One of the most common complaints heard in the podiatry office is heel and arch pain. The heel and arch bear the brunt of every step we take. So it's no surprise they end up hurting occasionally. Although anyone can suffer with heel and arch pain, those with flat feet, extremely high arches, an abnormal gait or a weight problem are the most commonly affected. Athletes also are affected due to the increased demand they put on their feet.

Although the causes of heel and arch pain are varied, most cases seen in adults involve a long, thick, fibrous band called the plantar fascia. The plantar fascia runs from the heel bone through the arch to the ball of the foot. When the fascia is stretched too far, the tissue can become inflamed, creating a condition known as plantar fasciitis.

This inflammation and stretching of the fascia also can lead to the formation of a heel spur. This is due to the constant tugging of the plantar fascia at its attachment to the heel bone. Plantar fasciitis is not a serious health problem, but it can be extremely debilitating because of the great amount of pain it can cause.

Fortunately, a variety of conservative treatments can alleviate the pain as well as cure the problem. These treatments include stretching exercises, ice and heat packs, anti-inflammatory medications, physical therapy, orthotics and cortisone injections. Most cases of plantar fasciitis will be cured with these methods of treatment.

If these conservative measures fail to relieve the pain, however, a new treatment using high-energy shock waves is now available. The shock waves stimulate the body's own healing mechanisms to help cure the problem. The high-energy shock-wave technology is similar to that used to break up kidney stones.

This treatment is fairly new, but it is being used more frequently to treat chronic cases of plantar fasciitis. This alternative gives us an additional treatment choice before considering surgery. The success rate of the shock-wave therapy appears to be roughly 50 percent. Various studies done on shock-wave therapy differ in success rates, with some higher and some lower. Although a 50 percent success rate may not sound great, any amount of success is good if it prevents surgery.

In children, especially those active in sports, heel pain often is caused by inflammation at the growth plate of the heel bone. This condition is called apophysitis. The growth plate (also known as the apophysis) is made of cartilage which becomes bone when the child's foot is fully grown. The pain is caused by pounding and pressure during sports and other activities that irritate and inflame the growth plate. Treatments for this problem include using gel heel pads, icing the heel, giving children's Tylenol to the child and limiting activities causing the pain. If you or your children suffer from heel or arch pain, make an appointment with a podiatrist to discuss your treatment options.

John Ariza, DPM, is a podiatrist (physician and surgeon of the foot) on the campus of Northern Nevada Medical Center in Suite 215, Vista Medical Terrace, 2345 E. Prater Way in Sparks. Call 355-1001 for an appointment or more information.

Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000