ESCANABA — The scourge to humanity that is heel pain. (Taking some dramatic license here.) But if you want drama, talk to someone in the throes of acute plantar fasciitis, the most common cause of heel or arch pain. Although we don’t have precise data, it is believed that this has been occurring for generations. For various reasons, it has become far more common, one experienced in greater numbers than ever before.

Part of the confusion surrounding this condition is the variability in presentation. Some experience a sharp piercing pain while others note only a burning sensation. A common symptom is greater pain when weight bearing after rest. With an ailment occurring this frequently, we’ve had considerable opportunity to study it, and certain generalizations have emerged. But, despite our improved understanding, numerous fallacies about plantar fasciitis remain.

My favorite cliche is derived from an x-ray. Certainly, when someone presents to a clinic with a complaint of heel pain, an x-ray is appropriate. After all, heel pain can be the result of a stress fracture of the heel. A common finding is a spike of bone off of the heel, pointed out, towards the toes. But we see these spurs in many people, even those who have never had a day of heel pain in their lives and is rarely the reason for their agony.

Anyone suffering from plantar fasciitis is going to look for answers, a solution to this sometimes crippling discomfort. A common mistake made by those dealing with the pain of plantar fasciitis is to assume greater cushioning is the answer. Many afflicted individuals will seek out the softest soled shoe possible. Or, alternatively, an arch support with the most cushioning material available will be used. As they will typically discover at some point, cushioning isn’t the answer.

The pain of plantar fasciitis is usually the result of prolonged, excessive stress to the ligament-like structure supporting the arch of the foot. Consequently, supporting it better usually results in relief. This process takes time to result in relief, meaning walking and standing with some type of support may not immediately lead to less pain. The sufferer will need to practice patience to experience improvement.

Reducing inflammation in this ligament will reduce the pain and can be achieved in numerous ways. The traditional approach is to inject a steroid medication (e.g. cortisone) into the area. Unfortunately, this is often all that is done, which doesn’t address the excess tension on the symptomatic structure and the pain commonly returns.

A more effective alternative is shock wave therapy, a regenerative technique leading to healing. After hundreds of studies on shock wave examining its effectiveness and success rate, we can definitively say shock wave is beneficial for plantar fasciitis and carries no risk of complications. Additionally, and importantly, this therapy improves the health of these tissues.

A frequent recommendation that is accurate calls for stretching. What is sometimes comical is what and how these exercises are performed. The primary object of attention is the Achilles tendon-muscle complex. The Achilles is the largest tendon in the body with the most force exerted upon it. When it is tight, a frequent finding in many Americans, various other parts are affected. Such is the nature of the kinetic chain and human biomechanics.

Those experiencing significant, acute plantar fasciitis are desperate for answers, but surgery is never an initial response. The success rate with conservative measures is too high to ignore. All corticosteroids have their downsides, and a popular option is the application of a specialized therapeutic laser light, relieving pain but also improving the metabolism and biochemistry of the cells composing the fascia. Wonderfully, there are no complications to its use.

For most cases of plantar fasciitis, the inflammation in this band of connective tissue is the consequence of prolonged physical tension. This stress is a result of less than optimal biomechanical functioning of the foot, Achilles, ankle, leg, etc.. Thus, altering the mechanical workings of these structures correctly will usually serve to reduce these abnormal forces. The body will heal up the inflammation if it isn’t continuously being reproduced. The optimal method is the fabrication of specialized body/leg/foot supports placed under the skeletal system. In other words, putting a prescription arch support inside your shoe has led to relief for millions.

Plantar fasciitis continues to ravage America, leading to millions of lost work hours, disability, pain, and reduced quality of life for millions of people. Consider for a moment how commonly it occurs: some experts claim nearly 75 percent of adults will experience plantar fasciitis at some point. Perhaps you begin to see the scope of the problem. But no one need suffer from chronic plantar fasciitis: there is a solution to this condition for everyone. Chronic pain causes emotional stress, increased release of adrenaline, and has numerous other harmful effects on the human body. Don’t live with the misery: find your answer to the debilitating epidemic that is heel pain.

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Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with offices in Escanaba, Marquette, and L’Anse. McLean has lectured internationally on wound care and surgery, being board certified in surgery, orthotic therapy and wound care. His articles on health and wellness appear in multiple local and national publications. Dr. McLean welcomes subject requests for future articles at drcmclean@outlook.com.