Plantar fasciitis

Plantar Heel pain also known as Plantar Fasciitis is a common foot condition.

 

Pain is typically located at the point the plantar fascial tendon inserts into the  heel bone (Calcaneus).

 

This fascia run down the foot attaching into the toes and helps form our arch. 

Diagnosis.

In the x-ray on the left you can see bony spurring at the point of pain- the plantar fascia insertion point. However the most recent reviews of all the research suggests the heel pain can be diagnosed on medical imaging as a range of physical tissue changes including thickening of the plantar fascia, abnormalities of the plantar fascia tissue, thickening of the fatty pad of the heel, heel spurs, hyperaemia within the fascia, abnormalities of the bone, bone marrow oedema and plantar fascial tear (Drake et al,2022).

Most people attending with plantar heel pain, will have some but not all these tissue changes

Symptoms.

1. Pain on first movement, particularly in the morning or after rest.

2. Pain on touch.

3. The pain can be aggravated by standing.

Causes.

Over load of the tissue. Too much standing, walking or running.

It is associated with being over weight.

It also occurs in long distance runners.

Treatment: 

1. Increasing ankle joint range of motion and tissue flexibility.

2. Reducing impact forces.

3. Reducing tension through fascia.

4. Increase foot strength.

Positive Podiatry can provide a wide range of customised and custom made foot orthotics. This depends on your individual requirements.

Steroid injection into the fascia should be used with care. The negative side effects of steroid injections can be plantar fascia rupture and breakdown of the fatty pad.

Shock wave therapy is only necessary in chronic cases over 6 months.

Make an appointment today for individualised advice is essential for rapid resolution.

References:

Drake,C et al. Medical Imaging for plantar heel pain: a systematic review and meta-analysis. Journal of Foot and Ankle Research,15 (4), 2022.

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