Plantar Fasciitis - Dr. Jeffrey E McAlister

Plantar Fasciitis

Plantar Fasciitis

Plantar fasciitis is a common painful foot condition. It is a condition of inflammation of the tight band of tissue that forms the arch of the foot. About 70 percent of patients with plantar fasciitis also have a heel spur that is identified on an X-ray. Athletes, notably runners, are at high risk for plantar fasciitis. It affects men more than women.

Symptoms of Plantar Fasciitis

The most common symptoms include:

  • Sharp pain directly underneath the heel
  • Pain that is worse in the morning, especially when first standing
  • Pain that worsens after prolonged activities or standing
  • Pain that is relieved with rest

Diagnosing Plantar Fasciitis

Often, no tests are necessary to diagnose plantar fasciitis. Test that may be necessary to include an X-ray or magnetic resonance imaging (MRI). These test help to make sure your pain isn’t being caused by another problem, such as a stress fracture or a pinched nerve.

Treatment Options for Plantar Fasciitis

Conservative Treatment for Plantar Fasciitis

Conservative treatment for plantar fasciitis is typically the first course of treatment. Many people recovery with rest, icing the area of pain and stretches. Recovery can take several months. Additionally, over-the-counter pain relievers can be helpful.

Stretching and strengthening exercises are often needed for recovery from plantar fasciitis. Specialized devices may also be necessary.

  • Physical therapy.A physical therapist can provide a series of exercises to stretch the plantar fascia and Achilles tendon. Exercises to strengthen lower leg muscles are often needed to stabilize your ankle and heel. Applying athletic taping to support the bottom of your foot can also be helpful.
  • Night splints.Your doctor may recommend wearing a splint to stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching.
  • Orthotics: Your doctor might prescribe off-the-shelf or custom-fitted arch supports (orthotics). These will help to distribute pressure on your feet more evenly.

Other Treatments for Plantar Fasciitis

  • Injections. Steroid injections into the tender area can provide temporary pain relief. However, multiple injections aren’t recommended as they can weaken your plantar fascia and possibly cause it to rupture.
  • Platelet-Rich Plasma Therapy (PRP): Platelet-rich plasma injected under ultrasound guidance can provide pain relief with less risk of tissue rupture than steroid injections. PRP also triggers the body’s own healing capability.
  • Shockwave Therapy: Often used in combination with other therapies (like PRP), shockwaves are directed at the area of heel pain to stimulate healing.
  • Minimally Invasive Plantar Fasciitis Treatment: Arthroscopic removal of the bone spur and removal of devitalized plantar fasciitis and scar tissue is the new, cutting-edge approach.

Surgery for Plantar Fasciitis

  • Surgery: Surgery is a last resort and is only needed when the patient has not responded to other treatments and the pain is severe. When surgery is the best option, the plantar fascia is detached from the heel bone.

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