Plantar fasciitis is one of the most frequent causes of so-called "leg pain" and is an inflammatory process localized to the plantar fascia. It affects about 2 million people annually – data reported in the United States, 10% of the population developing the condition throughout life.
The plantar fascia is a band of fibrous tissue that originates at the heel and extends up to the five toes (the metatarsal bones), and is one of the structures that provides the resistance of the foot, the medial longitudinal arch support of the plant (foot). This fascia is stretched when the foot arch is flattening out, absorbing the impact force when the heel contacts the ground. The plantar fascia is not very flexible and therefore, after repeated shocks small breaks can occur.
It appears most commonly after age 40, more common in women, being influenced by changes in body weight (obesity, pregnancy), otherwise the disease may be correlated with body mass index (BMI). PF occurs in people who by profession sit down too long or walk for too long: teachers, waiters, military, police, postman, dancers and even athletes (especially those who run long distance).
There are several factors that can lead to plantar fasciitis, such as:
- Flat feet or the opposite, too high of an arch
- Orientation to the inside of the foot during walking
- Excessive pronation
- Inappropriate footwear – too high heels, shoes that do not provide arch support (sole too thin) sudden transition from heel to no heel
- Running on the heels or on soft surfaces (sand)
- Inflammatory trauma (rheumatoid arthritis, ankylosing spondylitis, lupus, reactive arthritis, psoriatic arthritis, etc.)
- Hereditary factors.
The clinical picture – signs and symptoms
Plantar fasciitis is manifested by sharp pain in the heel, usually at 4 cm below the heel or sole of the foot and median. The pain is intense in the morning, upon rising, taking the first steps after resting the night, but it can get worse when you start walking or do activities such as running. Typically it only affects one leg and does not appear at night, which distinguishes it from other joint diseases, neurological or bone diseases, which can develop at this time. It is also associated with limiting posterior flexion of the ankle, the plantar fasciitis stretching site can be painful, and in runners there is increased likelihood of knee pain. 70% of plantar fasciitis patients may experience the development of bone growths, a "spur" on the heel,which is often considered responsible for painful symptoms. In fact, chronic plantar fasciitis can lead to the calcaneus "spur" and its surgical removal does not ease symptoms because the true cause of the pain is actually in the fascia.
Usually clinical diagnosis is required. Patient examination includes inspection and palpation of the plant, observing the leg while standing and during walking. The doctor decides if you need additional imaging, usually to rule out another condition, such as radiography, ultrasound or MRI.
Plantar fasciitis treatment is complex and long lasting, and includes hygienic-dietary treatment, medication, physical therapy, massage and physiotherapy, such as the services offered by Dr. Morh, the highest-rated Tampa chiropractor. If conservative therapy does not give the desired results, the alternative is to intervene surgically as a last resort, because the risk of complications is relatively high. Most people say painful symptoms improved within 3 months, with complete remission in a year for 90% of cases.
Hygienic-dietetic treatment consists of:
- Weight loss
- Wearing high arch foot inserts
- Wearing appropriate shoes with wedges and low heels (3-5 cm)
- Avoid walking barefoot on hard surfaces and / or uneven ground
Drug treatment involves administration of anti-inflammatory drugs (NSAIDs) for 2-5 weeks, but only under medical supervision. Frequent injections can weaken and break the plantar fascia.
Exercise care in plantar fasciitis stretching consists of leg exercises (e.g. in sitting with legs stretched out, with a rolled towel wrapped around the sole, holding the towel heads while pulling the right knee. Hold for 15-30 seconds.)
Massage is an effective method to reduce tension in the fascia. Cryotherapy, ice on the painful area for 15-20 minutes, 3-4 times daily or ice plant massage for 5-10 minutes can help relieve the pain.
Extracorporeal Shock Wave Therapy (extracorporeal shock waves) is a relatively new treatment method for plantar fasciitis and other diseases.
Diadynamic currents can be applied locally, ultrasound and point laser therapy at the pain point. In over 90% of cases using conservative treatment painful symptoms have been resolved. In cases with persistent symptoms (over 9 months), surgery is a last resort. The most common complications of surgery are: planting vault collapse, nerve damage, infection, etc.
With the right care and supervision, plantar fasciitis treatment can be non-invasive and relatively fast, so schedule an appointment today to get your foot checked out by a professional.