Plantar fasciitis

Diagnosis

The following procedure will assist the healthcare provider in diagnosing plantar fasciitis.

• Physical examination: A healthcare provider will examine the foot for painful location. The location of the pain might be used to identify the cause. Healthcare provider will examine the foot and inquire about the symptoms. The plantar fascia may be lightly pressed to assess for inflammation and check the level of pain.
• Imaging tests: Typically, tests are not required. If the patient is experiencing pain, healthcare provider may advise getting an X-ray or magnetic resonance imaging (MRI) to rule out other issues like a stress fracture.

An X-ray may occasionally reveal a spur-shaped fragment of bone protruding from the heel bone. These bone spurs were once frequently held responsible for heel pain and surgically removed. However, many individuals with heel bone spurs do not have heel pain.

Treatment

Typically, individuals suffering from plantar fasciitis experience relief within a few months through non-invasive treatments, including targeted icing of the affected area, gentle stretching exercises, and adjustments to or avoidance of activities that trigger pain:

Non-surgical treatment

• Medications: Plantar fasciitis pain and inflammation can be reduced with the help of medicines like NSAIDS, naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, among others). Avoid taking NSAIDs for more than 10 days straight without consulting a healthcare provider.
• Self–care: For at least a week (if possible), patient is advised in refraining from any activities that triggered the plantar fasciitis or playing sports. Patient may use cold compression and apply 10 to 15 minutes of cold compress to the foot twice day. This will reduce inflammation, roll a frozen water bottle over the bottom of the foot while covering it with a thin cloth to protect the skin.
• Physical therapy: A physical therapist can demonstrate the stretching and strengthening exercises for the lower leg muscles as well as for the plantar fascia and Achilles tendon. The patient may be shown how to use athletic taping to support the bottom of the foot by the therapist.
• Night splints: Wearing a splint that keeps the plantar fascia and Achilles tendon in a lengthened posture overnight to facilitate stretching while the patient sleep may be advised by a physical therapist or other healthcare professional.
• Orthotics: This arch supports that are either off-the-shelf or specially made to match the wearer’s arch, can help to evenly distribute pressure on the feet. Healthcare provider may advise either ready-made insoles that may be purchased over-the-counter or specially manufactured orthotics that are shaped precisely to the patient’s foo.
• Walking boot, canes or crutches: In order to prevent them from shifting their foot or from putting their entire weight on the foot, a healthcare provider can advise using one of these for a brief duration.
• Surgical or other procedures

Healthcare provider might advise the following if alternative methods are unsuccessful after several months:

• Injections: Temporary pain relief may be obtained by injecting steroid medicine into the painful area. It is not advised to take multiple doses because doing so could weaken the plantar fascia and even cause it to burst. To help with tissue repair, healthcare provider can inject platelet-rich plasma made from their own blood into the sore area. Precision needle placement during injections can be helped by ultrasound imaging.
  • Extracorporeal shock wave therapy: In order to promote healing, sound waves are directed at the painful heel area. This is used to treat chronic plantar fasciitis when more conservative measures haven’t worked. Although this therapy hasn’t been proven to be consistently successful, several trials have showed encouraging results.
  • Ultrasonic tissue repair: Using ultrasonic imaging, this minimally invasive technique directs a needle-like probe into the injured plantar fascia tissue. The injured tissue is subsequently broken up by the probe tip’s fast vibrations before being suctioned out.
  • Percutaneous needle tenotomy: Healthcare provider will insert a needle into the plantar fascia via skin during a percutaneous tenotomy. The area receives more blood than usual from the body, which encourages the plantar fascia’s natural ability to heal.
  • Surgery: Surgery is rarely necessary to separate the plantar fascia from the heel bone. It is typically only a choice in cases of extreme pain where all other options have failed. With local anesthetic, it can be carried out as an open surgery or by a little incision. The two most typical surgical procedures are:
    • Gastrocnemius recession: To relieve strain on the plantar fascia, healthcare provider will stretch the calf muscles.
    • Plantar fascia release: To release some of the additional tension, healthcare provider will make a few very small incisions (cuts) in the plantar fascia.

Healthcare provider or surgeon will specify the kind of surgery that the patient require to address the plantar fasciitis.