Heel/Achilles pain help

If your pain is concentrated in the back of the heel into your achilles tendon, it sounds like you're dealing with what I deal with - occasional achilles tendonitis driven by a heel spur at the insertion point of the tendon into the heel bone. If you had PF, it seems the pain would be more concentrated along the bottom of your foot. My wife deals with that on occasion.

When my heel spur inflames my achilles tendon, it will feel like a knife going through that area anytime I try to even flex my foot. I can't stand on it or walk. I normally am off my feet for at least a couple of days and have to get a steroid to calm the inflammation.

Whether you see an orthopedist, or a podiatrist or some other doctor, they'll generally tell you the best preventive measure is stretching it for a few seconds each, throughout the day. That has helped me prevent more frequent occurrences. The last resort is surgery to remove the heel spur, but that is really disruptive to your life, as you're off your feet for the first few weeks, followed by being in a boot for another stretch of time. It's about two months at least until you can bear weight and walk on it.

The podiatrist I see told me about another option I recently tried, which is shockwave therapy into the affected area. They can give you at least two and up to five individual treatments, a couple of weeks apart. Insurance doesn't cover it, but it's only about $75 per treatment, so very doable. They press the device against your affected area, which can be a bit uncomfortable and a little painful at times, but the treatment only lasts about 2 minutes each.

But the doc told me not to take any steroid meds for at least the next six weeks following the final treatment. I happened to get contact dermatitis on my lower legs, causing a fiery skin rash. I had to get a steroid prescription to calm it quickly, but I forgot about the podiatrist's instructions, so I may have nullified the effect, at least to some extent. That said, the heel spur hasn't caused any real aggravation since.

I'm still gauging things to see if I'll need to give in and get the surgery. I'm hoping not. I did hear of one person who did and he said he wished he would have done it sooner. He was back up and going for runs once his recovery was done. The surgery involves putting you out, making a small incision, detaching the tendon from the heel bone, shaving off the spur, smoothing out the surface, then re-attaching the tendon to the bone via some clamps. I asked the doc who performs these surgeries how effective is it in keeping the tendon in place. He said he once did the surgery on a woman who afterward fell down some steps. The tendon held but her heel bone fractured. So, the clamps hold great, but in her case, the pressure had to go somewhere.

Also, I finally started using some inserts, and those have really helped, too. Sorry for writing a book here, but I know what it's like to deal with this crap, and wanted to try to be helpful.