Plantar fasciitis is a painful condition affecting the connective tissue that stretches between the heel and the middle of the foot. It is usually caused by overuse, injury or muscular abnormalities.
In extracorporeal shockwave therapy, a machine is used to deliver sound waves to the painful area. It is not known exactly how it works, but it is thought that it might stimulate healing of the
Your plantar fascia (fay-sha) supports the arch of your foot as you run or walk. It is a thick, inelastic, fibrous band that starts in your heel, runs along the bottom of your foot, and spreads out
to your toes. Plantar fasciitis is an inflammation of this fibrous band. If you are female or have a job that requires a lot of walking or standing on hard surfaces you are more at risk for plantar
fasciitis. Additional causes include Being overweight, Having flat feet or high arches, Wearing shoes with poor support, Walking or running for exercise, Tight calf muscles that limit how far you can
flex your ankles, Running on soft terrain, Increase in activity level, Genetic predisposition.
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other
medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience âFirst stepâ pain (stone bruise
sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.
Plantar fasciitis is one of many conditions causing "heel pain". Some other possible causes include nerve compression either in the foot or in the back, stress fracture of the calcaneus, and loss of
the fatty tissue pad under the heel. Plantar fasciitis can be distinguished from these and other conditions based on a history and examination done by a physician. It should be noted that heel spurs
are often inappropriately thought to be the sole cause of heel pain. In fact, heel spurs are common and are nothing more than the bone's response to traction or pulling-type forces from the plantar
fascia and other muscles in the foot where they attach to the heel bone. They are commonly present in patients without pain, and frequently absent from those who have pain. It is the rare patient who
has a truly enlarged and problematic spur requiring surgery.
Non Surgical Treatment
Shoe therapy, finding and wearing shoes that allow your feet to be in their natural position, is the most important treatment for plantar fasciosis. Shoes that possess a flat heel, are wide in the
toe box, lack toe spring, and have flexible soles are most appropriate for this foot problem. An increasing number of shoe companies are producing shoes with these design characteristics, but shoes
that include all these features are still difficult to find. For some suggested footwear models, see our clinicâs shoe list. Most conventional footwear can be modified by stretching the shoeâs
upper, stretching out the toe spring, removing the shoeâs liner, and cutting the shoe at certain key points to allow more room for your foot. Visit your podiatrist to help you with these shoe
modifications. Correct Toes is another helpful conservative treatment method for plantar fasciosis. Correct Toes addresses the root cause of your plantar fasciosis by properly aligning your big toe
and reducing the tension created by your abductor hallucis longus on the blood vessels that feed and "cleanse" the tissues of your plantar fascia. Your plantar fasciosis-related pain will diminish
when the dead tissue is washed away. A rehabilitation program, which includes targeted stretches and other exercises, for your foot may be helpful too. Dietary changes and aerobic exercise are
particularly important for overweight individuals who have plantar fasciosis. Water aerobics may be most appropriate for those individuals whose pain does not allow them to walk or cycle. Physical
therapy may be another helpful treatment modality for this problem, and includes ultrasound, electrical stimulation, contrast baths, and range-of-motion exercises. Massage, acupuncture, reflexology,
and magnet therapy are holistic approaches that may be helpful.
Most practitioners agree that treatment for plantar fasciitis is a slow process. Most cases resolve within a year. If these more conservative measures don't provide relief after this time, your
doctor may suggest other treatment. In such cases, or if your heel pain is truly debilitating and interfering with normal activity, your doctor may discuss surgical options with you. The most common
surgery for plantar fasciitis is called a plantar fascia release and involves releasing a portion of the plantar fascia from the heel bone. A plantar fascia release can be performed through a regular
incision or as endoscopic surgery, where a tiny incision allows a miniature scope to be inserted and surgery to be performed. About one in 20 patients with plantar fasciitis will need surgery. As
with any surgery, there is still some chance that you will continue to have pain afterwards.