Plantar Fasciitis

Overview

Plantar Fasciitis is indeed a common cause of heel pain, typically characterized by inflammation of the plantar fascia, a fibrous tissue that runs from the heel to the toes. This condition occurs due to overuse or excessive stretching of the plantar fascia, leading to pain and discomfort, especially when walking or standing. It commonly affects one foot at a time but can occur in both feet simultaneously.

Treatment for Plantar Fasciitis often involves rest, ice, stretching exercises, orthotic devices, and supportive footwear. In some cases, physical therapy or corticosteroid injections may be recommended. Severe cases that do not respond to conservative treatments may require surgery as a last resort.

The most common symptoms of Plantar Fasciitis include

1. Heel pain, especially with the first steps in the morning or after long periods of rest.
2. Pain in the arch of the foot, which can be sharp or dull.
3. Stiffness in the foot, particularly in the morning or after prolonged sitting.
4. Swelling around the heel, although this is less common.
5. Tightness in the Achilles tendon, which connects the calf muscles to the heel bone.

These symptoms can vary in intensity and may worsen with prolonged standing, walking, or physical activity. It’s important to seek treatment if you experience persistent or severe symptoms to prevent further complications.

Procedure

Plantar Fasciitis can usually be managed with at-home treatments and over-the-counter medications. Your healthcare provider may suggest the following options to relieve symptoms and prevent future occurrences: Over-the-counter NSAIDs like aspirin, ibuprofen, and naproxen can reduce pain and inflammation. However, it’s important not to take NSAIDs for more than 10 days in a row without consulting a healthcare provider. Rest is crucial, and taking a break from activities that exacerbate plantar fasciitis for at least a week can help. Icing your foot for 10 to 15 minutes, twice a day, can help reduce inflammation. Wearing supportive shoes with built-in arch support, avoiding flat shoes like sandals or flip-flops, and refraining from walking barefoot are recommended. Orthotics or shoe inserts that provide extra arch support can be beneficial, and your provider may recommend pre-made inserts or custom-made orthotics. Immobilization by wearing a walking boot for a few weeks can reduce pressure on the plantar fascia and promote healing. Massaging and stretching techniques shown by your healthcare provider or a physical therapist can help. In some cases, corticosteroid injections into the plantar fascia can reduce inflammation and pain. Platelet-rich plasma (PRP) therapy injections can promote healing and repair damaged tissue. Extracorporeal pulse activation technology (EPAT) shockwave therapy can increase blood flow to the plantar fascia, promoting faster healing. Percutaneous needle tenotomy involves using a needle to stimulate blood flow to the plantar fascia, aiding in its repair.

For cases of plantar fasciitis that do not respond to conservative treatments, surgery may be considered. The two most common types of surgery for plantar fasciitis are:

1. Gastrocnemius recession: In this procedure, the surgeon lengthens the calf muscles (gastrocnemius muscle) to reduce the pressure on the plantar fascia. This can help relieve tension and reduce stress on the fascia.
2. Plantar fascial release: During this procedure, the surgeon makes small incisions (cuts) in the plantar fascia to release some of the tension. This can help reduce inflammation and pain in the plantar fascia.

Surgery is typically considered a last resort when other treatments have not provided relief. It’s important to discuss the risks and benefits of surgery with your healthcare provider to determine if it’s the right option for you.