PLANTAR FASCIITIS AND ITS TREATMENT
Plantar Fascia is a thick band of connective tissue fibres that run across between the heel bone called calcaneum and toes. Plantar fasciitis is the most common cause of heel pain.
What is plantar fasciitis?
In plantar fasciitis, the connective tissue at the heel level of calcaneus bone becomes inflamed, that causes stabbing, throbbing, and aching type of pain.
How do I know I am suffering from plantar fasciitis?
Majority of the times the main complaint of plantar fasciitis is pain on the bottom of the foot, at and around the heel and arch area.
The common symptoms and pain pattern to note is:
- Morning pain: First few steps in the morning are very painful, pain eases after a few steps.
- Pain is worse when standing or walking after prolonged rest or sitting.
- Pain eases with walking and worsens again towards the end of the day.
- Pain is worse with standing for a long period.
- Pain is often worse after exercises, rather during exercises.
Who is prone to develop Plantar fasciitis?
Though the reasons for plantar fasciitis is not always clear, the following are more likely to suffer from the plantar fasciitis:
- Age: between 40 –60yrs.
- Aerobic dancing and ballet dancing.
- Recently increased activity/intensity.
- Tightness: tight quadriceps/hamstrings /calf/heel.
- A recent activity without treating leg muscle tightness.
- Recently started walking, running, jumping, or standing activities.
- Recently started exercising/walking on hard surfaces. Ex: Factory workers.
- Plantar fascia injury due to Overstretching the sole of the foot during exercise.
How do I know that my heel pain is a Plantar Fasciitis and how severe is my plantar fasciitis?
Plantar fasciitis can be diagnosed clinically. If in doubt Musculoskeletal diagnostic ultrasound scan can confirm the plantar fasciitis and its severity. Ultrasound is also able to confirm the other associated problems around the heel. Such as fat pad atrophy, calcaneal spur (a piece of bone sticking out from the heel bone), calcification within the plantar fascia, plantar fascia tear, active inflammation, plantar fibroma (a palpable lump in the sole of the foot) and perifacial effusion.
A diagnostic ultrasound scan can measure the thickness of the plantar fascia at the heel bone level. The severity of the plantar fascia can be determined based on the thickness of the plantar fascia and appearance of the plantar fascia.
Diagnostic musculoskeletal ultrasound scan is a non-invasive, quick and inexpensive diagnostic tool. Ultrasound scan offers an immediate diagnosis. At our clinic, we can show you the live images and discuss the ultrasound findings if you wanted.
Are there any other problems mimicking plantar fasciitis?
Plantar fibroma is the other condition which can mimic as plantar fasciitis, especially when the plantar fibroma is located closer to the plantar fasciitis location. Ultrasound scan can differentiate between the ‘plantar fibroma, and ‘plantar fasciitis’.
What happens if plantar fasciitis is ignored?
If plantar fasciitis is ignored the condition can become chronic and affects the way you walk to relieve the plantar fasciitis pain. As a result of this altered gait pattern knee, hip and /or back can be affected.
What is the treatment of the plantar fasciitis?
Plantar fasciitis treatment is based on the causative factor which triggered this problem. Clinical consultation can help to identify the possible reason/s to develop the plantar fasciitis, also helps to provide you with a tailor-made treatment option.
In general, the plantar fasciitis pain treatment options are:
Lower limb stretching exercises, foot muscle strengthening exercises, Ice packs, work related modifications, insoles, night splints, NSAIDS and anti-inflammatory medications, physiotherapy.
When do I benefit from the Cortisone injection treatment for plantar fasciitis heel pain?
- If you are unable to cope with the exercises and or pain medication.
- When the above treatment options are failed to provide you with a pain relief.
- If you are struggling to cope with your hobbies, duties at work and affecting the quality of life.
- Recurrent plantar fasciitis pain following a successful steroid injection for the plantar fasciitis heel pain in the past.
What is the difference between the blind cortisone injection and Ultrasound guided cortisone injection?
Blind steroid injection also known as anatomical guided steroid injection is given by palpating the location of pain and injection without a guidance. on the location of pain.
Ultrasound guided corticosteroid injection: With this procedure needle is monitored throughout under the guidance of ultrasound imaging and cortisone is infiltrated exactly in the desired location.
What are the advantages of Ultrasound image guided injection over anatomical guided cortisone injection to the plantar fasciitis problem?
- Ultrasound scan helps to identify the source of the problem.
- After identifying the source of pain, needle is directed under direct ultrasound guidance to the problematic area, hence avoids an accidental injection into the plantar fibers or in the plantar fat pad.
- Plantar fat pad atrophy can occur if cortisone is repeatedly injected accidentally into the plantar fat pad, instead of perifascial region of the plantar fascia. This results in a long-term heel pain.
- Ultrasound guided injection treatment outcome is much superior in comparison to the blind injection’s outcome, due to the high injection accuracy under the ultrasound guidance.
- Ultrasound guided injections are better tolerated due to avoidance of accidental contact of bone.
What is the success rate of cortisone injections for plantar fasciitis pain?
Due to the possibility of accurate infiltration of cortisone medication to the plantar fasciitis location under ultrasound guidance, the treatment success rate over 95%. We have seen high success rate in patients who have not responded to the blind injections or the other Conservative management.
How many Corticosteroid injections can I have?
Not more than three injections per year for each plantar fasciitis problem.
However, we suggest keeping the number of corticosteroid injections to fewer injection possible.
Are there any other alternative injections other than cortisone shots for plantar fasciitis?
Platelet rich plasma (PRP) injections are becoming extremely popular as an alternative to the cortisone injections for the plantar fasciitis.
Platelet rich plasma injections are derived from the Patients own blood and growth factors are separated using a centrifuge machine. These growth factors are injected back into the inflamed part of plantar fasciitis under the ultrasound guidance.
These growth factors help to regenerate that connective tissue; hence the PRP treatment effect lasts much longer compared to the Cortisone injections.
How many PRP injections can I have?
There is no limit on how many PRP injections one can have since PRP injections are natural growth factors derived from the patient’s own blood.
However, we recommend a course of three injections with a short interval between the two injections to complete the healing cycle.
More information about ‘corticosteroid injection, or platelet rich plasma injection (PRP)’s can be found at michaelc469.sg-host.com website, under Patient information section
How can ‘Joint care clinics’ help me?
‘Joint Care Clinics’ are private clinics located around Midlands and Newcastle offering a ‘one stop clinic’ service to the people suffering from musculoskeletal problems including the ‘plantar fasciitis’. That means we can offer you a consultation, diagnostic musculoskeletal ultrasound scan (to determine the problem and its severity) and ultrasound guided cortisone injection or platelet rich plasma (PRP) injection or Hyaluronic (Gel) injections in the same appointment. Or we can offer you a consultation and diagnostic ultrasound scan alone.
Majority of the patient reports over 90% of pain relief in a week’s time following a cortisone injection to the plantar fasciitis.
Please contact joint care clinics on 0333 444 2013 or email@example.com if you have any further questions or book an appointment.
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AREAS COVERED BY JOINT CARE CLINICS
We cover a wide area throughout Warwickshire and surrounds, either by home visit or clinics in the following areas: Rugby, Coventry, Warwick, Aylesbury, Milton Keynes, Leamington Spa, Stratford, Kenilworth, Whitnash, Atherstone, Bedworth, Leicester and Nuneaton. We also have clinics throughout the West Midlands including Birmingham and Solihull. We have a clinic in Newcastle covering the North East.
If you do not see your area listed please still get in touch as we may be able to refer you to another practitioner in your area.