Dr. Lorry A. Melnick, DPM, Denver has vast experience in the field of podiatry. A graduate of Colorado State University and The Illinois College of Podiatric Medicine, he started his own private practice in 1976. Board certified by The American Board of Podiatric Surgery, He has experience as a diabetic podiatric consult as well as being a clinical instructor of podiatric surgery.
Owner of the busy Cherry Creek Foot & Ankle Clinic in Denver, Dr. Melnick performs everything from routine checkups to out patient surgery at the hospital. He uses Diagnostic Ultrasound to treat ankle injuries, plantar fasciitis, neuromas and other disorders. He employs lasers for treating fungal conditions. Dr. Melnick also designs and provides custom orthotics to his patients. Dr. Melnick has been a podiatric consultant to several nursing homes in Denver over his career.
We were fortunate enough to take some time out of Dr. Melnick's schedule to discuss the subject of heel pain and how it can be treated.
We were fortunate enough to take some time out of Dr. Melnick's schedule to discuss the subject of heel pain and how it can be treated.
Dr. Melnick, what is the most common cause of heel pain?
Dr. Melnick: The most common cause would be plantar fasciitis which is a tightening of the plantar fascia. As you walk the fascia tends to be tight so it tends to pull as the foot hits the ground. That pulling at the back of the heel causes inflammation to the plantar fascia. When you get up in the morning you experience a lot of pain, stiffness and soreness that tends to dissipate as you walk it out a little bit. It can also happen after sitting for awhile.
Is it a recurrent condition in your patients?
Dr. Melnick: Yes, we see it a lot in people who tend to have a lack of support in their shoes, and in runners with a lot of sports injuries that will have plantar fasciitis. We also tend to see it in overweight patients as well.
Does footwear contribute to this condition? What do you recommend as far as footwear is concerned?
Dr. Melnick: Footwear can definitely be a factor if there is no support, no arch support in the shoe. We find that orthotics seem to really work out well because they will fit in most shoes. We take out the insole that comes with the shoes and then put in an orthotic that is actually made to the shape of the patients arch and foot. What it does is lift up on the plantar fascia and takes the pressure off so as they walk it is not pulling where it inserts into the heel or the calcaneus.
What are the treatment options for this condition?
Dr. Melnick: There's a wide range of treatments that we have from conservative to surgical. A lot of times we'll do a steroid type injection, physical therapy, orthotics, stretching, oral medications. Those a lot of times will knock out the pain and people do very well. There is a small percentage of people who don't respond to this type of treatment. For those patients we will do a minor procedure where we lengthen the plantar fascia, there are also some new procedures now where you can inject platelet rich plasma into the area which causes an inflammatory response and gets the area to heal. Those are some newer treatments we are using to treat plantar fasciitis.
Do a lot of the patients you see ignore their injuries until their condition becomes severe?
Dr. Melnick: Yes, we see that a lot. Patients will start out and have a little bit of pain when they get up in the morning and they think it will go away over time. Normally it will tend to get worse. They are hobbling to get out of bed in the middle of the night when they get up to go to the rest room or they are hobbling when they get out of bed in the morning. They tend to be sore after sitting when they stand up. After awhile, the pain tends to get pretty nasty and they come in for treatment.
Is it possible to seek treatment and still engage in your normal routine?
Dr. Melnick: Oh yes, our goal is to get people back to normal and get them back to their daily activity. During treatment, if they are a runner I would generally wait until we calm things down to have them go running. We have a lot of patients that are able to do upper body exercises, they are able to use elliptical machines, swimming is another good example. So there are exercises we can do that will not stress the plantar fascia.
Dr. Melnick, what do you recommend to your patients after treatment? Are there things they can do to avoid this in the future?
Dr. Melnick: Sure. I show them some stretching exercises so that they can stretch the plantar fascia and I also put a lot of them in orthotics and that tends to control the motion in the foot, lift up on the plantar fascia and take the pressure off the heel.
Doctor, what do you think is the biggest consideration someone should make when seeking treatment for heel pain?
Doctor, what do you think is the biggest consideration someone should make when seeking treatment for heel pain?
Dr. Melnick: In seeking treatment for heel pain I think it's important to see a specialist, someone who tends to treat that problem regularly. There is a lot of techniques we use to get them back to activity fast.
Dr. Melnick, thank you for your time today.
Dr. Melnick: You're very welcome.
Dr. Lorry A. Melnick, DPM, Denver, is owner of The Cherry Creek Foot & Ankle Clinic in Denver. His office can be reached directly at 303-355-1695. His clinic website is ccfootclinic.com.
Kevin Nimmo is a writer and online media strategist. He interviews subject matter experts and educates his readers based on information provided by experts in their respective fields. He is also Executive Editor of The Western Medical Journal.
Kevin Nimmo is a writer and Executive Editor of The Western Medical Journal. The Western Medical Journal features interviews with medical specialists who are experts on in their respective fields. From Chiropractic to Internal Medicine to Podiatry, we ask the questions most never get the opportunity to ask. Check us out at http://www.westernmedicaljournal.com
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