Heel Pain: Healing the Heel
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Chapter 9: Growth Factors—regenerating your plantar fascia
“the diseased part of your plantar fascia is debrided (scraped), and replaced by tissue growth factors processed from your own blood—all through a small needle like device, so that the plantar fascia tissue regenerates (grows) where it could not before. All this is done under high resolution diagnostic ultrasound—so there is no guesswork or shotgun type approach!”
Using high resolution diagnostic ultrasound, this new, minimally invasive, and natural treatment, developed by Dr. Barrett, uses the patient’s own blood to repair their damaged or degenerative plantar fascia. It is done on an outpatient basis, and is a completely comfortable and mostly painless procedure to undergo. The patient is usually generally anesthetized for a short period of time, while the heel is anesthetized with a local anesthetic, and a small tube of blood is withdrawn from the patients arm the same as when you have a blood test. Using a specialized process, the patient’s blood is used to harvest the growth factors Fig 9-a and 9-b. Using high resolution diagnostic ultrasound (fig 9-c), the degenerative areas of the plantar fascia are identified and excised or scraped with a needle like rasp, followed by placement of the patient’s own growth factors by injection, into these treated areas of degenerative tissue fig (fig 9-d & e) . In order to accelerate the growth factors, this treatment is followed with a course of low energy shockwave treatments fig. 9-f. The shockwave treatment causes the alpha granules in the patient’s platelets to open and release the growth factors into the tissue that is being rejuvenated. Remember that the platlet is a specialized bold cell that is usually only thought of as the “cell” that makes the blood clot. Platelets also carry important and necessary growth factors to the wound to start the healing process. The patient is able to walk immediately the same day, and usually returns to regular activity in a few weeks, but is encouraged to take it easy for several days after the procedure. Depending on the severity of the condition, occasionally a second infiltration treatment, or additional low energy shockwave treatments are required. Because this type of treatment is effective in more than 85% of the cases, and it is very minimally invasive (fig 9-g) the patient is allowed to walk immediately. This type of treatment does NOT make the heel pain go away immediately, as there needs to be a regeneration of new plantar fascia tissue where the degenerated area was scraped. Usually the patient has less pain than before the procedure at about 2 weeks, but complete resolution can sometimes take an additional treatment and up to 6 months. Most patients are fully improved between 6 and 12 weeks. The important aspect about this procedure is that it does NOT impair or alter the biomechanical function of the plantar fascia.52
We recommend that the patient limit the amount of standing or walking they do during the first 48 hours. It has emphasized that because we are actually trying to induce an inflammatory response in the fascia itself, it is important not to take any anti-inflammatory medication.
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About the Book
Written by one of the world's experts in heel pain, Dr. Stephen L. Barrett has shared more than two decades of his clinical, academic, and surgical knowledge for the patients with heel pain in this book. Heel Pain: Healing the Heel, is written in easy to understand language, with color photos and illustrations so that every person with heel pain can empower themselves for optimal treatment whether mild or severe. Dr. Barrett is considered the "Father of Endoscopic Foot Surgery", and has trained more than 5000 surgeons throughout the world in his patented minimally invasive surgical techniques. Since he introduced the EPF technique in 1990, more than 1 million of his procedures have been performed. This book is comprehensive and has chapters dealing with many different causes of heel pain, as well as many types of treatment. The newest technology for the treatment of heel pain is included in this book including the use of growth factors for the treatment of plantar fasciitis (fasciosis). Conservative, non surgical treatments are also well explained in this book. This book also explains the "hope" for those patients who have had previously failed heel surgery.
About the Author
Stephen L. Barrett, D.P.M., MBA is an Adjunct Associate Professor, Midwestern University College of Health Sciences, Arizona Podiatric Medicine Program, and is in active private practice. He is board certified by the American Board of Podiatric Surgery, the American Board of Podiatric Orthopedics and Primary Podiatric Medicine, and by the American Academy of Wound Management. He a contributing editor for the Journal of the American Podiatric Medical Association with a specialty designation for peripheral nerve surgery. He has authored more than 30 peer reviewed journal articles, written chapters for and edited textbooks, and has lectured throughout the world over the last two decades. His minimally invasive surgical techniques are included in "Campbell's Operative Orthopedics", which is considered one of the landmark medical textbooks in orthopedic surgery.