Plantar fasciitis (also known as plantar fasciopathy or jogger's heel) is a common painful disorder affecting the heel and underside of the foot. It is a disorder of the insertion site of ligament on the bone and is characterized by scarring, inflammation, or structural breakdown of the foot's plantar fascia. It is often caused by overuse injury of the plantar fascia, increases in exercise, weight, or age. The plantar fascia is the thick tissue on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis.
Defining Plantar Fasciitis
The condition, sometimes referred to as, 'flip-flop disease,' presents persons affected with pain ranging from mild twinges to pains that can be excruciating and stabbing on the undersides of their heels - sometimes along the arches of their feet. The pain the person experiences tends to be worse in the morning and diminish throughout the day.
The, 'plantar fascia,' is a flat band of tissue or ligament which connects a person's heel bone to their toes. It supports the arch of the person's foot. Should the person strain their plantar fascia, it becomes swollen, weakened, and irritated or inflamed. The result is that the person's heel and the bottom of their foot hurts when they walk or stand.
Plantar fasciitis is a common condition among persons who are middle-aged, although it may also occur in persons who are younger and on their feet a lot, such as soldiers, nurses, or athletes. The condition can affect either one or both of a person's feet.
Causes of Plantar Fasciitis
Plantar Fasciitis is usually caused by feet that roll inward too much when you walk. Shoes with poor arch support are another cause. The presentation and severity of the condition are correlated strongly with obesity, weight gain, sedentary lifestyles, as well as careers that involve standing on hard surfaces. Where athletes are concerned, running an increased number of miles, or foot injuries during activities, may initiate plantar fasciitis. Plantar fasciitis can result in a heel spur on the calcaneus, although the spur itself is the result of the underlying condition, not causing pain.
Plantar fasciitis is caused by strain on the ligament which supports the arch in a person's foot. Repetitious strain can cause tiny tears to occur in the ligament. The tears can cause pain and swelling which is more likely to occur if you:
Symptoms of Plantar Fasciitis
The majority of people who experience plantar fasciitis have pain when they take their first steps of the day after getting out of bed, or after sitting for a period of time. They may experience less pain and stiffness once they have taken several steps, yet their feet might hurt more as the day continues. Their feet might hurt them most when they climb stairs, or after standing for lengthy periods of time. Those who experience foot pain during the night might have a different foot problem known as, 'Tarsal Tunnel Syndrome.'
Diagnosing Plantar Fasciitis
To diagnose plantar fasciitis, a doctor will check the person's feet and watch as they stand and walk. The doctor will ask questions concerning the person's prior health, to include past illnesses or injuries. During the visit, the doctor will inquire about any symptoms the person is experiencing, such as the location of the pain and the time of day the person's foot hurts them the most. The doctor will also want to know how active the person is, as well as the forms of physical activities the person is involved in. An X-ray of the person's foot may be taken should the doctor suspect that there is a problem with the bones in their foot; a stress fracture, for example.
Treating Plantar Fasciitis
There are different forms of treatment for plantar fasciitis, from stretching to surgery. Many people attempt to treat the condition at home prior to seeking professional treatment. Common home remedies include stretching, NSAID's, and night splints. Night splints are a good choice, with eight-three percent of persons experiencing some relief after using them. Ultrasound-guided puncturing of the heel periosteum and the insertion of the plantar fascia, with supplemental steroid injection, may eliminate plantar fasciitis.
Persons who visit a practitioner for plantar fasciitis might be treated with things such as orthotics, therapeutic shoes, or physical therapy, although these treatments can take up to a year to produce benefits; they also do not help everyone. Should first-line forms of treatment do not succeed, three to six weeks in a short leg cast is often successful in reducing both pain and inflammation. Steroid injections provide lasting relief to some persons with intractable fascia pain. Some persons might undergo surgery to detach the fascia from their heel bone and expect good results. Both steroid injections and surgery involve the risk of intense pain and fascia rupture. Surgery has the additional risks of both nerve injury and infection.
There is a form of treatment called, Extra-corporeal Shock-wave Therapy (ESWT) that is noninvasive and shows promise in treating plantar fasciitis. Researchers led by Lowell Scott Weil Jr, DPM, reported an eight-two percent success rate in its use on persons whose symptoms had not responded to other forms of noninvasive treatments. While the treatment is noninvasive, it is painful; it can also take up to three months to take full effect. The costs related to ESWT treatments are very high, with the costs for each treatment ranging between $500 and $3,000. Treatment using ESWT for plantar fasciitis generally requires two or three treatments.
There is no one, single treatment that works best for every single person where plantar fasciitis is concerned. There are a number of things that people can try:
If these forms of self-treatment do not help, a doctor might provide you with splints to wear at night. The doctor may give you steroid shots in your heel, or other forms of treatments. You most likely will not need surgery. A doctor only suggests surgery for persons who still experience pain after attempting other forms of treatment for a period of six to twelve months.
UPDATE: Mar 1st, 2015 - Interventional radiology treatment relieves chronic plantar fasciitis
Patients suffering from chronic plantar fasciitis now have a new weapon against this debilitating foot ailment, according to research presented at the Society of Interventional Radiology's Annual Scientific Meeting. Researchers utilized ultrasound imaging and specific ultrasonic energy to penetrate, emulsify and remove diseased fasciitis tissue. Permanently removing damaged, pain-generating tissue allowed room for healthy tissue to regrow in its place, restoring normal function.
Two weeks after treatment, greater than 90 percent of patients reported improvement in symptoms, and these improvements were maintained at six months. Patients also reported being highly satisfied with the treatment and had no treatment-related complications.
"It is important for patients suffering from chronic plantar fasciitis to know that they have treatment options," added Razdan. "We have patients who are in so much pain they can't even play with their kids or take their dog for a walk. This ultrasonic treatment can give patients their lives back and let them enjoy their lives. We are excited to see significant results from this treatment," he said.
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time.
Chronic plantar fasciitis is the most common debilitating foot complaint, affecting approximately 10 percent of the population and accounting for more than 1 million doctor office visits annually.
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