For more information on surgical techniques, please see American Podiatric Medical Association site, Scanner site, Foot Doctors.
Request an appointment
Home Our Staff Our Offices Self Help

Problems here include:

• Pain beneath the heel, often called plantar fasciitis, sometimes said to be associated with heel spurs, although we believe that heel spurs are normally asymptomatic.

• Bony lumps at the back of the heel (Haglands deformity). This is normally caused by friction against the shoe caused by mal-alignment of the heel bone.

• Problems with the tendo Achilles, either where it inserts into the heel bone or at it’s junction with the associated muscles.

• Children often experience pain in the heel at around 10 to 12 years of age. This is linked to a condition called calcaneal apophysitis or Severs disease. This problem is a traction deformity where the tendo Achilles pulls against a piece of bone, which is trying to attach itself to the heel bone. The problem is self-limiting but can be managed with heel pads, orthoses, ice massage or occasionally reduction in sports activities.

Plantar Fasciitis

This condition involves the inflammation of a long ligament under the foot where it inserts into the heel bone. It is usually worse on rising in the morning or after rest and, if left untreated, the pain can last for years. Treatment includes:-

• Calf stretching exercises.

• Heel pads.

• Orthotics.

• Ice massage.

• Anti-inflammatories.

• Ultrasound or low power laser.

• Cortisone injection.

• Very occasionally surgery to detach part of the ligament from the bone. This may be done either as open surgery or by keyhole surgery using a camera.

A leaflet giving further details of the condition and treatment is available from the Clinic on request.

Surgery is best carried out through a 2cm incision on the top of the foot at the base of the affected toes. Surgery takes approximately half an hour and it is important to free the small ligament between the bones to allow adequate access to the nerve. After a rest at home of 3 or 4 days, the patient can get out, although walking is possible immediately. It is important to rest, because after the removal of the neuroma, there is a space left (dead space) and it is vital to prevent a haematoma formation here. Occasionally, a tingling beneath the foot can be felt for some months, which is the cut nerve settling down.

Other Procedures

• Injection of alcohol into the nerve area – this may be painful and is not long-lasting.

• Release of the inter metatarsal ligament. This procedure is being evaluated and accurate statistics are not available yet.

Cryotherapy – a needle is passed through the skin into the nerve, which is then frozen. This procedure may control the pain for a period of time but does not offer a long-term solution. Research, however, continues.