Physical Therapy and Heel Spurs

Q:  I have been a reader of your column for a long time and have always enjoyed it, but I am concerned with your most recent article addressing heel spurs. Being a physical therapist, I was very much surprised to see that you neglected to use physical therapy as an intervention for heel spurs. You mentioned exercising and stretching, but who provides this care? Having many friends who are orthopedic surgeons, I find it highly unlikely that they would have the time to sit with a patient and explain to them the mechanics of stretching.

I also believe you missed out a large portion of treatment in terms of modalities like phonophoresis and iontophoresis. Phonophoresis drives hydrocortisone solution into the tissue using ultrasound, and iontophoresis uses electrical current to drive anti-inflammatory medication in.

I mean no disrespect by this letter, but as a therapist who treats three to five of these patients per month with very good results, I was slightly offended at not having my profession mentioned in your article. Thank you for your consideration.

A:  Your point is well taken. Physical therapists are of great assistance for providing patient education about proper gait, strengthening exercises, etc. and also for treatment modalities. To deliver a full range of care for patients requires a team approach, which includes nurses, therapists of many types, social workers, and other health professionals.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.