Foot & Ankle

12 Ways Treat Plantar Fasciitis

By October 22, 2019 No Comments

What is Plantar Fasciitis?

Plantar fasciitis is a disorder involving the connective tissue known as the plantar fascia – a long supportive band which runs across the arch of the foot. Overtime, this band of tissue loses its malleability and becomes more easily aggravated by movement.

As the plantar fascia becomes irritated, the body responds by causing inflammation in the bottom of the foot, compressing the nerves therein and inducing bouts of pain.

Plantar fasciitis is most notable after long periods of rest, when the plantar fascia has had a chance to become rigid once more. Throughout the day, as the plantar fascia is stretched and becomes more elastic, pain may subside until the next long period of rest.

Due to its relative position (connecting the heel to the base of the toes), the symptoms of plantar fascia troubles express themselves most noticeably when the arch of the foot is in flexion.

Plantar fasciitis is most common in runners, the overweight, and those with high arches. These added stressors make the tissue tough and therefor, less able to adapt to the changes needed for daily, fluid motion.

How Do You Get Plantar Fasciitis?

Risk factors for plantar fasciitis are extremely broad which makes defining specific causes very difficult. While most acute injuries to the arch of the foot may very likely lead to cases of plantar fasciitis, they are just as likely to lead to other degenerative illnesses with similar symptoms.

Beyond acute injury, some of the most common risk factors for plantar fasciitis are:

  • Overuse of the plantar fascia – long, routine periods of standing or constant vigorous exercise
  • Overloading the plantar fascia – obesity and repetitive heavy lifting
  • Tight Achilles tendons
  • Constant inward rolling of the foot
  • High arches
  • Weak collagen structures in the foot

Since plantar fasciitis is characterized by microtears and scarring, any event which may cause within the plantar fascia is likely to lead to some for of plantar fasciitis.

Other common conditions often mistaken for plantar fasciitis include heel pad syndrome, reactive arthritis, and osteoarthritis. In order to determine whether the plantar fascia is indeed to blame for a persons arch discomfort, they may have to watch the signs develop carefully overtime or seek medical consultation.

Do I have Plantar Fasciitis?

Plantar fasciitis typically develops slowly overtime and with mistreatment of the arch of the foot. Treatment is simple, though understanding the risk factors and the symptoms they cause can help an individual catch it earlier and therefor have better results from treatment.

Common symptoms of a plantar fascia issue include:

  • Pain centralized at the bottom or heel of the foot
  • Pain when the arch is in flexion, such as bending the foot
  • Severe pain in the foot after periods of rest
  • Gradual pain development in the foot which subsides as the foot is put into motion
  • Reduced range of motion in the foot, especially after periods of rest
  • Inflammation
  • Tenderness to the touch

According to studies published by the College of Surgeons of England, “between 4% and 7% of the general population has heel pain at any given time and about 80% of these are due to plantar fasciitis.”

Given these statistics, the chances of a person having the disorder at some point in their lifetime is more than probable. While most of these patients generally recuperate fully through conservative methods, in some cases the issue can develop into a chronic problem. If these symptoms have developed into a daily issue, it may be time to seek treatment.

How Can I Treat My Plantar Fasciitis?
Plantar fasciitis can develop into a chronic issue, but it doesn’t typically start off that way. If a person manages to keep track of the emerging signs, lifestyle changes or conservative intervention may be enough to fix the issue. If the problem has developed farther, or if conservative treatments fail to meet the needs of the patient, more radical therapies may be applied to the issue.

Lifestyle and home remedies
Self-care and home remedies are popular methods as a first approach for someone dealing with plantar fascia pain. Some of these include:

Orthopedics and increased arch support
Avoid shoes with minimal shock absorbency or buy insoles which support high arches. The added support means less strain on the plantar fascia and less chance for the microtears to develop into permanent scar tissue.

Healthy weight
Obesity is a causal factor in many health-related issues. The extra weight puts undue burden on the rest of the body which soft tissues have to make up for. The larger the weight, the larger the burden, and the worse soft tissues such as the plantar facia break down.

Exercise Adjustment
Change athletic gear often. Do low-impact exercises or exercises which put less strain on the arch of the foot. Stretch and limber up before long sessions of rigorous activity. The added support and decreased burden on the plantar fascia, especially during its recovery, will help enable it to heal better.

RICE
Rest, Ice, Compress, Elevate. When combined, these proven tactics help boost the body’s natural responses to injury as well as minimize any pain or inflammation being experienced.

Conservative Treatments for Plantar Fasciitis
Conservative treatments go a step beyond at home remedies. These are typically doctor prescribed or recommended treatments which come with an action plan for minimizing pain and increasing function of the plantar fascia.

Medications
Over-the-counter medication may be enough to help patients treat the symptoms of plantar fasciitis. Ibuprofen, naproxen, and acetaminophen can quell pain and reduce the inflammation caused by plantar fascia injury. It should be advised that continued use of these medications reduce their effectiveness and may cause other symptoms to develop.

In some cases, doctors may prescribe stronger dosages of these medications or may apply medications aimed at blocking the brains ability to interpret pain. Every prescription should be heavily researched before a patient agrees to apply them.

Physical Therapy
Physical therapies are simply methods of treatment by physical means. These include massage, guided stretching or exercise, and acupuncture. By reducing the stiffness of the plantar fascia, these methods aim to reduce the symptoms this stiffness causes. Additionally, most may be applied at home with a little bit of training, so they have garnered quite a but of popularity in recent years.

Splinting
Splints are a simple at home treatment which may be recommend in addition to any of the above methods. By splinting the foot overnight, a patient will stretch out the arch of their foot overnight ensuring that a patient will not wake up to a stiff plantar fascia. This extra stretch can relieve plantar fasciitis pain which is common for some patients in the early waking hours.

Invasive Treatments for Plantar Fasciitis
If the above methods fail to alleviate the issue or if a patient’s functional goals have not been met, more invasive treatments may be considered. Invasive treatments are named such as they include long recovery periods as well as routines of some of the conservative methods listed above.

Steroidal Injections
Steroid injections have garnered some acclaim in the last half century due to their increased ease of access. Those these treatments may relieve some of the pain a patient experiences, studies have shown that overtime, use of these treatments can cause ruptures in the plantar fascia leading to further complications.

Extracorporeal shock wave therapy
Shock wave therapy is a treatment by physical means where acute pressure is applied periodically to the base of the heel. This method works on the train of thought that causing mild damage to the area will incite a healing response from the body. The procedure can cause swelling, pain, bruising, and numbness for a period of time.

Surgery
Surgery is typically a last resort in the treatment of plantar fasciitis. Along with a radical shift in a patient’s lifestyle immediately following, surgical intervention for plantar fasciitis may cause irreparable damage to the plantar fascia for the remainder of a patient’s life. Side effects typically include weakened function of the foot and chronic instability.

Few people need surgery to detach the plantar fascia from the heel bone. It’s generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.

Alternative Therapies
Alternative therapies fall somewhere in between conservative treatments and invasive treatments though pose less of a risk to a patient’s lifestyle than more aggressive means.

Platelet Rich Plasma Therapy
Platelet Rich Plasma, or PRP, therapy involves a simple outpatient procedure in which a patient’s blood is drawn, processed, and then reinjected into the site of an injury. Platelets are one of the body’s natural defenses against injury. By isolating these tissues, mixing them with other growth factors, and using precise equipment to reinject them, PRP incites a healing response in the body then amplifies its effects by providing raw materials for the body to use in the repair.

Stem Cell Therapy
Similar to PRP, stem cell therapy is a simple outpatient procedure which involves extracting and processing tissues (fat or bone marrow) and reinjecting these tissues into the site of an injury. These stem cells are a derivative of the fat or bone marrow and can be used by the body to create an environment suitable for repair. Once inside the body, these cells send out chemical impulses which attract healing factors in the body and help them better repair any damaged tissue.

The benefits to alternative treatments such as stem cell and PRP therapies is how effective they are over conservative treatments and how less of a lifestyle impairment they are over invasive treatments. Both of the above treatments have been shown to help reduce pain in patient’s for over six months as well as promote the health and reconstruction of the damaged tissues.

If you are considering seeking these regenerative therapies for your plantar fasciitis, contact the CELLAXYS offices today. With over 30,000 procedures logged and a combined 30 years of experience in regenerative therapies, we’ll be sure to have answers to any questions you may have.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni