What is Prolotherapy of the Heel?

Prolotherapy is non-surgical fascia augmentation. The plantar fascia is a strong fibrous band that extends from the bases of the toes to the heel bone (the calcaneus or inferior calcaneal tuberosity) on the bottom of the foot. The fascia actually extends around the bottom of the inferior calcaneal tuberosity. The fascia can be felt in the bottom of the foot as the plantar arch.

What conditions are Prolotherapy used for in the heel?

1. Plantar fasciitis. Plantar fasciitis is actually a misnomer for a condition known as plantar fasciosis. In fasciosis the plantar fascia at its attachment at the heel bone becomes weakened and damaged and strained. The fascia stops healing and going through the normal reparative process. The heel pain may be from direct trauma as in direct injury or a repetitive stress injury from taking thousands of steps per day. Obesity and/or foot dysfunction can also be aggravating factors.

2. Heel spur syndrome. This is usually a combination of plantar fasciitis/fasciosis with the addition of a calcaneal heel spur. This spur is an attempt of the body to repair an area under repetitive weight bearing stress.

3. Atrophy of the fat heel pad. Beneath the inferior calcaneal tuberosity is a normal fat pad. This can thin out. It happens especially in people who have significant weight loss from dieting or aging. Obesity ironically can also cause thinning of the fat pad. Excess weight can crush and thin the fat in the heel pad.

4. Inferior calcaneal tuberosity micro-fractures (not macro or large fractures), which are failing to heal.

How does Prolotherapy work?

Prolotherapy restarts the normal inflammatory healing cascade. Essentially the pain is caused be non-healing or non-repair of the above conditions. Prolotherapy thickens the soft tissues beneath and around and attaching into the heel bone therefore producing additional soft tissues padding and cushioning and fascia repair and strengthening.

What other conditions is Prolotherapy used for?

Prolotherapy is used to treat ligamentous laxity around a joint. This laxity creates joint instability which causes abnormal motion, this creates pain and arthritis. This pain can be acute or chronic. Prolotherapy is also known as Proliferation Therapy or Prolo for short. Prolo causes proliferation of connective tissues such as ligaments, tendons and or fascia. Prolo can be used to treat arthritis, arthrosis, tendonitis, tendonosis, fasciitis, fasciosis, joint weakness, separations and many other conditions.

How is Prolotherapy performed?

In our practice the involved area is anesthetized. A glucose-dextrose solution with local anesthesia is then infiltrated into the connective tissue at its attachment to bone or in the area it has become weakened or damaged. This procedure is usually performed under ultrasound imaging guided technique. This injection causes a micro-trauma and induces the normal inflammatory response. This in turn thickens the connective. Basically your body heals and repairs itself.

Who performs Prolotherapy?

A doctor trained and experienced in prolotherapy. This could be a physical medicine specialist, a pain specialist, or an orthopedist or podiatrist with the special training. I (Dr. Buividas) have received special training in prolotherapy and have successfully treated many patients, performing the technique exclusively on foot and ankle conditions.

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