Plantar Fasciitis
Description:
Plantar fasciitis is an injury or overuse syndrome involving the plantar fascial ligament in the arch of the foot that runs from the ball of the foot to the bottom of the heel. This band of tissue is protective to the deep structures of the foot and is not a primary stabilizer of the archway.
This condition is associated with other foot conditions such as:
The pain is characterized as sharp with the first few steps in the morning and also in the evening after increased activities or with minor relief as it is “warmed up” during light walking and massage.
Treatment: Conservative Care:
| Rest: | Crutches and non-weight bearing on the affected foot for 1 to 3 weeks is the best care for this kind of overuse syndrome or injury, but a simple decrease in activities may relieve symptoms. Avoid bare feet and shoes without support (sandals, flip-flops, house shoes, etc.). |
| Stretching: | Static stretching in the morning AND evening using the proper technique will speed recovery and minimize re-injury. |
| Medication: | Anti-inflammatory medication (e.g. Ibuprofen, Naprosyn)aspirin products, and Acetaminophen can help with the chronic pain, but are not much help with the acute pain. |
| Injection: | An anesthetic (numbing agent) mixed with cortisone (anti- inflammatory) is placed at the point of pain to relieve the sharp pain associated with the first few steps in the morning and/or pain at night after increased activities. |
| Arch support: | Temporary arch supports, supportive athletic shoes, or a higher heel on a shoe will all provide additional rest to the injured ligament. Custom molded orthotics is the best solution for immediate and long term treatment. |
| Night Splints: | A night splint is a device that keeps a constant tension on the ligament while it is healing by keeping the foot at a 90 degree angle to the lower leg. |
| Physical Therapy: | Examples of physical therapy include massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation. |
Surgical Options:
Various procedures exist, but releasing the plantar fascial ligament near the heel with or without removing an existing heel spur will essentially lengthen the ligament and provide permanent relief. The incision is minimal (1cm to ½ inch) at the inside of the heel and sutures are removed at 2 weeks. The procedure is performed in an outpatient facility under sedation and partial weight bearing is allowed after 48 to 72 hours of non weight bearing.
