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Plantar fasciitis is one of the most common problem's we see, successful conservative treatment occur's in over 98% of the cases.Plantar fasciitis pain is mainly from the mid-arch of the foot to the to the heel bone. Fasciitis is strain on the ligament on the bottom of your foot.The pain from plantar fasciitis is normally from the heel into the arch.It's worse, first thing in the morning or after driving or setting for a period of time at work or a long lunch.It takes a number of step's to loosen up the fascia when we start walking.When you first notice symptoms it's important to start passively stretching your fascia, there are some great video's on you tube to show you how, also use OTC arch supports, compression foot-arch sleeves and heel cushion's to reduce pressure on the heel area.If the pain doesn't go away in the first 30 to 60 days we need to see. Treatment's are conservative and non-surgical and are successful over 98% of the time with no surgery. Treatment is a combination of support of the arch with a custom made orthotic and a injection of a mild steroid injection given from the side of the heel with a cold spray to numb the skin.
Many times by changing shoes or using a OTC arch support fasciitis and go away over a few weeks. Also stretching and sometimes wearing a night splint can also help. You can also wrap the arch to support it much like people do for a tendinitis of the elbow (tennis elbow).The use of arch compression sleeves can support the fascia also.
What are the best treatment's for HEEL PAIN and PLANTAR FASCIITIS?
If you do not improve, then conservative treatment can work in over 98% of the time with a combination of treatment's including mild steroid injection's which are safe, these are given from the side of the heel with a cold spray to numb the skin the significantly reduce any discomfort from the shot.Custom made orthotics will support the arch long term and reduce the possibility of the pain coming back. Custom made are hand made from a non-weight bearing cast of the foot to capture the the arch height they are flexible and you can run and workout with them. Orthotics also can be made for dress type shoes.
Surgery is rarely indicated, we also use PRP injections which are platelets and stem cells to heal the fascia. There are many advanced surgical treatments including endoscopic plantar fascia release and the newer Tenex procedure. These are performed on a outpatient basis under twilight sleep.
Plantar Fasciitis is a foot related problem where you have pain in the bottom of your foot from the front to the back. It's normally worse first thing in the morning or after sitting or driving for a period of time. Most patients relate it's the worst when they get out of bed in the morning and it takes them a number of steps to loosen it up so they have less pain.
It's important when this first starts to make sure you search out ways to stretch your fascia this is important because it's like warming it up like you would before you workout to increase the blood supply which helps the soreness to go away. Also initially it is important to wear shoes with some degree of support as much as possible. Using over-the-counter arch supports can also be helpful in initial treatment. Shoes with a slight heel tend to be more helpful because they change the angle of the foot and reduce the stress on the plantar fascia. Sometimes using over-the-counter wrapping of the arch can be successful these are generally made out of elastic material. Using anti-inflammatories can be helpful to reduce the soreness this should be used for no more than 7 days.
When the plantar fasciitis continually hurts over the first few months normally some professional treatment is necessary. When you first see me we want to explain what exactly is going on, the foot is structured the bones on top of your foot form a triangle and the plantar fascia attaches at the front of the foot on the bottom at approximately 10 different spots and attaches only on the heel at one spot. Most plantar fasciitis pain occurs towards the heel area. I'm physical exam the faccia can be very painful and tight.
When you look at the treatments available at our office conservative care Works high in the 90 percentile range. Initially the goal is to reduce the generalized discomfort and pain quickly. Depending on the location of the centralized pain we can use an injection have a low-grade steroid injection with a cold spray from the side of the foot to minimize discomfort. The use of wrapping the arch can be helpful in some cases also. The injection it's given one two three times over the course of the first month. In cases of chronic plantar fasciitis it is necessary to use a custom-made orthotic for the support of the arch. These are handmade and are made from a flexible resilient plastic material that is flexible and extremely comfortable. With this treatment fasciitis normally never recurs , they can be used for sports activities and can be made for most types of shoes for non sports activities. At this point if we still have problems with Improvement we can consider a PRP injection which is a form a stem cell type injection. The PRP is drawn from your own blood, it maximizes the healing properties and is rejected in and around the fascia , cam Walker is used post PRP injection to reduce stress to the fascia and allow quicker healing.
In extremely rare cases surgery may be necessary, this is done on an outpatient basis under a Twilight sleep or possibly done with in the office setting. The surgery itself is a lengthening of the insertion of the fascia, once all conservative treatment have not been successful this procedure is highly effective for correction. Patients still need to wear the orthotic post-surgery and wear a cam Walker for the first few weeks after the fascia is released.