Plantar fasciitis is an injury or overuse syndrome involving the plantar fascia ligament in the arch of the foot that runs from the ball of the foot to the bottom of the heel.
This band of tissue is protective to the deep structures of the foot and is not a primary stabilizer of the archway. One could get plantar fasciitis through overuse or strain of the bottom of the foot.
The pain is characterized as sharp with the first few steps in the morning and also in the evening after increased activities or with minor relief as it is “warmed up” during light walking and massage.
Although some instances of plantar fasciitis may need surgical care, conservative treatment seems to be the best route to treat patients with plantar fasciitis. About 70% of the patients in our office will have immediate relief with injection therapy, and permanent relief from both heel and arch pain with custom molded orthotics.
Crutches and non-weight bearing on the affected foot for 1 to 3 weeks is the best care for this kind of overuse syndrome or injury, but a simple decrease in activities may relieve symptoms. Avoid bare feet and shoes without support (sandals, flip-flops, house shoes, etc.).
Stretching in the morning and evening using the proper technique will speed recovery and minimize re-injury.
Anti-inflammatory medication can help with chronic pain associated with plantar fasciitis, but is not much help with the acute pain.
An anesthetic (numbing agent) mixed with cortisone (anti-inflammatory) is placed at the point of pain to relieve the sharp pain associated with the first few steps in the morning, or with pain at night after increased activities.
Temporary arch supports, supportive athletic shoes, or a higher heel on a shoe will all provide additional rest to the injured ligament. Custom molded orthotics are the best solution for immediate and longer term treatment.
A night splint is a device that keeps a constant tension on the ligament while it is healing by keeping the foot at a 90 degree angle to the lower leg, and can be beneficial to the healing process of plantar fasciitis.
Examples of physical therapy that can assist with plantar fasciitis include massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation.
Surgical procedures have a high success rate and are usually performed in a small procedure room or outpatient surgical center under a light anesthesia. Several effective procedures exist, but releasing the plantar fascia ligament near the heel with or without removing an existing heel spur will essentially lengthen the ligament and provide permanent relief. The incision is minimal (1cm to ½ inch) at the inside of the heel and sutures are removed after 2 weeks.
The procedures are relatively short and post operative period averages 1-2 weeks with partial weight bearing with or without a cam walker – post operative shoe.
The best way to treat plantar fasciitis is with rest, orthotic supports, stretching, and ice. Anti-inflammatories, cortisone injections, ‘night splints’, or a walking boot are also options for more severe cases, and when warranted, surgery has a good outcome as well.
Yes, most plantar fasciitis cases go away on their own. This problem is in fact a type of ‘overuse’ syndrome and/or injury.
The main cause of plantar fasciitis is an acute injury or overuse syndrome. Contributing factors are unsupportive shoe gear (sandals, flip-flops, bare feet, etc.), over pronation, and prolonged periods of time standing on hard surfaces like concrete.
Most podiatrists treat plantar fasciitis conservatively with rest, anti-inflammatories, cortisone injections, arch supports/orthotics, night splints, or a walking boot with or without crutches. Most podiatrists are trained to perform the simple surgical treatment as well, but usually only when conservative treatment fails.
Since rest and proper arch support are the best treatment modalities, sitting or desk duties are preferred for patients with plantar fasciitis. Patients should take 1 to 3 weeks off work if prolonged standing, walking, climbing stairs, or heavy lifting and exertion are their main duties.
Don’t let your plantar fasciitis get the best of you, contact Moore Ankle and Foot Specialists today and let’s get started on your treatment.
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