where they have it in their ankle. There could also be a peripheral neuropathy such as diabetic patients can get extra pain in their heel versus the type of neuropathy that causes numbness. There could also be gout attacking the heel.
Other types of inflammation could be bursitis or tendonitis in the area of the ankle and the heel and patients just basically call it heel pain and sometimes it's actually their ankle or the side of their foot that's hurting them when they show us.
Interviewer: Sure. It's hard sometimes to tell. But for the vast majority of the people, it's really this plantar fasciitis condition that's causing their problems?
Dr. Colon: That's right.
Interviewer: Now how common is heel pain? We talked about it before. I've heard that as high as one in four Americans is going to experience heel pain at some point in their life. Am I right about that?
Dr. Colon: Yes, that's right. It's very common. We see it every day in our office. It's recently been on the rise. The cases of heel pain have increased. I think due to environmental changes in the American way of life. I think there's much more of a sedentary lifestyle than in years past. More people are sitting down on their computers rather than going outside, exercising, and running around.
Especially with children, we see a lot of children that have an increase in weight gain, obese children that are getting conditions such as heel pain, painful flat foot and even childhood diabetes from this phenomenon.
Interviewer: Wow, that's fascinating. Now from what I understand, some extremely high percentage of people, and I think you said before it's over 90% of the people that come in to see you with heel pain, you can cure using what you call conservative measures, which are nonsurgical in nature. Is that right?
Dr. Colon: That's right. Most of the cases can be treated conservatively. And a very small percentage need surgery to cure their heel pain.
Interviewer: Once again, if I ever heard a reason to go see the doctor, that's one. If you're having these kinds of sharp, like feels like there's a nail in the bottom of your foot and you don't go see the doctor and it turns out that over 90% chance that you get this taken care of quite simply and easily, it just seems to me, you wonder why it takes so long sometimes for people to come in. So folks, the big teaching point for me tfoday, again, is just come in and see the doctor because you can get it taken care of.
Now if someone has heel pain and they come in to see you, what can they expect? What happens the first time they come to see you?
Dr. Colon: On their first visit we receive a full podiatric history and physical which includes a full foot examination, ankle examination and a gait analysis. X-rays will be taken in the office and if there's more damage or suspected -- or I suspect something in their tendons that can't be diagnosed on X-ray -- we can send them out for an MRI. But usually we can do everything in the office.
Interviewer: I see. That is just absolutely great. So what could I do, if I don't have heel pain right now and I would like to be one of those three out of four that don't get it, what can I do to prevent heel pain?
Dr. Colon: The biggest thing is to be proactive. Take good care of yourself. Exercise regularly. Keep your weight under control and to wear the proper shoe gear. Obviously don't go barefoot. We want to see people in nice supportive shoes like a nice running shoe, walking shoe. For people with structural deformities, flat foot deformities, they would use orthotics in their shoes and that would prevent them from getting the pain associated with flat foot or other types of foot deformities later that are a result of having flat feet.
Interviewer: That's great. Well Doctor, I want to thank you for taking the time to talk to us today about this because if -- it means 25% of the people that we know have this problem and can have this problem solved.
Dr. Colon: Yes, that's correct. I would invite anyone with heel pain to make an appointment for a free initial consultation at our office. We are located at the following address:
Dr. Michele S. Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223
www.footdoc.moogo.com
