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The response to the question below was authored by Marc Mitnick DPM

Above the heel pain

by Katherine
(Louisiana)

Hi! Over a year ago I hurt my left foot working out I went to a podiatrist and was diagnosed with planter fasciitis. I was taking anti inflammatories but still having pain. Along with the pain a lump started forming I between the heel and arch. I went to another podiatrist who also said it was planter fasciitis so is started getting physical therapy on my own. They did ultra sound therapy and deep massages. The lump finally went away but the pain didn't. I then went to another doctor who gave me a shot and put me in awaking boot for a month. The pain is gone but another lump formed but it feels like a shoe string going across the top of my heel. I have been stretching, massaging and icing what else can I do?

RESPONSE

Hi Katherine,

In individuals that have repeated plantar fasciitis there are a few things worth mentioning.
You do not mention whether you have orthotics or not, but in my practice, orthotics are the cornerstone of any treatment for plantar fasciitis. The reason is quite simple. All the other treatments you mention are to relieve the pain, but none of them address the underlying problem. If the underlying problem is not addressed properly then you will probably keep having episodes of plantar fasciitis assuming you maintain your current lifestyle and activity level.
The plantar fascial ligament acts as a bow string to support the arch of the foot. If a foot flattens out too much, it puts

tremendous pressure on the ligament and the ligament becomes inflamed at its insertion into the heel bone. (this is the most common, but not only cause of heel pain). An orthotic supports the ligament so that it will not over stretch and thus the heel pain will eventually go away if it is not being constantly irritated.
The other point I would like to make is about your type of heel pain complaint. Because you have had repeated heel pain issues and because there has been excessive swelling and prolonged swelling, I am a bit concerned about other potential problems.
The first thing that comes to mind is the possibility of a tear in the plantar fascial ligament. This does not happen regularly, but certainly happens frequently enough that at this point, with your repeated episodes, someone should look into that possibility.
This would require an MRI which is very good at determining whether there is a tear or other pathology in the ligament.
Another, more remote possibility is a fracture in the heel bone. A stress fracture may occur without history of trauma, from nothing more than exercise. An MRI would also point out a fracture if there indeed, is one present.
I know you have been to a few podiatrists, but quite frankly I am very underwhelmed by the quality of care that you have received. Find a doctor who is willing to really investigate the problem and then who is willing to address the underlying cause of your problem.

Marc Mitnick DPM
DISCLAIMER

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

MY PRODUCT RECOMMENDATIONS(items I prescribe in the office)

Orthotics for multiple types of foot pain best buy in a pre-made orthotic click link below

Orthotics for heel and arch pain for those who must wear dress shoes click link below

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Click to verify - Before you buy!

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Fla

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Ontario, Canada

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Fla.

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Judy

(location unknown)

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New York

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Memphis, TN

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Scotland

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J. Simmons

(location unknown)

Dear Dr. Mitnick, The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics. I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again. Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

Yours truly,

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Tennessee

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Redondo Beach, CA

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LH

(location unknown)

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(location unknown)

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(location unknown)

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Madison, Alabama

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Denison, TX

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Tampa, Florida 33624

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Texas

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Tampa, Florida 33624

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Steve

Dear Dr.Mitnick

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Regards,

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Edmonton,Canada

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South Africa

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Mansfield Ctr, CT

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Steve

Placentia, California

First, I want to let you know that you have the best web site I've found related to foot issues. (The only thing I had difficulty finding was the "ask a question" page.)

Unknown

Unknown location

I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

Ric J.

Unknown location

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Pacific Grove, CA

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All the best,

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Alameda, California

By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!

Anonymous

Thank you for your very interesting and informative site!

Anonymous

Hi. I come to your site often looking for information. It is really informative and I appreciate it very much. I have RA and have been having considerable amount of foot pain...... Dee RN

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New Zealand

Thank You for my answer! I have been schedule for a bone density scan, allingment, and I am in the process of getting orthotics made, and checking out the natural remedies. Thank again! What a great web site!

Sincerely

Josette

Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

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Arizona

I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida

1st of all THANKS A LOT for your great site......

Anna

Poland

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M P

South Carolina

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Natalie

unknown location

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Arlington, VA

Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

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San Clemente, CA

Dr Marc is fantastic...He seems to know exactly what you are feeling with the problems you are having. I wish he was in my home town so I could go to him with my problems!!!!!!!!!!!!!

Pam

location unknown

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location unknown

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Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous

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Poland

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Seattle, WA

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Bonnie

location unknown

Also, and importantly, just want to praise this web site. Thorough and thoughtfully presented, it certainly must be of considerable assistance to anyone with a foot problem. Terrific -- and very interesting.I trust the address comes up easily for those seeking information.

Bill

New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

Chrissy

location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown

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-Sunny.

location unknown

Thank you very much for the information, I will consider it. Excellent web site.

Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown

THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS

thanks again, this site is very helpful.

mark

Boston, MA

Like others have stated...This site is amazing and I am so thankful that it was created.

....Keep up what your doing. Your a life saver.

Michelle

Colorado

Thanks again for the information provided on your site. It's easy for non-medical folk to understand your writing, and helps provide better communication between patient and doctor.

annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

Canada

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

Bonnie

location unknown

Again, Thank you from the bottom of my heart for taking the time to answer my question....your an angel!

Nancie

Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown

Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC

Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA

I cannot thank you enough for your response, opinion, and suggestions! I want you to know how much it means to me, and I'm sure everyone else who has ever asked you a question! I feel like you're a lifesaver and have empowered me to take a stronger role and stand up for myself and my feet!

Jodi

location unknown

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Above the heel pain

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