Plantar fasciitis is the most common cause of heel pain. The plantar fascia is a broad ligament-like structure that extends from the heel bone to the base of the toes, acting like a thick rubber band on the bottom arch of the foot. With a few extra pounds on board, or with activities such as exercise, the plantar fascia can develop microtrauma at its insertion into the heel bone, or anywhere along its length.

This causes pain which can be quite severe at times. Women, large individuals, runners and anyone whose job requires a lot of walking or standing on hard surfaces are more likely to get the condition. It's usually most painful when an individual takes the first steps in the morning after getting out of bed, but the pain can recur after sitting for a while or at the onset of any activity. In severe cases, the individual simply cannot bear any weight on the foot.

There are many treatments for plantar fasciitis, including orthotics, splinting, ultra sound, weight-loss and cortisone injections. In many cases, however, these treatment options may not work. The newest treatment being touted on the market today is shockwave therapy. The typical cost of this therapy is between $6, 000 and $7, 000. The cost, combined with mixed reviews of the treatment's success rate, is causing controversy in some medical circles.

While this kind of therapy is advocated by Podiatrists as a helpful measure, Orthopedists looking at the same medical literature tend to interpret the data as requiring further proof. This area for debate makes shockwave treatment a perfect example of why it's important to leverage external review specialists to help determine the medical necessity and viability of new treatment options. Orthopedic specialists, like those offered through AllMed Healthcare Management, constantly review newly published medical science literature to assure that spending large sums on pain management is medically sound and the best treatment option for the cases in question.