Heel Pain Treated Right,
the First Time.
Success Rate
Exam Protocol
Than Just Plantar Fasciitis
Fasciitis at All
Heel Pain Has Many Causes.
We Find the Right One.
Heel pain is rarely as simple as a single diagnosis. It can stem from nerve entrapment, bone edema, fat pad atrophy, or plantar fasciitis, and in many cases, more than one of these is happening at the same time. When only one cause is identified and treated, the pain persists.
At Next Step Foot & Ankle Clinic, we specialize in getting to the root cause. Our thorough diagnostic approach uncovers what’s actually driving your pain so we can build a treatment plan that targets the real problem, not just the symptoms.
What Could Be Causing Your Pain?
Heel and arch pain can come from many different sources. Often it’s more than one thing at once. That’s why treatment fails when the diagnosis is incomplete.
Our 6-Point Diagnostic Protocol
We don’t guess. We use a systematic approach to rule out every possible cause of your pain before recommending treatment.
Detailed History & Listening
We start by listening carefully to your complaint, your history, and what you’ve already tried. This alone often reveals clues that previous doctors missed.
Symptom-Directed Physical Exam
A thorough, multi-step exam of your lower extremity. Every day patients tell us “no one has ever examined my foot so carefully before.”
In-House Ultrasound
Real-time imaging to see plantar fasciitis disease, nerve enlargement indicating entrapment, fat pad atrophy assessment, and nerve decompression. Many clinics don’t even have one. We use ours every day.
X-Ray Analysis
Structural evaluation of bone alignment, joint spacing, and any bony abnormalities contributing to your pain.
Diagnostic Injections
Targeted injections to confirm exactly which structure is causing your pain, pinpointing the source with precision.
Mechanical Testing
Mechanical offloading techniques to test and verify the diagnosis before committing to a treatment plan.
Treatment Options
Once we have the right diagnosis, we build a treatment plan designed to get you pain-free or vastly improved within days. Most patients don’t need surgery.
First Visit Relief Protocol
On your first visit, our goal is to have you 85-90% better within 2 days. We do several things at once for maximum impact. This approach has been very successful for our patients.
3D Custom Orthotics
Not generic arch supports. We do a thorough exam so your orthotic actually controls your foot and decreases stress on the plantar fascia. Designed for your specific biomechanics.
Joint Contracture Treatment
Specialized equipment to address joint contractures that contribute substantially to heel pain. Promotes healing without interrupting your lifestyle.
Therapeutic and Diagnostic Injections
We use techniques to control injection pain. The vast majority of our patients say they’ve felt significantly less discomfort compared to injections they’ve had elsewhere.
Shockwave Therapy
Shown to be as effective as surgery when appropriately applied. Quick results, no interruption to daily activities, and promotes long-term tissue healing.
Class IV Laser Therapy
The gold standard in laser therapy. Robotic, computerized laser providing anti-inflammatory, analgesic, and accelerated tissue repair benefits.
Injectable Tissue Repair
Extracellular matrix and amnion injections that provide a structural repair model for damaged tissue. Often used with shockwave therapy for significant degeneration.
Combination Therapy
By combining multiple modalities we magnify the effects. Your treatment plan is tailored to your specific diagnosis, not a one-size-fits-all approach.
Minimally Invasive Surgery
When needed, we offer procedures through incisions about the width of a pencil eraser. Quick return to work and activity. Multiple surgical approaches available.
Nerve Decompression
For heel pain caused by nerve entrapment. Releases the compressed nerve to eliminate pain at its source. Performed by our AENS-certified nerve specialists.
Real Patients, Real Results
“I went to another doctor who told me I had plantar fasciitis without even touching my foot. At Next Step, Dr. Silvester did a thorough exam, used ultrasound, and found that I actually had nerve entrapment along with the fasciitis. Once we treated both, the pain finally went away.”
Questions About Heel & Foot Pain
Honest answers to the questions we hear most.
Why hasn’t my heel pain gotten better with treatment?
The most common reason is an incomplete or incorrect diagnosis. About half the patients we see have more going on than just plantar fasciitis, and about 20% don’t have it at all. If you’re being treated for the wrong thing, the treatment won’t work. Our 6-point diagnostic protocol identifies what’s actually causing your pain.
Will I need surgery for my heel pain?
Most patients don’t need surgery. Our first visit protocol is designed to have you significantly better within a couple of days. When surgery is necessary, we offer minimally invasive procedures through very small incisions with quick recovery.
What about the injection? I’ve heard horror stories.
We use a technique to help control the pain of injections. The vast majority of our patients say they’ve felt significantly less pain with our injections than injections they’ve had elsewhere. You are always in charge.
What’s the difference between your orthotics and ones I can get elsewhere?
Most orthotics are nothing more than expensive arch supports that don’t account for what your specific foot needs. We do a thorough exam so your 3D custom orthotic actually controls your foot and decreases stress where it matters. Designed for your biomechanics, not a generic shape.
Are any of these treatments covered by insurance?
Your initial evaluation and diagnostic workup are typically covered by insurance. Some of our advanced therapies (shockwave, laser therapy, injectable tissue repair) are not covered by insurance. Our team will explain all costs upfront before any treatment begins.
How long does heel pain take to heal?
With our first visit protocol, most patients feel 85-90% better within 2 days. Long-term healing of the damaged tissue varies depending on the diagnosis, but we build a plan that includes both immediate relief and a long-term solution to keep you better.
I’ve had heel pain for months. Is it too late?
No. In fact, many of our patients come to us after dealing with pain for months or even years. If your foot pain has persisted for more than 2-3 months and isn’t improving, it’s a strong indicator that something needs to be properly diagnosed and treated. The sooner you come in, the more options we have.
Can heel pain be a nerve problem?
Absolutely. Nerve entrapment is one of the most commonly missed causes of heel pain. The nerve can be compressed or irritated, mimicking plantar fasciitis. X-rays don’t show this, which is why it’s often overlooked. Our diagnostic protocol specifically tests for nerve involvement.
What if I’ve been dealing with heel pain for a long time?
Whether your heel pain is new or has been going on for months, we can help. Our 6-point diagnostic protocol identifies the real cause, and our advanced therapies give us options that most clinics don’t have. The sooner you come in, the more options we have to get you better.
Related Conditions
Stop Living with Foot Pain.
Whether it’s your heel or your arch, our goal is to find the real cause and get you back on your feet within days.