DR TARIQ JAGNARINE
FAM MEDICINE, ENDOCRINOLOGY/ DIABETES
Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, web like ligament that connects the heel to the front of the foot. It acts as a shock absorber and supports the arch of your foot, helping persons walk.
Plantar fasciitis is one of the most common orthopaedic complaints. The plantar fascia ligaments experience a lot of wear and tear due to daily activities. Too much pressure on the feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
The cause of plantar fasciitis discomfort is still unclear. A 2003 study suggested that the condition may involve degeneration of the ligament due to strain.
CAUSES OF PLANTAR FASCIITIS
Active men and women between the ages of 40 and 70 are at the highest risk for developing plantar fasciitis. It is also slightly more common in women than men. Women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy.
Persons are at a greater risk of developing plantar fasciitis that are overweight or obese. This is due to the increased pressure on the plantar fascia ligaments, especially if they have sudden weight gain.
Some jobs may result in increased risk of plantar fasciitis such as barbers, waiters, tailor, drivers, athletes, etc.
Having a structural foot problem, such as very high arches or very flat feet increases the chances of developing plantar fasciitis. Tight Achilles tendons, which are the tendons attaching the calf muscles to the heels, may also result in plantar fascia pain. Simply wearing shoes with soft soles and poor arch support can also result in plantar fasciitis. Plantar fasciitis is not typically the result of heel spurs.
PLANTAR FASCIITIS SYMPTOMS
* The major complaint of those with plantar fasciitis is pain at the bottom of the heel or sometimes at the bottom mid-foot area. It usually affects just one foot, but it can affect both feet. Pain from plantar fasciitis develops gradually over time. The pain can be dull or sharp.
* Some people feel a burning or ache on the bottom of the foot extending outward from the heel.
* The pain is usually worse in the morning. Climbing stairs can be very difficult due to heel stiffness.
* After prolonged activity, the pain can flare up due to increased irritation or inflammation. People with plantar fasciitis do not usually feel pain during the activity, but rather just after stopping.
PLANTAR FASCIITIS TESTING AND DIAGNOSIS
A physical exam of the foot is done to check for tenderness and the exact location of the pain. This is to make sure that the pain is not the result of a different foot problem. During the evaluation, patients may need to flex their foot while they push on the plantar fascia to see if the pain gets worse flexing and relaxing. Signs of mild redness or swelling are explored for, along with any foot deformity.
Additionally the reflexes, muscle tone, sense of touch and sight coordination balance are examined.
An X-ray or an MRI scan may be necessary to check that nothing else is causing the heel pain, such as a bone fracture.
PLANTAR FASCIITIS TREATMENT
* Home treatments like rest, icing, and using braces and anti-inflammatory drugs are often the first ways to treat plantar fasciitis. If those do not ease the pain, an injection of a corticosteroid directly into the damaged section of the ligament can help.
* Physical therapy is a key part of treatment for plantar fasciitis. It can help stretch the plantar fascia and Achilles tendons. A physical therapist can show persons exercises to strengthen the lower leg muscles, helping to stabilize their walk and lessen the workload on the plantar fascia.
* If pain continues and other methods are not working, extracorporeal shock wave therapy is recommended. In this therapy, sound waves bombard the heel to stimulate healing within the ligament.
* Plantar fasciitis surgery: Surgery is the most dramatic therapy. This is done only in cases in which pain is severe or lasts more than 6 to 12 months. In a plantar fascia release, surgeons partially detaches the plantar fascia from the heel bone. This reduces tension, but weakens the arch of the foot, and full function may be lost.
* Surgery can result in chronic pain and nerve damage, so it should be considered only after trying other treatment options.
PLANTAR FASCIITIS EXERCISES
Gentle stretches can help relieve and even prevent plantar fasciitis. Stretching the calves and the plantar fascia itself, helps loosen the muscles and reduce heel pain. It is important to take time off from certain exercises, like running, to give the plantar fascia time to heal. Swimming and other low-impact activities can provide some exercise without worsening the heel pain.
* Stop and stretch while exercising to keep the pain from returning. Remember to stretch before beginning workouts.
HOME REMEDIES FOR PLANTAR FASCIITIS
Reducing pain and irritation or inflammation in the plantar fascia ligament is an important part of treatment, but this does not address the underlying damage to the ligament.
* Initial home treatment includes staying off the feet and applying ice for 15 to 20 minutes, three or four times per day to reduce swelling.
* Reducing or changing the exercise activities. Using arch supports in shoes, replacing worn-out athletic footwear, and doing stretching exercises may also help to relieve pain.
* Panadols, Ibuprofens, Diclofenac, may soothe pain in the ligament.
* Braces and supports
* Night splints are another treatment that can help stretch the calf and the arch of the foot. Night splints are a type of brace that holds the foot in a flexed position and lengthens the plantar fascia and Achilles tendon overnight. This can prevent morning pain and stiffness.
* Special orthotics or arch supports, for shoes may help alleviate some of the pain by distributing pressure, and they can prevent further damage to the plantar fascia.
* Stay at a healthy weight. If overweight, try to lose weight to reduce pressure on the plantar fascia.
PLANTAR FASCIITIS COMPLICATIONS
Persons can develop chronic heel pain if they ignore the condition. This can change the way they walk and cause injury to your:
Steroid injections and some other treatments can weaken the plantar fascia ligament and cause potential rupture of the ligament.
Surgery carries the risks of bleeding, infection, and reactions to anaesthesia. Plantar fascia detachment can also cause changes in the foot and nerve damage.
Most people do not need surgery to relieve pain from plantar fasciitis. Instead, their condition improves through physical therapy, home treatments, and medical treatments. However, treatment can take several months to 2 years to improve the symptoms.
Healthy pain free feet, can helps to provide a more productive day. Additionally not every heel pain is -“SPUR” which would be discuss in the next article.