Plantar Fasciitis

Everything You Need To Know

Plantar Fasciitis (PF) is a condition which is known to affect between 3.6 to 7% of population. It affects at least 8% of the running population.

What is it? It is actually a pain in the side of the heel bone. It causes immense pain and discomfort in the arch of the foot.

Not much is known about the cause of PF. As the condition progresses, the individual might not always feel the difficult pain or discomfort and the condition remains undetected for long. In several cases, people are usually unaware of the condition that is taking place at their heel. In the region where Plantar Fascia inserts just under the heel, a slight degeneration of PF collagen fibres takes place. This causes a strange physiological response, which leads to proliferation of fibroblasts or replacement of collagen cells.  These are usually under the original tissue. The fibroblasts are disorganized by nature, which means their load isn’t well distributed. This causes a stress in the tissue.

Along with the problem of proliferation of the fibroblasts, some vascular tissues like veins, capillaries and the arteries also increase. Wherever blood vessels go, nerves have to follow. Thus, slowly, the symptoms start off due to the presence of nerve ending in this point of tissue. The individual starts feeling the pain slowly, which starts with a dull pain and slowly increases.

PF is said to be a self-resolving condition. This means that in case of most sufferer’s the pain is known to subside within a year. However, this means a year of pain and it is quite difficult. People try to manage the symptoms in different ways so that they can get relief from the condition.

Relief can be got through several ways. All methods might not work for everyone. It might work for some patients and not for other. Patients are usually given a number of options and are advised to try out as many options as they can.

Risk Factors which are commonly found in patients suffering from plantar fascia pain.

  • Increased foot pronation
  • Tight Achilles tendon and also the intrinsic foot muscles
  • Too much running
  • Obesity (when BMI is more than 30kg per m2)
  • High arch
  • Discrepancy in leg length
  • Continuous long hours of standing
  • Long hours of walking (military people)

It can be assumed that in every case of PF where some or all of the above conditions are prevalent, there might be several more people, who go through the same risks but never face the problem of PF or suffer from it during their life. Thus, can we actually blame these conditions for PF? This is one of the main reasons, why it is not possible by medical research to understand the causes of this condition.

Here are some conservative treatment options which are available for the sufferers.

Therapeutic Modalities and Stretching

Stretching the specific plantar fascia and the different intrinsic muscles of the foot is said to be an effective way to relieve the pain of the heels. As per a new research, which considers the eccentric load (loading a muscle and then stretching it effectively and carefully under this load) is known to be helpful also. In case of a successful treatment for conditions like epicondylalgia and tendinopathy, eccentric load is well researched too, which is said to be under the same pathological processes. Thus, we can say that as more and more data is collected we can measure its success rate for the treatment of PF.

Different Analgesic Treatments and Rest

As the pain begins, one can get relief with rest and a few types of activity modification. An ice massage is also helpful. You need a frozen water bottle or you can also use a frozen orange and roll it in the arch of your foot. There are many anti-inflammatory and non-steroid drugs available like ibuprofen which helps in reducing the pain. However, it is always recommended to consult your Doctor or the pharmacist, before you start any medicine to get relief from pain.

A small placebo-controlled research on the different non-steroidal anti-inflammatory drugs for the treatment of the condition is said to offer short-term relief from disability and pain.

Night Splints, Using Heel Cups and Arch Supports

These methods can help in reducing pain but results might differ from one person to another.

Injections

Platelet-rich Plasma Injections and Corticosteroid is said to be quite effective in reducing the stubborn symptoms and provide relief. However, as per a recent study of Dry Needling (medical acupuncture), it was found that pain is relieved for a very short period of just four weeks.

It is seen that on several occasions, management and conservative treatment is not enough. The individual can develop a chronic condition too. In such severe cases, there are different surgical options available. However, I feel, this should be the last option. Conservative options are quite effective in controlling the pain and the condition resolves soon in a short time.

Are you suffering from heel pain? It could be caused by Plantar fascia. I sincerely hope that this information has helped you. This practical advice might help you in understanding the problem and will help in reducing the pain. It can also resolve the condition faster than your expectation.