Do you feel a stabbing pain in your heel with your first steps out of bed in the morning? You’re not alone! Every day, thousands of Americans suffer from this condition. Plantar fasciitis, more commonly known as heel pain, is by far the most common complaint patients bring to podiatric physicians.

Aching heels can truly affect your lifestyle and disrupt essential activities and prevent you, to a large extent, from playing sports or simply going for a walk. An accurate expedient diagnosis of the cause of your symptoms will help you receive the appropriate treatment.

There are several causes of heel pain. The most common include:
*Plantar Fasciitis – Inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar) surface of the foot, from the heel to the ball of the foot. Both heel pain and heel spurs are frequently associated with plantar fasciitis.
*Heel Spurs – A bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. Heel spurs can result from strain on the ball of the foot and repeated tearing away of the lining or membrane that covers the heel bone.
*Excessive Pronation – Excessive inward motion can create an abnormal amount of stretching and pulling on the ligaments and tendons that attach to the bottom back part of the heel bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back.
*Achilles Tendinitis – Pain at the back of the heel is associated with Achilles tendinitis, which is inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone.
*Tarsal Tunnel Syndrome – This syndrome causes a large nerve in the back of the foot to become entrapped, or pinched. Similar to carpal tunnel syndrome in the hand, tarsal tunnel syndrome can cause heel pain.

Other possible causes of heel pain include rheumatoid arthritis and other forms of arthritis (e.g., gout); Haglund’s deformity (a bone enlargement at the back of the heel bone in the area where the Achilles tendon attaches to the bone); inflamed bursa (“bursitis”), a small, irritated sac of fluid; neuromas (nerve growths) or other soft-tissue growths; and bruises or contusions, which involve inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.

Some contributing factors associated with heel pain are age (with increasing age, often there is decreasing flexibility); any sudden change in activity (particularly activities that increase weight bearing or pressure on the foot); flat, pronated feet or high-arched feet; a sudden increase in weight; pregnancy; stress from an injury; a bruise incurred while walking, running, or jumping on hard surfaces; or medical conditions such as tarsal tunnel syndrome.

If you have any questions on heel pain, contact Dr. Bowman at Houston Foot Specialists.

As we enter the holiday and winter season, many of us will be attending Holiday parties, eating and drinking with our co-workers, friends and family.  Soon after these parties many of you will be seeing your podiatrist because of severe pain to your joints in the foot and ankle.

Gout is one of the most painful forms of arthritis that occurs in the foot.  It occurs when too much uric acid builds up in the body from excessive digestion of rich foods and alcohol.  Gout usually starts with a sudden onset of intense pain in one or more of the joints; most common is the big toe. The joint is accompanied by pain, swelling, redness, heat and stiffness in the joints.  For most people the first attack wakes a person from sleep and typically there is no recollection of injury to the joint prior to the onset of pain.

While symptoms usually occur in the big toe joint, any joint may be involved.  Other common sites are the instep of the foot, the ankle and the knee.  When the foot is involved, wearing shoes id very difficult and painful, as are attempts to move the joint or stand on the foot.  Seeking treatment and early diagnosis form a podiatric physician is crucial as gout can cause damage and in serious conditions, disability in the affected area.

If the attack is in the toe, elevate the foot, avoid standing and walking, and wear only a loose slipper until seen by a podiatric physician.  In general, treatment for gout works by reducing the levels of uric acids in the body.  Dr. Bowman’s first line of treatment is administering NSAID’s or Non-Steroidal Anti-Inflammatory Drugs and often a blood test to measure the amount of uric acid in the body.  Some corticosteroids (oral or injection) may be prescribed as well.  Certain medications to lower the levels of uric acid may be also be given.

If Gout attacks continue despite the treatment, excessive deposits of gouty crystals or Tophi within the joint, or if arthritis causes continual discomfort, surgical treatment by Dr. Bowman may be necessary to remove the crystals and repair the joint.

Your Podiatrist may prescribe the following general foot care tips during treatment of gout.  These tips will help in relieving and avoiding pain during recovery.  These will also help in prevention of future attacks from taking place:

    -    Ensure your feet are comfortable by wearing appropriate foot wear.  Shoes with ample space for the toes to move and they should fit properly.

    -    Avoid activities that put stress on the joints such as standing for long periods of time.

    -    Do stretching of the feet regularly; this will assist in strengthening of the affected joints and promote increased blood circulation.

    -    Eating a healthy gout diet; this mainly involves a reduction of foods and alcohol that have a high concentration of purines (i.e. liver, red meats, dried beans and peas, etc.) while trying to substitute them with alternative foods.   Dr. Bowman can give you a list of foods to avoid.

    -    Try to maintain a healthy body weight, as being overweight may result in stress and pressure being exerted on joints located in the feet.  The stress and pressure may also cause pain and slow down the gout treatment you are undergoing.

Gout is one of the most painful medical conditions known.  For further information or to get your questions answered feel free to contact Dr. Jeffrey N. Bowman at www.houstonfootspecialists.com or by calling Houston Foot Specialists at 713-467-8886.