Plantar Fascitis
This is the most common cause of pain in heels.
In this disease, the plantar fascia ligament is inflamed, which supports the arch of the foot.
The most common symptom is pain on the first step (usually morning). After an extended period of rest or sitting, the first few steps are painful.
Causes
The main cause of Plantar fasciitis is unclear.
However, risk factors include obesity, excessive exercise. Excessive standing on hard surfaces, sedentary lifestyle, flat foot, unequal leg length, etc.
Occasionally, heel spurs, Achilles tendon tightness, inappropriate footwear may also contribute to the cause.
More often than not, associated metabolic abnormalities like diabetes, hypothyroid may also contribute to the disease.
Symptoms
- Sharp pain in heels (usually unilateral)
- Pain worsens during their first steps after getting out of bed
- Swelling
- Numbness
- Tingling
Diagnosis
- Detailed history and physical examination are the most important factors of diagnosis.
- Occasionally, imaging tests like X-ray is done to rule out associated calcaneal spurs.
- Ultrasound, MRI may be advised to rule out other causes like fascial tears.
Treatment
Most of the time, plantar fasciitis cases improve by conservative management within six months to one year.
- Conservative management includes
- Rest
- Ice application
- Use of anti-inflammatory drugs
Physiotherapy offers several effective options for treating plantar fasciitis
- Stretching Exercises: Specific stretches for the Achilles tendon and calf muscles can alleviate tension on the plantar fascia.
- Strengthening Exercises: Targeting muscles that support the arch can improve foot stability and reduce strain on the plantar fascia.
- Massage and Soft Tissue Mobilization: Manual techniques can help release tightness in the fascia and surrounding muscles.
- Ultrasound Therapy / Extra Corporeal Shock Wave Therapy: This can promote healing by increasing blood flow and reducing inflammation.
- Icing: Cold therapy helps manage pain and inflammation.
- Orthotics: Customized shoe inserts provide support and correct biomechanical issues contributing to plantar fasciitis.
- Taping and Strapping: Techniques like kinesiology taping can offer temporary relief and support.
PRP injections – this is a novel therapy used for resistant cases
Platelet-rich plasma (PRP) therapy can benefit plantar fasciitis by promoting tissue healing. In this treatment, a concentrated form of the patient's blood, rich in growth factors, is injected into the affected area. PRP stimulates cell repair and regeneration, reducing inflammation and accelerating the recovery process for individuals suffering from plantar fasciitis.
If all the above measures fail to give improvement then surgical management may be recommended.
Surgical Management
Plantar fasciotomy is the last resort. It can be performed in a minimally invasive manner, however, it requires a skilled orthopaedic surgeon.
To know more kindly contact the best orthopaedic surgeon Dr. Rahul Modi for further queries.
This surgery is frequently performed by the best orthopaedic surgeon Dr. Rahul Modi for treating Plantar Fascitis.