Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot. The plantar fascia acts like a bowstring and supports the arch and several muscles inside the foot. When there is increased stress on the arch, microscopic tears can occur within the plantar fascia, usually at its attachment on the heel. This results in inflammation and pain with standing and walking and sometimes at rest.
While heel pain has many causes, it is usually the result of poor biomechanics (abnormalities in the way we walk). This can place too much stress on the heel bone and the soft tissues attached to it. The stress may result from injury, or a bruise incurred while walking, running or jumping on hard surfaces: wearing poorly constructed footwear or being significantly over weight. Systemic diseases such as arthritis can also contribute to heel pain.
The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.
Non Surgical Treatment
The proper treatment for your heel pain depends entirely on the specific cause(s) of your symptoms. Therefore, it is critical to understand the cause(s) of your symptoms before beginning any treatment program and if you are unsure, then seeking medical advice is essential to develop the proper treatment program for your condition. Some common treatments are listed and can be performed at home. Keep in mind that not all of these treatments are appropriate for every condition, but they usually a good place to start. Rest, reducing activities for a few days can help to reduce the most severe pain. Ice, applying ice to the heel for 10 minutes several times a day will help to reduce inflammation. Stretching exercises, to lengthen the muscles in the back of the leg, including the hamstrings, will help to ease pain, reduce focal pressures to your feet and assist in recovery. For plantar fasciitis, this may be the best treatment of all. Avoid going barefoot, when without shoes excessive stress and strain is placed on the plantar fascia. Proper shoe gear, supportive shoes that fit and are not too worn along with good arch support help to reduce the stress and strain on the plantar fascia over time. Medications, non-steroidal anti-inflammatory medication, such as Motrin (ibuprofen), may help to reduce inflammation. If the pain persists or worsens after a couple of days, an appointment may be necessary where Dr. Talarico may add one or more of these additional modalities to your treatment program. Orthotic b, whether pre-fabricated or custom orthotic is used, these devices can help reduce the underlying structural abnormalities of the foot which have lead to the development of plantar fasciitis. These are often used to limit the recurrence of plantar fasciitis pain. Strapping, a special taping technique to help reduce the strain on the fascia. Injection therapy, in some instances injections are used to reduce the inflammation and reduce pain. Night Splint, this allows you to maintain an extended stretch on the plantar fascia while sleeping. Over time, this has shown to reduce the morning pain which some people experience. Removable Walking Cast, in some case of severe heel pain this may be used to keep your foot immobile for a few weeks allowing it to rest and heal. Physical Therapy may be recommended to aid in pain relief. At The Foot & Ankle Center, PC, Dr Talarico will often utilize two additional in-office modalities, EPAT and MLS Laser Therapy, which are very effective in treating most inflammatory conditions of the foot and ankle, including plantar fasciitis.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do not have to be remade.
heel pain treatment
Make sure you wear appropriate supportive shoes. Don't over-train in sports. Make sure you warm up, cool down and undertake an exercise regime that helps maintain flexibility. Manage your weight, obesity is a factor in causing plantar fasciitis. Avoid walking and running on hard surfaces if you are prone to pain. You should follow the recognized management protocol "RICED" rest, ice, compression, elevation and diagnosis. Rest, keep off the injured ankle as much as possible. Ice, applied for 20 minutes at a time every hour as long as swelling persists. Compression, support the ankle and foot with a firmly (not tightly) wrapped elastic bandage. Elevation, keep foot above heart level to minimize bruising and swelling. Diagnosis. Consult a medical professional (such as a Podiatrist or doctor) especially if you are worried about the injury, or if the pain or swelling gets worse. If the pain or swelling has not gone down significantly within 48 hours, also seek treatment. An accurate diagnosis is essential for proper rehabilitation of moderate to severe injuries.