The Advanced Heel Pain Centers of South Florida are a specialized extension of JAWS Healthcare. We designed The Heel Pain Centers around our physician’s expertly focused approach to the diagnosis and treatment of heel pain. Heel pain is a very common and often debilitating problem that is easily treatable given the right combination of expertly trained physicians, a wide variety of state-of-the-art treatment options, and a team dedicated to getting you comfortable as quickly as possible.
We are the first specialty care center in South Florida to offer a combination of comprehensive diagnostic and treatment options specifically focusing on heel therapy. Regardless of the symptoms and clinical presentation, the physicians of the center will work together with you to properly diagnose the condition and recommend a relevant treatment program to bring you relief once and for all.
The Advanced Heel Pain Centers of South Florida were established with the idea of advancing the treatment of heel pain. With the increased knowledge of heel pain and the advancements in treatment options, patients have an increased number of choices in their care. From advanced examination to diagnostic testing including digital x-rays and dynamic ultrasound, our team of foot and ankle specialists will provide a comprehensive analysis of the cause of your heel pain. Our entire goal and emphasis is to provide an individualized treatment for each patient. We consider lifestyle, goals, activity, previous treatments and length of pain and deliver a customized treatment regimen for each individual.
Heel pain is not normal and should be treated without waiting. Prolonged heel pain will result in a more difficult and lengthy treatment course. If you have tried some basic treatments and have not found relief, it’s time you made an appointment with one of our doctors. As leaders in the field of podiatric medicine and surgery, our physicians take pride in offering their patients advanced options that are non-invasive and minimally-invasive to help cure heel pain. Due to our comprehensive expertise in the treatment of heel pain, we are continually at the cutting-edge of the latest treatment options.
Causes of Heel Pain
Not all cases of heel pain are plantar fasciitis and very often, our podiatric foot and ankle specialists are advising patients of other sources of pain not previously diagnosed or treated.
Some associated possible sources of heel pain include:
- Plantar Fasciitis
- Calcaneal Heel Spur Syndrome
- Calcaneal Heel Bursitis
- Calcaneal Heel Nerve Entrapment
- Arthritis of the Heel
- Tarsal Tunnel Syndrome
- Heel Fracture or Stress Fracture
- Flexor Tendonitis/Tendinosis
Heel Pain is most prevalent in active people and generally results from an irregular walking gait that places too much stress on the heel bone and the attaching soft tissues. The heel bone, or calcaneus, is the largest bone in the foot and is the first part of the foot to contact the ground during walking. Heel pain occurs in the front, back, or bottom of the heel. Compensation for existing heel pain may soon cause symptoms in the opposite heel. Heel pain can also be caused by foot injury, wearing flimsy or insufficient footwear, obesity, or bruising from activity on hard surfaces. Chronic heel pain can lead to pain in other lower extremity locations, including the toes, ankles, knees, and hips.
Advanced Heel Pain Treatments
The medical field is constantly changing and updating as new techniques and technologies are developed to help people cope with health issues. The podiatry field is no different. Foot care techniques have been advancing rapidly to meet people’s needs, especially over the last few decades.
From orthotics to platelet rich plasma (PRP) treatments and injection therapies to laser treatments, conservative measures for chronic conditions and pain have improved. Even surgical techniques have become less invasive while still repairing damage and offering relief. The experts in our offices have worked hard to integrate these cutting edge treatments so we can continue offering the very best remedies to our patients. One area in the podiatric arena that has seen particular growth is treating heel pain. Heel pain is one of the most common complaints that drive people to seek professional podiatric help. It can also become chronic and hard to eliminate if you don’t come in soon enough. That is why The Advanced Heel Pain Centers opened wanting to offer more targeted treatments to those suffering from uncomfortable heels.
If you’re suffering from heel pain, the experienced podiatrists at Jaws Podiatry can help you find the best solution to relieve your discomfort and restore your feet to full health. The sooner the condition is addressed, the more quickly you can walk pain-free. The vast majority of cases involving uncomfortable heels are remedied using conservative treatments, so don’t let the idea of surgery keep you from getting the help you need.
Some of our advanced heel pain treatment options include:
- Platelet Rich Plasma Therapy
- Adipose (fat-derived) / BMAC (Bone Marrow Aspirate Concentrate) Stem Cell Injection Therapy
- Amniotic Therapy
- Ozone Therapy
- Minor Ozonated Auto-hemotherapy
- Low / High Level Shockwave Therapy
- Percutaneous Micro-tenotomy (deep needling)
- Percutaneous Plantar Fasciotomy
- Traumeel Therapy
- Botox Therapy
Our Stem Cell & Platelet Rich Plasma Procedures are one of the most advanced regenerative injection treatments for treating lower extremity conditions. Adult stem cell & PRP injections are an excellent treatment for heel pain — and, in many cases, it may be the preferred alternative to minimally-invasive surgery.
PLATELET RICH PLASMA (PRP):
What is it?
Platelet rich plasma (PRP) is a revolutionary treatment that relieves pain by promoting long lasting healing of musculoskeletal conditions. This rapidly emerging technique is showing promising results with sub-acute & chronic plantar fasciitis & Achilles tendonitis. Our physicians can determine if this advanced, non-surgical treatment is right for you.
How does PRP therapy help?
The body’s first response to soft tissue injury is to deliver platelet cells. Packed with growth and healing factors, platelets initiate repair and attract the critical assistance of stem cells. PRP therapy’s natural healing process intensifies the body’s efforts by delivering a higher concentration of platelets. To create PRP therapy, a sample of your blood is drawn, volume depending on the clinical presentation, and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The concentrated platelet rich plasma (PRP) is then injected into and around the point of injury, jump-starting and significantly strengthening the body’s natural healing signal. Because your own blood is used, there is no risk of a transmissible infection.
How long does it take?
The procedure takes approximately one hour, including preparation and recovery time. Performed safely in our state-of-the-art medical office, PRP therapy relieves pain without the risks of surgery, general anesthesia, or hospital stays and without a prolonged recovery.
How often should this procedure be done?
Up to two injections may be given, depending on the clinical presentation. You may, however, gain considerable to complete relief after the first injection.
What are the expected results?
Because the goal of PRP therapy is to resolve pain through healing, it could prove to have lasting results. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses. Research studies and clinical practice have shown PRP therapy to be very effective at relieving pain and returning patients to their normal lives. Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses and the condition is irreversible.
During pregnancy, a fetus is surrounded by a fluid known as amniotic fluid, which serves to both protect the fetus and aid in its growth. Doctors discovered that amniotic fluid was beneficial in treatments such as the healing of wounds and musculoskeletal injuries. Over time, this treatment has been developed thanks to advancements in the ability to screen donors and amniotic fluid for safety, as well as the ability to safely preserve these tissues at very low temperatures until they are ready for use.
How is amniotic fluid useful?
Amniotic fluid has several properties that make it well suited to medical applications such as healing damaged or degenerated tissues. Many of the molecules contained in amniotic fluid reduce inflammation and immune response. Unlike most other tissues found in the body, amniotic fluid is immune privileged, meaning it can be injected into another person without producing an immune system reaction. Further, amniotic membrane tissues contain groups of connected proteins called collagen matrices. These collagen matrices serve as a sort of scaffolding in the healing process. New tissues grow around the framework provided by these collagen matrices.
What should you expect?
Our Doctors have had success with Amnio Therapy in healing damage tissues such as muscles, tendons and joints. After receiving Amnio Therapy, healing will take between several weeks and a few months to notice the results. Many patients get healing and pain relief after a single injection. However, based on an individual patients’ condition and symptoms and their doctor’s assessment, additional injections may be advised. Further, as with any treatment for pain, not every patient will have success with this treatment.
ADVANCED STEM CELL TREATMENTS:
Bone Marrow Aspirate Concentrate (BMAC) Therapy
Bone Marrow Concentrate (BMC) is a promising regenerative therapy to help accelerate healing in moderate to severe soft tissue injuries. Similar to Platelet Rich Plasma (PRP), BMC harnesses the body’s natural ability to heal itself by using regenerative cells found in a patient’s own bone marrow. Bone marrow is the soft tissue found in the hollow interior of bones.
In adults, marrow contains a rich reservoir that produces new blood cells, including regenerative cells. These cells can be extracted from the patient’s hip and used for BMC injection therapy. The process of obtaining and preparing these powerful regenerative cells is relatively simple. The physician removes a small amount of the patient’s bone marrow. Local anesthesia is used, providing minimal discomfort. The bone marrow is then placed in a centrifuge, which separates the regenerative cells and platelets from the rest of the blood products. The result is a concentrate that is 5-11 times richer in regenerative cells and growth factors. With new techniques and technological improvements, regenerative cells can easily be obtained and concentrated in a simple office procedure.
Unlike other cells of the body, bone marrow regenerative cells are undifferentiated, which means they have the ability to replicate themselves into a variety of tissue types. Our body is in a constant state of repair and regeneration. Unfortunately, as we mature with time, the quantity of regenerative cells declines. For example, as in infant, one in 10,000 cells is a regenerative cell versus one in 2,000,000 by the time we reach 70. This partly explains why our injuries often take longer to heal as we age.
Adipose-Derived Stem Cell Therapy
There is no medical controversy involved in Adipose Derived Stem Cell (ADSC) Therapy practiced by our office. Your own adipose tissue (fat) is the source of the stem cells that will be extracted and then ultimately injected at the site of your injury or pain. The use of autologous (coming from the patient’s own body) stem cells for orthopedic conditions including heel pain is FDA-cleared; it is neither controversial nor dangerous. The use of ADSC is legal and safe. Adipose tissue is very rich in stem cells; primarily mesenchymal stem cells.
Fat harvesting for ADSC therapy is done by a board-certified plastic surgeon with a very simple process called lipo-aspiration. It is important to understand that lipo-aspiration is vastly different from liposuction. Liposuction is performed by a plastic surgeon in our office-based surgical suite using local anesthesia. Liposuction removes a very large volume of fat and is intended for a cosmetic result.
Lipo-aspiration uses a small amount of local anesthetic, a small instrument slightly larger than a small needle, which removes a very small amount of fat (5-10cc), and does not render any visible change in appearance. The entire process is virtually painless. The stem cells are then combined with platelet rich plasma (PRP) to activate them. After injection of ADSC/PRP, real healing begins. The stem cells stimulate your own body’s healing response and perform a variety of healing functions by differentiating, or changing, into whatever type of cells are needed at the injury site, including ligament, tendon, cartilage or bone.
What is prolotherapy?
First, it is important to understand what the word prolotherapy itself means. “Prolo” is short for proliferation, because the treatment causes the proliferation (growth, formation) of new soft tissue in areas where it has become weak.
Ligaments are the structural “rubber bands” that hold bones to bones in joints. Ligaments can become weak or injured and may not heal back to their original strength or endurance. This is largely because the blood supply to ligaments is limited, and therefore healing is slow and not always complete. To further complicate this, ligaments also have many nerve endings and therefore the person will feel pain at the areas where the ligaments are damaged or loose.
Prolotherapy uses a dextrose (sugar water) solution, which is injected into ligaments such as the plantar fascia where it attaches to the bone. This causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients, thus stimulating the tissue to repair itself.
TRAUMEEL ® Injection is a natural pharmaceutical solution used to treat musculoskeletal injuries and acute and chronic inflammation. It is injected to the problem site to help regulate and support the body’s immune response, helps relieve pain and further aid the healing process.
TRAUMEEL ® Injection Solution, registered with the FDA, is officially classified as a homoeopathic combination remedy and is formulated with 12 botanical substances and one mineral substance. TRAUMEEL® Injection Solution is indicated for the treatment of symptoms associated with inflammatory, repetitive or overuse injuries such as plantar fasciitis.
Unfortunately there is little public awareness in the states about this treatment option, however in professional athletic circles there is great demand and respect for this therapy. The treatment is appealing because of its immediate effects combined with a low side effect profile compared to steroid injections and anti-inflammatory medications.
EXTRACORPOREAL SHOCK WAVE THERAPY:
What is Extracorporeal Shock Wave Therapy (ESWT)?
ESWT is a fast and gentle non-surgical method of reducing heel pain. It is derived from lithotripsy, a technique used today to disintegrate kidney stones without the use of invasive surgery. The device delivers pneumatically-generated low or high pressure shock waves that travel through the skin. Inflamed soft tissue and bone calcifications that receive these low or high energy pulses will heal stronger without harm to the surrounding tissues. Electricity is not sent into the body. High energy pulsations of ultrasonic waves stimulate the body’s natural self-healing process.
Who does this treatment benefit?
ESWT is especially beneficial for patients that have chronic heel pain and Achilles tendinitis and have not had much success with traditional therapies such as medications, injections, orthotic therapy or physical therapy. If you suffer from plantar fasciitis, heel spur syndrome or Achilles tendonitis, you may be a candidate for this treatment.
Can anyone receive this treatment?
The doctors at Jaws Podiatry will determine if you are a candidate for ESWT. It is reserved for special cases where conventional treatments have not provided adequate relief of pain.
Does this treatment involve surgery or medications?
ESWT means that there is no surgery, no anesthesia, no injections and no medication.
What is involved in the treatment?
The procedure is performed in our office. After a thorough evaluation, we will carry out a simple manual examination of the painful area. The trigger point, or sore area over the heel will be located and marked. Ultrasonic transmission gel is applied to the foot. The ESWT hand piece is then positioned to gently and extensively transmit shockwaves over the injured area. The feedback you provide helps to determine the fine positioning of the applicator and the measurement of the impulse frequency. Once you are comfortable at a low level, the energy is gradually increased over several minutes.
How long does the treatment take?
A typical session lasts about 15 minutes.
How soon can I expect results?
Most patients will notice improvement after the first treatment, however, overall healing continues for 3 months after the last treatment. Success rates with this advanced treatment is approximately 70-80%.
Are there any side effects with ESWT?
There are virtually no side effects with ESWT since no medication, surgery, injections, or anesthesia is involved. Some patients may experience a short period of slight tingling, warmth or numbness immediately after their treatment.
JAWS podiatry is now offering ultrasound-guided Botox injections; a new treatment for patients with plantar fasciitis resistant to conservative treatments including corticosteroid injections. Botulinum toxin is injected into the plantar fascia to reduce pain and inflammation. Botulinum toxin has unique properties of targeted decrease in pain combined with relaxation of the contracted structures addressing the cause and effect simultaneously. Please see the attached study for more information.
PERCUTANEOUS PLANTAR FASCIOTOMY: (PARTIAL RELEASE OF LIGAMENT)
Percutaneous plantar fasciotomy is used to treat recalcitrant plantar fasciitis that has failed to respond to an appropriate duration of conservative treatments. The minimally-invasive procedure involves releasing a small portion of the plantar fascia, just beyond its origin as it comes off the heel bone (calcaneus). This is usually an area where the tissue has abnormally thickened, tightened, calcified, scarred, and it is this constellation of pathology in whole or in part which likely causes the ongoing pain.
The procedure is performed under local anesthesia in our office-based surgical suite. The incision is less than 2mm in length (the size of a key-hole). The procedure does not completely disrupt the entire plantar fascia, which is an important structure for arch stability. This procedure is usually combined with either a stem-cell or platelet rich plasma injection for optimal results.
This procedure is used to treat chronic (not acute) plantar fasciosis that has failed prolonged conservative management. It should be performed only by a surgeon who has significant experience in minimally-invasive procedures and techniques.
OZONE / PROLOZONE THERAPY:
What is Ozone?
Ozone is a safe naturally-occurring type of oxygen. Ozone has been used in the practice of medicine for about 100 years. Oxygen naturally has two molecules attached to each other, O2. Ozone is essentially O2 with an added single molecule of oxygen making O3. When the ozone is introduced into the damaged foot and ankle area, the single molecule of oxygen splits from the other 2 causing high levels of regular oxygen plus single oxygen molecules in the tissue. This combination is so powerful that it immediately leads to the bodies innate ability start “rebuilding” joints, ligaments and tendons.
How does prolozone work?
Prolozone works by increasing oxygen to areas of damaged connective tissues. These areas generally have low oxygen levels and decreased blood flow thus decreasing their ability to heal. In addition, swelling and inflammation to these areas results in further decrease levels of oxygen needed for healing and repair. With low oxygen levels to the damaged area, the body is unable to start the healing process and this is why many people don’t get better with treatments. They actually worsen as this cycle of damage, inflammation and decreased oxygen never ends. Even though there are stem cells and growth factors available in the body to heal the area, they are unable to reach the area due the low amounts of oxygen and blood flow to the area.
When oxygen levels and blood flow are increased through ozone treatments, important cells rapidly grow and lead to natural healing of painful foot, ankle and knee areas. In addition, all of the nutrients necessary for repair will rush to the painful area. Ozone also does much more than this as it actually alters the bodies healing pathways and turns chemicals on that promote healing.
WHAT TO EXPECT?
Your doctor will examine the area of specific pain. Local anesthesia is sometimes used during the treatment for comfort. Additional natural substances may also be used to enhance healing. Most people usually require multiple sessions to maximize outcome and improvement.
In some cases, ozone may be used in combination with other regenerative procedures such as platelet rich plasma (PRP). Since Ozone must be made and used quickly, your doctor produces the healing molecules just prior to performing the treatment. Prolozone is a natural time-tested safe and effective treatment that directly treats the cause of pain. Traditional medicine typically treats the symptoms, regenerative medicine treats the cause and leads to true healing.