It is one of the more common causes of heel pain. It is an inflammation of a thick band of fibrous tissue that runs across the bottom of you foot and connects your heel to your toes. The patient commonly feels a stabbing pain first thing in the morning in the heel area of the foot when he/she takes the first step. It can get better as the day goes by but after resting a while the pain is back. It is more common in runners, overweight patients and people that ware shoes without proper arch support.
WHAT CAUSES IT?
Normally, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. Tension and stress on that bowstring can become too great and small tears can arise in the fascia. Repeated stretching and multiple tears can cause the fascia to become irritated, inflamed and sore. However in many cases of plantar fasciitis, the cause isn't clear.
WHAT ARE THE RISK FACTORS?
Age. It is more common in the 40 to 60 y/o age group
Certain types of exercise that place great stress on the heel and tissues attached. This include running, ballet, aerobic dance and jumping.
Obesity. Being overweight can put a lot of stress on the plantar fascia.
Occupation. Those that require you being on you feet constantly during the day specially on a hard surface.
WHAT ARE THE COMPLICATIONS?
Letting plantar fasciitis go unchecked for a long time can lead to chronic heel pain that hinders your regular activities. Additionally changing the way you walk to avoid the pain can lead to ankle, knee, hips or back problems.
HOW IS IT DIAGNOSED?
The history and a physical exam is usually enough. It is important to locate the area of tenderness.
ARE IMAGING STUDIES NEEDED?
Usually not, however if the doctor has any concerns he may order and MRI or x-ray but, since he may want to rule out a fracture or check for bone spurs.
WHAT IS THE BEST AND MOST EFFECTIVE TREATMENT?
Most patient that visits our office has tried oral anti-inflammatories, ice, physical therapy and even steroid injections with only obtained temporary and partial relief. One innovative type of treatment provided in our office that produces excellent results is called Prolotherapy. It is great for treating this condition.
Prolotherapy is a technique consisting of injecting tissue irritating substances, such as hypertonic glucose(sugar water), among others, into the tissues. These tissue irritating substances called prolifereants stimulate healing, and repair when injected into precise points called the enthesis. Basically the enthesis is the point where tendons and ligaments attach to the bone. The proliferant when injected into these very precise points stimulate tissues to proliferate (therefore thename Prolotherapy) and heal.
Arch supports are also very important in patient with low and high arches. The extreme inward foot motion caused by pronation, forces the knee and hip out of alignment. This movement places added pressure through the knee, shin, thigh, pelvis and back. The excessive foot rotation can lead to foot and ankle injuries, achilles tendonitis, heel pain, kneecap inflammation, bunions, shin splints, ailments of the hip and lower back, as well as injury to muscles, tendons and ligaments in the lower leg.