Dr. Corey Fox
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Long Island Podiatrist serving Massapequa and all of Nassau County

Throughout the years of seeing people with heel pain come through our door, one question has persisted:

Why do people suffer so long before coming in for help?

Heel Pain

Honestly, we do understand some of the reasons. For one, heel pain can be one of those conditions that you feel nothing can really be done about.

Or that, while it’s persistent, it’s just not bad enough to warrant a visit to a foot doctor.

OR it will eventually go away on its own. Any year now…

All of these reasons are nonsense, of course. But there’s one fear we do understand: What if I need surgery for my heel pain?

It’s understandable that surgery would not be your first desire for heel pain treatment. But you might be surprised to know that it isn’t for us here at Massapequa Podiatry Associates, either!

Why is Surgery a Last Resort?

When treating heel pain and other foot and ankle conditions, surgery will almost never be a first option. It’s more of a last resort.

The reason is pretty simple: when you perform surgery on an area, that area is never quite the same. Sometimes those changes will be barely detectable or completely invisible. For others, however, those changes may matter. An athlete might find their Achilles tendon will never be quite as strong as it used to be before surgery, for example. Or the odds of injuring it again are a little higher. Those things matter.

Whenever non-surgical treatments have a reasonable chance of providing the relief you need, we will opt for those over surgery. Only when these options fail, or the case is such that surgery is the only way to move forward, will we consider surgery. It just makes sense.

Fortunately, there are effective non-surgical options for treating heel pain. Let’s take a look at some of them and how they may be applied in certain situations.

Extracorporeal Shockwave Therapy (ESWT)

When heel pain is a concern, shockwave therapy (ESWT) is a very viable option.

This form of treatment uses a surface device capable of generating high-energy soundwaves. These waves can pass through layers of tissue to penetrate the site of a soft tissue injury.

When stimulated in this manner, the cells at the site of an injury can gain increased metabolism—in essence, revving their engines. That, combined with the second effect of increased blood flow to the area, provides the tools the body needs for accelerated healing and pain relief.

An ESWT session lasts around 5-10 minutes. We usually recommend several sessions over a period of time. Although “shockwave” sounds a bit intense, there are few side effects to the treatment. You might have some slight bruising, a little bit of swelling, or minor tingling, but these symptoms tend to disappear very quickly.

An FDA study has shown ESWT to be very effective for pain, with 92% of participants reporting a significant reduction in discomfort.

Shockwave Therapy


Amniovo is an advanced treatment option that uses injections of amniotic growth factors to encourage regeneration and healing in a soft tissue injury. Patients with conditions such as plantar fasciitis and Achilles tendinitis tend to be good candidates for this method.

The growth factors used in Amniovo are taken from the amniotic membrane within the human placenta (with absolutely no harm or risks for mothers and babies, of course) and processed into an injectable form.

The growth factors in this treatment help accelerate the healing of micro-tears in soft tissues, such as those that can develop in the plantar fascia and Achilles tendon. They have also been shown to reduce inflammation and the development of scar tissue.

Amniovo has become very popular among athletes, but you certainly don’t need to be one for this treatment to be a consideration!


When the Achilles tendon is the cause of heel pain, Tenex treatment may be a possibility.

This procedure employs a very small surface incision through which a MicroTip tool is inserted. This tool vibrates with ultrasonic energy to remove damaged tendon tissue, allowing for a more efficient and effective recovery.

How do we know what parts of the tendon to attack? Ultrasound imaging allows us to pinpoint exactly where the MicroTip needs to go, without posing any danger to your healthy tissue.

A typical Tenex procedure uses local anesthesia and is completed in 20 minutes or less. Recovery time is relatively short as well, and patients can expect a full return to activity in 2-6 weeks.

There are cases where Tenex might be used on soft tissues outside the Achilles tendon, but these are not as common.

Classic Conservative Care

While we’re proud to offer advanced treatments such as ESWT, Tenex and Amniovo, sometimes even these are not necessary. In some cases, all that may be needed is a period of rest and maybe some anti-inflammatory medication.

If rest is effective, we will likely also recommend physical therapy to strengthen the area and help prevent future issues.

In other cases, custom orthotics may provide the support and balance you need to address a heel pain issue.

Heel Pain Solutions that Are Best for You

As there are different kinds of heel pain, there are different ways that they can be addressed. Not every option above may be viable for your particular condition, but we will always discuss the non-surgical treatment options that are.

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