Plantar fasciitis (pronounced "Plant-tar fash-ee-EYE-tis") is pain, swelling and inflammation of the plantar fascia. The plantar fascia is a broad, tough band of tissue that run between the 5 toes and the heel bone. It supports the arch of your foot. Plantar Fasciitis is the most common form of foot pain in Australia. It is often associated with heel spur (also known as calcaneal spur) - the formation of a bony growth at the inside front of the heel bone.
Heel pain is at its worst with a person's first steps out of bed in the morning; also, after periods of rest (i.e. sitting). The pain usually subsides after walking for a while. Find out here, what exactly causes Plantar Fasciitis, how to treat this condition and what what preventive measures you can take.
The condition is caused by excess pulling and strain on the plantar fascia ligament. Excess strain on this ligament happens for various reasons: for example people who are overweight or over 50 have a higher chance of experiencing heel pain. Also, if you are in a job that requires standing on hard floors and/or for long periods of time, you're more likely to get Plantar Fasciitis. The most common cause, however, is incorrect foot posture, combined with tightness in the calf muscles.
Heel pain will not go away overnight and some patience is required, but in most cases self-treatment is very effective and a lot cheaper and less invasive compared to medical intervention. This is what you can yourself:
Research has shown that addressing the cause of Plantar Fasciitis (excess strain on the ligament) is by far the most effective way of treating heel pain. Many Australians have feet that over-pronate: this means the feet are rolling in and the arches collapse during walking. It's a very common problem, affecting over half of the population! Footlogics orthotic insoles correct the problem of over-pronation. The result is a strong reduction in the stress placed on the plantar fascia ligament. Normal foot function is restored and inflammation of the ligament is reduced. Eventually the heel pain will dissapear.
Combined with daily exercises , orthotics are a non-evasive, natural way of correcting the feet and treating the cause of Plantar Fasciitis.
Today a number of medical treatment options are available. They should only be considered after less invasive self-treatment with insoles and exercises yields no noticeable improvement.
Cortisone-steroid is a very strong anti-inflammatory agent. It is commonly used for ailments such as tennis elbow and chronic knee and shoulder pain. The chemical is injected directly into the area of inflammation. The result is almost immediate pain relief as the inflammation freezes up. However, if poor foot mechanics has not been addressed over time the pain and inflammation will return. It could be 6-10 weeks, maybe longer and another injection will be required.
For a number years now shockwave therapy (ETS) is being used to treat heel spurs. It's a gentle form of treatment of inflammation, calcification or injury. Shock wave therapy has virtually no side-effects and renders invasive surgery unnecessary. ETS can be applied to the heel whether a heel spur is present or not. Shockwave therapy has been shown to yield similar results as local cortisone treatment. But shockwave therapy is a long-term treatment and does not have any harmful side effects. In particular, the natural fat deposit under the heel is not broken down as can happen with cortisone-steroid injections.
There are a number of "alternative procedures" that are used in the treatment of heel pain. The effectiveness varies a great deal from case to case. Some types of natural homeopathic preparations maybe used to reduce inflammation. The effectiveness is unknown as not many people have tried is and no research is available as such.
Furthermore, there is traditional Chinese medicine concerned with the treatment of heel problems. Especially acupuncture and other therapeutic measures are used. Needles are placed both at the location of the inflamed heel, as well as on the hands and the ears. The effectiveness of this treatment method is better documented. Some health funds in Australia cover accupuncture, so it could be worth as try for some people.
Another alternative treatment is so-called cryotherapy, whereby through strong temperature reduction in area of the heel, the aim is to reduce the sensitivity of the nerve root. Similar to icing in a sportsinjury, the symptoms of a heel spur may be reduced. The disadvantage is that the pain usually returns after the treatment is finished. So repeat treatment would be required.
As a last resort, in cases where conservative treatment approaches are unsuccessful, surgical measures may be considered. This is especially true when it comes to severe pain, limiting the patient's mobility, severely affecting every day life. The surgical procedure can be performed either under general anesthesia or spinal anesthesia. Usually, a 5 cm long incision is made into the plantar fascia ligament at the level of the heel bone. If present, the heel spur can be removed during the operation. Following the procedure, regular physiotherapy in the form of stretching and strengthening exercises will be required. Most patients will be back on their feet after about 3 months.
Plantar Fasciitis research
In the past 10 years a lot of research has been done in regards to the treatment of Plantar Fasciitis. The general consensus among medical experts is that this condition is mainly due to excess stress on the tissue. Therefore, any successful treament should involve reduction of plantar fascia strain with daily exercsises and/or supportive shoe inserts (orthotics).