The medical term ‘Plantar Fasciitis’ means an inflammation of the attachment of the plantar fascia on the heel bone. The plantar fascia is a thick, rather rigid band, which ranges from the bottom of the heel bone to the toes. It is seen as a sort of extension of the Achilles tendon. It is little elastic and plays an important role in creating the foot arch during walking and standing.
The typical complaint is a stabbing and dull pain below the heel, especially in the first steps in the morning or after having been seated for a while. After some time of movement, the pain decreases but re-intensifies as the evening comes.
As possible causes, overweight, an overloading of that particular spot or a stiffness of the Achilles tendon are often indicated.
Flat or cavus foot is frequently associated
Plain X-rays with weight-bearing
Ultrasonography, MRI for the plantar aponeurosis status
The treatment will therefore be focused on multiple factors:
- Local and oral anti-inflammatory drugs
- Alternating hot and cold baths
- Vitamin C
- Wearing shock-absorbing heels (Nike air shoes, Crocs, MBT shoes…)
- Stretch exercises for the lower limb, particularly of the Achilles tendon
- If this proves insufficient, you can have an electro-shockwave therapy or attempt an infiltration with Cortisone. Provided some patience, 95% of the patients will over a period of several months become painfree.
- PRF or PRP Injections (plasma rich in platelets with growth factors) must be improved
If ordinary therapy proves unsuccessful, a tarsal tunnel syndrome must be thought of, or, in a few cases, a heel pad syndrome, after which treatment should be adjusted.
Only very rarely, an operation should be proposed.
- With this, approximately 2/3 of the attachment of the plantar fasciitis is cut loose. This can be either an open or an endoscopic surgery.
- Elongation of the Triceps surae seems more efficient