Plantar Fasciitis (Heel Pain): Treatments & Rehabilitation
Plantar fasciitis, is a common condition that causes heel pain. It can be treated using exercises, stretching, night splints, & corticosteroid injections. Plantar fasciitis is the inflammation of the plantar fascia, which is a fibrous tissue and is responsible for supporting the arch found in one’s foot. The pain, therefore, occurs when the plantar fascia is subjected to a lot of strain that causes minor tears in the tissue, particularly near the heel bone.
Research shows that some of the common causes of plantar fasciitis include overtraining, being overweight, reduced dorsiflexion of the ankle, and wearing shoes that are not appropriate.
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Plantar Fasciitis Treatments
Plantar fasciitis is known to be a self-limiting condition and can take around six to 18 months to recover. According to a research, although 25% of patients stated that rest works for them, people who are athletes, or have a high level of activity in their routine, find rest to be ineffective and as such are recommended to carry out a plan of relative rest.
This involves doing other types of activities which contribute towards the recovery of plantar fasciitis rather than those which may aggravate the condition.
Treatments for plantar fasciitis can be divided into two categories; non-invasive and invasive.
Research suggests that 90% of plantar fasciitis cases are resolved through non-invasive or conservative treatments. Similarly, the same research also mentions that plantar fascia-specific stretching or PFSS has been shown to eradicate plantar fasciitis.
Exercises and Stretches
A number of studies have been conducted which say that stretching of the foot muscle and plantar fascia has been known to reduce heel pain. Techniques include wall stretches, curb stretches along with stretches that make use of a slant board or a two to four-inch piece of wood placed in places where the patient stands for longer periods, such as in offices, kitchens, etc., and stretching the calf accordingly.
Also, dynamic stretches which involve a can or a tennis ball being used to roll one’s arch open can be helpful in relieving heel pain. Also, cross-friction massage and towel stretching have been recommended as a morning routine. Furthermore, myofascial massage of the plantar fascia as a method to recover has also been proposed, with the reason being that the technique increases the blood flow to the infected area.
This is also supported by another study which suggests that myofascial therapy has been shown to improve heel pain. However, they do recommend that the routine is administered by a physician as it can involve certain complications.
Night Splints and Arch Supports
Studies have shown that the use of foot orthotics reduce foot pain and enhance the functioning of the foot. Foot orthotics essentially prevents the patient from having over pronation of the foot and helps the plantar fascia relax.
A number of foot orthotics have been recommended which include but are not limited to heel cups, prefabricated arch supports, and custom-made shoe insoles.
Similarly, night splints have been shown to keep the foot and ankle in a neutral position which prevents the dorsiflexion of the plantar fascia and therefore improve the condition. However, it has been studied that long-term use of night splints has been limited as patients find it difficult in terms of compliance because night splints can cause a disturbed sleep routine.
Apart from the treatments mentioned above, one can also use NSAIDs or ice, among other things, for treating heel pain. Ice massages, ice baths, or an ice pack are some of the common methods of applying ice.
Similar studies state that if plantar fasciitis tends to persist for more than six months after performing the conservative methods mentioned above, then invasive methods are to be administered accordingly.
Studies state that corticosteroid injections have been known to heal plantar fasciitis significantly if administered early on. However, there are certain risks involved and hence the treatment is only administered in case if the condition is recalcitrant. The success rate is stated to be 70% or more.
A plantar fasciotomy is a form of surgery that may be performed if no other method is proving to be effective in the treatment of the condition. It involves releasing the plantar fascia through endoscopic or radio frequency techniques, and the success rate of the treatment has been between 70 to 80 percent.
These are some of the treatments that you can try if you are suffering from plantar fasciitis or heel pain. Although there are easy to do home treatments possible for this condition, if you’re suffering from severe pain, then do consult your doctor for a proper diagnosis and treatment.