I volunteer at a clinic some Friday afternoons and had an unusual experience recently. There was a patient who had very acute heel pain and really needed an injection for this problem; however they were extremely afraid of getting an injection having heard from friends that it is extremely painful. This does not usually happen in my office either because patients have heard from other patients of mine that heel injections are not painful, or my assistant assures them that there is minimal pain associated with this injection.
So why are some heel pain injections extremely painful and ours not?
The answer is quite simple and was demonstrated very dramatically at the volunteer clinic the other day. The answer is simply to do a very quick and practically painless block of a nerve at the ankle which goes to the heel and causes the heel injection to be painful. We spray a cold spray on the skin over the nerve to the heel and inject a tiny bit of a short-acting anesthetic. This takes about a second and is barely felt. In a few minutes the nerve going toward the heel is asleep and we put the injection into the heel with little or no pain. At the clinic, it was amazing to both the patient and the medical staff to have a painless heel pain injection!
So why doesn’t everyone put a tiny bit of anesthesia around the nerve (posterior tibial nerve) at the ankle and make the heel pain injection virtually painless? Perhaps the reason is that these days as doctors are so rushed the few minutes of extra time is just not taken to do a two-step procedure where it could be a single step or perhaps the technique has just been forgotten. With my patients, I always spend a few extra minutes and obtain a little local anesthesia before a heel pain injection is given and very, very, rarely does anyone complain that it is painful.
To learn more about treating heel pain, visit our website at www.healthyrunning.org.