Define Plantar fasciitis and its sign and symptoms, Treatment with stretching exercise

What is plantar fasciitis?

Contents

Plantar fasciitis is a sport related repetitive strain injury. This problem is very common in U.S. therefore around 2 million people have treated annually for plantar fasciitis. A sharp pain in the inner aspect of the heel and arch of the foot with the few steps in the morning is most typical complaint in the people suffering from plantar fasciitis.

Excess weight can also lead to nonbearing pain n the heel. The pain usually diminishes after ten to twelve steps of walking as the plantar fascia become stretched. However, after prolonged periods of standing, especially on harsh cemented surfaces, a throbbing pain, a dull ache, or a fatigue like sensation can resurface again in the median arch of the foot.

How long does it take to recover from plantar fasciitis?

Characteristics of plantar fasciitis

  • The plantar fascia is a thick, fibrous, relatively inelastic sheet of connective tissue originating from the medial heel, where it then passes over the superficial musculature of the foot and inserts onto the base of each toe.
  • The plantar fascia is the thick connective tissue that supports the arch on the bottom of the foot (heel side). It runs from the tuberosity of the heel bone forward to the heads of the metatarsal bones (toe bones & mid foot bones)
  • It stabilizes the MLA (median longitudinal arch) of the foot against ground frictional forces.
  • Normally, it works perfectly without causing any injury.
  • There are some risk factors associated with plantar fasciitis such as faculty mechanics of foot due to structural abnormalities, age-related degenerative changes, overweight, training errors.
  • Excessive tensile forces can also cause micro-tears in the plantar fascia, in the presence of such risk factors.
  • It is very common in people with occupations involving prolonged standing, teachers, delivery personnel, construction workers, cooks, nurses, athletes, and military personnel due to their long time standing and long running events.
  • Proper treatment and preventive approach can treat plantar fasciitis effectively.

The proper treatment and preventive approach can be achieved with the help of complete understanding of anatomy and kinematics of the foot and ankle. A complete knowledge of contributing risk factors of plantar fasciitis and dynamic function of plantar fascia during movement or walk can also act as an aid in deciding the treatment protocol for the patient suffering from plantar fasciitis.

Anatomy of the plantar fascia and the medial longitudinal arch of the foot

Why does my plantar fasciitis hurt in the morning?

Plantar fasciitis is a condition that causes severe pain in the heel and makes the normal activities complicated. But there are several causes that are responsible for plantar fasciitis. In order to learn the exact cause the parts of the foot which are affected by this disease, you must be aware of the anatomy of the plantar fascia. Our foot and ankle mainly consist of three parts named: rear foot, mid foot, and fore foot.

  • The rear foot consists of four bones: Distal aspects of the tibia and fibula (leg bones), calcaneus (heel bone), and Talus.
  • Similarly, Mid foot consists of 5 bones, cuboid, navicular, and 3 cuneiforms
  • Forefoot consists of 19 bones: 5 metatarsal bones + 14 phalanges.

The plantar fascia originates from the medial calcaneal tuberosity, which is further divided into a medial, central, and lateral band that attaches to the superior surface. The foot has a visible medial longitudinal arch (MLA) that aids in distributing the force attributed to weight bearing. The MLA of the foot resembles two rods: a rear rod consisting of the calcaneus and talus, which are connected at their base by the plantar fascia. When force is applied to the apex of the MLA, the arch depresses, the two rods separate, and tension is distributed throughout the plantar fascia. The main ligaments that aid in supporting the MLA is the long and short plantar ligaments and the calcaneonavicular ligament (spring ligament). During static stance, the MLA is supported by the plantar fascia, the ligaments, and the osseous architecture of the foot. During late ambulation, the plantar fascia assumes a dynamic role in reconfiguring both the MLA and the rear foot in preparation for toe-off.

How do I know if I have plantar fasciitis?

Usually, a healthcare provider diagnoses the disease like plantar fasciitis, who diagnose the condition based on your description of the symptoms of the disease. A physical examination can also be done by the physician; he may examine your feet, and press the bottom of your feet. The area is most likely to be very painful upon pressing in plantar fasciitis.

Some symptoms associated with plantar fasciitis are pain upon rising, improvement after walking for several minutes, pain produced by pressure applied to a specific location on your foot but not with pressure in other areas. Such symptoms and description of the symptoms to the doctor will help him diagnose the condition more effectively. You may also recommend an X-ray of your foot in order to check the underlying fracture that causing the pain.

What increases your risk of plantar fasciitis?

You have a high chance of developing plantar fasciitis if you

  • Are middle-aged or older.
  • Walk with an inward twist or roll of the foot or have high arches or flat feet.
  • Are overweight or suddenly gain a lot of weight.
  • Have tight Achilles tendons (which attach the calf muscles to the heel bones) or tight calf muscles.
  • Have habits or do activities that increase the stress on your feet, such as:
    • Wearing shoes with poor cushioning.
    • Walking or running without being conditioned for these activities.
    • Changing your walking or running surface (for example, from grass to concrete).
    • Having a job that involves prolonged standing on hard surfaces.
  • Are athletes or a member of the military? Some athletes, especially runners, are more likely to get plantar fasciitis because of:
    • Things that affect the way their feet strike the ground, such as not having enough flexibility in the foot and ankle or having stronger muscles in one leg than in the other.
    • The repetitive nature of sports activities.
    • Improper training.

What are the symptoms of plantar fasciitis?

The pain is the major symptom in the people who are suffering from plantar fasciitis. They feel stiffness in the bottom of the feet and heel, there could be a chance that you may suffer from the pain at the bottom mid-foot area. This kind of pain usually develops and grows with time gradually. Some people suffer from this disease very dull pain that does not affect the quality of their life; however, it should not be ignored. In some people, there is a sharp and shooting pain, along with pain, they can feel burning or ache on the bottom of the foot extending outward from the heel. The pain associated with plantar fasciitis affects just one foot but it can extend to both the feet.

In the morning time, the pain is worse when you start walking after just getting out from the bed. Similar is the case with long term sitting or if you walk after lying down for a while. Heel stiffness makes it very difficult for you to climb the stairs. The prolonged activity or continuous walk can cause inflammation in the foot which can exacerbate the condition and cause extreme pain. The patient can felt the flare up of pain after working which was not so severe while working.

What are the causes of plantar fasciitis?

Heel spurs are not the main reason for plantar fasciitis. A heel spur can be characterized by a hook of bone that can form on the heel bone or calcaneus (heel bone) of the foot. A very few people suffer from the pain due to heel spurs (say it 1 out of 20), and as per AAOS (American Association of Orthopedic Surgeons), 1 out of 10 people have a heel spur.  Excess weight can also lead to nonbearing pain n the heel. The pain usually diminishes after ten to twelve steps of walking as the plantar fascia become stretched. However, after prolonged periods of standing, especially on harsh cemented surfaces, a throbbing pain, a dull ache, or a fatigue like sensation can resurface again in the median arch of the foot.

There are many other causes of plantar fasciitis:

Overweight:

If you are obese or overweight, you are at greater risk of developing plantar fasciitis. When you gain weight suddenly, it starts putting extra pressure on your plantar fasciitis ligaments. You may suffer bouts of plantar fasciitis, if you are pregnant and if you are in 8 or 9 months of your pregnancy because the weight gain at that time is highest.

Long time walking or running:

You may be more likely to develop plantar fascia problems if you’re a long-distance runner. If you are in a profession where you need to walk a lot, such as a factory worker or a delivery person, you may have more risk of plantar fasciitis. The highest risk of developing plantar fasciitis is in between the age of 40 to 70, you may notice the periods of heel pain in active male or female of such age. It is more common in women than in men.

Foot problems:

Such as high arches or very flat feet and other foot problems can give rise to the condition like plantar fasciitis. There are tendons which attach your calf muscles to your feet called Achilles’ tendons, if you have very tight Achilles tendons, you may develop plantar fasciitis pain. Simply wearing shoes with soft soles and poor arch support can also result in plantar fasciitis.

What are the risk factors associated with plantar fasciitis?

Though plantar fasciitis can arise without an obvious cause, factors that can increase your risk of developing plantar fasciitis include:

Exercise:

Long distance running, ballistic jumping activities, ballet dancing, aerobic dance and other activities that place a lot of stress and strain on your heels and attached tissues can contribute to an earlier onset of plantar fasciitis.

Age:

Age 40 to 60 is most appropriate for the condition like plantar fasciitis.

Foot mechanics:

Flat foot, foot pronation (over stress on the inner side of the foot), having a high arch can also put extra pressure on the plantar fascia. Such foot mechanics can also affect the way weight is distributed and cause pain in plantar fasciitis.

Obesity

Excess pounds put extra stress on your plantar fascia. Pregnant women mostly suffer from this condition which is more severe in late pregnancy. Excess weight makes impossible for one to stand for a long time.

Occupations that keep you on your feet. 

Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.

How to diagnose plantar fasciitis?

A detailed history and physical examination can help a doctor in diagnosing the plantar fasciitis. A history of patient suffering from heel pain due to plantar fasciitis must include, initial onset of injury, current symptoms, occupation, recent weight gain, progression of the frequency, intensity, and duration of weekly training runs, training routes (including hills), running shoes and its age, as well as the training goals. By diagnosing the foot by hands (palpation), your doctor can diagnose the tenderness over the medial calcaneal tuberosity and the MLA (median longitudinal axis). Your doctor can diagnose the condition by performing a physical exam to check for tenderness in your foot and the exact location of the pain to make sure that it’s not the result of a different foot problem.

You will be asked to flex your foot while your doctor pushes on the plantar fascia to see if the pain gets worse when you flex and much better as you point your toe. If you have a mild redness or swelling, it will be noted first by the doctor. He may also ask you for time and duration about flare up of the heel pain. He may recommend you for multiple exercises in order to avoid the pain. There are many exercise programs which are helpful in reducing pain and inflammation associated with plantar fasciitis.

The strength and weakness of your muscle will also be checked by your doctor. He may also check the health of your nerves by identifying your reflexes, muscle tone, sense of touch and sight, coordination, and balance. An X-ray or an MRI scan may be necessary to check that nothing else is causing your heel pain, such as a bone fracture.

What are the complications associated with plantar fasciitis?

Plantar fasciitis is a condition which can turn into severe foot pain if left untreated. You should never ignore the condition. This is conditions which can make it difficult for you to walk and cause injury to your legs, knees, hips, and back. Some healthcare professionals use steroid injections and some other treatments which can weaken the plantar fascia and such treatment can cause potential rupture of the ligament. Another option left after complications of the plantar fasciitis is surgery which can carry the risk of bleeding, infection, and reactions to anesthesia. Changes in your foot and nerve damage can occur due to plantar fascia detachment. Gastrocnemius muscle (the chief muscle in the calf of the leg) resection can also cause nerve damage.

Can plantar fasciitis be bone spurs?

Biomedical explanations for plantar fasciitis is as common as plantar fasciitis, however, it sounds clever. There are three particularly common biomechanical “explanations” for plantar fasciitis, which are covered in three sections below, these sections neither useless nor they qualify for “root cause” tag of plantar fasciitis.

  • bone spurs
  • flat feet
  • tight calves

There are so many causes of plantar fasciitis. Some causes appear to cause at the same time. Sometimes it is very difficult to diagnose the root cause of plantar fasciitis due to multiple causes that occur at the same time. It’s simply too complicated an equation, and the scientific literature is riddled with contradictions.

Hard bony growths in the arch are painful?

Heel spurs or calcaneal spurs or also called bone spurs.

It usually appears as smoking gun. Bone growth on the front of the heel is quite common, it usually occurs in 10-20% of the population. In the people, suffering from plantar fasciitis, the heel pain is mainly due to a bony outcropping on your heel, for this reason, people do not want even a pebble in their shoe.

Not as bad as it looks. Having a bone spur is more like stepping on a very thin cracker than a nail.

What are heel spurs?

Are heel spurs and plantar fasciitis the same?

Heel spurs are a brittle and thin calcification of the plantar fascia. They are not bony in structure and not like a rock in your shoe. It is somewhat similar to the tin foil which makes plantar fascia crispy and brittle. So, unfortunately, bone spurs are a lot more than the normal mechanical problem. Stepping on a bone spur is more like a stepping on a nail condition. Lots of people also have painless bone spurs. One can also aware that if you are suffering from any kind of a pain in your foot, it is not necessarily a bone spur. A plantar fascia or other soft tissue structure can also cause pain of same intensity. A bone spur can be removed surgically, but sometimes the pain does not disappear even after surgery which indicates that there could be any other cause of the pain in the foot. In some cases, Spurs also grow back.

Are heel spurs a cause of plantar fasciitis?

As per a review in a journal “Though once synonymous with plantar fasciitis, calcaneal spurs have, for several decades, largely been regarded in the orthopedic literature as incidental findings, however, it may be premature to completely dismiss the significance of plantar calcaneal spurs”.

It’s been cleared that when other tissue X factors are present, Spurs are more painful and problematic. But it is also shown that such factors can also cause symptoms such as pain similar to plantar fasciitis (no matter if you have heel spurs or not). It is also a possibility that in absence of such factors, heel spurs are completely painless. Bone spurs are most obvious and most likely root cause of plantar fasciitis, but it is not the truth. It seems like the root cause but there is no connection between the heel spurs and plantar fasciitis. Other alleged root causes are even less satisfying.

Treatment of plantar fasciitis

Alleviating pain, healing promotion, motion, and strength regain, training errors removal should be the basic and conservative treatment of the plantar fasciitis. The treatment should also include providing the good amount of nutrition and limiting the biochemical deviations caused by structural abnormalities.

Deep tissue procedures for plantar fasciitis

Such as the Graston Technique (manual therapy that utilizes specially designed devices) and Active Release Technique (a patented manual therapy technique), to break up scar tissue and restore soft tissue motion. Graston tool is a myofascial technique that is used to break the adhesion at the origin of the plantar fasciitis. There is evidence which supports the efficacy of deep tissue procedures in the treatment of sprain injuries. Stimulation of fibroblast proliferation, leading to collagen synthesis that promotes the healing of plantar fasciitis is seen in the treatment with myofascial techniques. Myofascial techniques replace the degenerative tissues with the more functional tissues.

What are some exercises that can be helpful in plantar fasciitis?

Home exercises for plantar fasciitis:

  • Patients can be taught about home exercise program for myofascial release therapy. Here we are taking an example of a person who has a plantar fasciitis in the right foot.
  • The patient needs to sit on a flat surface, the seated patient should cross his legs as the right leg over the left knee.
  • Now grab your first, second and third proximal phalanges (bones found at the base of the fingers or toes) with their right hand.
  • With your left hand, apply the pressure on central band of plantar fascia (explained in the anatomy of plantar fascia).
  • Now extend the toes at the metatarsophalangeal joints with the right hand, while applying a distal to proximal traction with the left hand.
  • This procedure can be repeated as necessary. You should talk to your doctor regarding this exercise; he will teach you how to roll a golf ball, laundry ball with nubs, or frozen plastic bottle under the median longitudinal arch to stimulate the plantar fascia.

Other exercises for plantar fasciitis:

Another treatment which is best for plantar fasciitis is “Stretching”. It may help you in reducing the initial inflammation by keeping your weight off from your foot. An ice pack application on the sore area for 15 to 20 minutes is also considered as beneficial, when applied three to four times a day. Your doctor may also prescribe you some Nonsteroidal anti-inflammatory medicines such as ibuprofen, naproxen etc that reduce the pain as well as inflammation. You should always continue with your home exercises as it helps you to stretch your Achilles tendon and plantar fascia. Home exercises effectively reduce the recurrence of the pain associated with plantar fasciitis.

In the exercise shown above:

  1. Lean forward against a wall with your one knee straight and heel on the ground, keep your other knee in the bent position.
  2. When you lean, your heel cord and foot arch should stretch.
  3. Hold in the same position for 10 seconds, relax and get straight again.
  4. You should repeat the full exercise for 20 times for each sore heel.
  5. It should be noted that in order to keep the knee fully extended on the side being stretched is very important.

The second exercise you can practice in order to soothe your sore heel is:

  1. Lean forward on a countertop; Put your foot in front of other by spreading your feet apart.
  2. Flex your knees and squat down, keeping your heels on the ground as long as possible.
  3. When your heel stretch, your heel cords and foot arches will also stretch.
  4. Hold on in this position for 10 seconds, relax and get straighten up.
  5. Repeat the procedure for 20 times.

After two months of initial treatment, about 90% of people with plantar fasciitis show improvement significantly. Off-the-shelf shoe insert device like a rubber heel pad, shoes with shock-absorbing soles are advisable to wear on daily basis. A steroidal anti-inflammatory medication may also be injected in your heel if you do not any significant improvement in pain and inflammation, even after several treatments. In some cases, surgery is needed for a chronically contracted tissue.

What is a plantar fascia-specific stretching program?

  • Cross your affected leg over your other leg.
  • Using the hand on your affected side, take hold of your affected foot and pull your toes back towards shin. This creates tension/stretch in the arch of the foot/plantar fascia.
  • Check for the appropriate stretch position by gently rubbing the thumb of your unaffected side left to right over the arch of the affected foot. The plantar fascia should feel firm, like a guitar string.
  • Hold the stretch for a count of 10. A set is 10 repetitions.

Perform at least three sets of stretches per day. You cannot perform the stretch too often. The most important times to stretch are before taking the first step in the morning and before standing after a period of prolonged sitting.

Anti-inflammatory medications for the plantar fasciitis

In order to reduce the inflammation in the arch and heel of your feet, your doctor may prescribe you anti-inflammatory medications. Such medications are Advil, Motrin, Ibuprofen, and Aleve.

You should take this medication as and when required. You should take this medication as directed on the carton of the medicine.  Resume for this medication for two weeks again if your condition worsens and then stops.

Your stomach can be upset due to such medications; therefore, you should eat while taking these medications.

Arch support for plantar fasciitis

Arch or heel can be supported by the Over the counter inserts such as Spenco, Cross Trainers. They are beneficial in providing support and soft cushion.

You may require custom inserts based on the need of individual needs.

Additional Stretch: Achilles tendon stretch for plantar fasciitis

  • Place a shoe insert under your affected foot.
  • Place your affected leg behind your unaffected leg with the toes of your back foot pointed towards the heel of your other foot.
  • Lean into the wall.
  • Bend your front knee while keeping your back leg straight with your heel firmly on the ground.
  • Hold the stretch for a count of 10. A set is 10 repetitions.
  • Perform the stretch at least three times a day.

Modified training for runners such as swimming, bicycling, and the elliptical machine.

Cushions for supportive measures for plantar fasciitis

  • In order to reduce ground reactive forces of the plantar fascia, you should place a viscoelastic heel cup or a small cushioned doughnut, over the medial calcaneal.
  • People who stand for prolonged periods over a fixed spot, a cushioned mat can also be placed over a hard working surface. It will help in reducing the ground reactive forces in the foot of the patients.

Manage overweight for treating plantar fasciitis

Heavy weight or obese people are more likely to feel the pain in the foot due to excess weight on the heels. A dietician can help in making a daily meal plan for healthy weight loss. She can also calculate burn rate from daily exercise.

Electric muscle stimulation for plantar fasciitis

electrical muscle stimulation for plantar fasciitis

There is another therapy which is required to reduce pain, restore muscle tone; aid in the healing process is called as ultrasound and electric muscle stimulation combination therapy.

What are other medications for plantar fasciitis?

Medications such as nonsteroidal anti inflammatory medications, dexamethasone along with Iontophoresis is also beneficial in reducing the inflammation associated with plantar fasciitis. Applying a cold pack to the MLA (median longitudinal arch) for 20 minutes on and one hour off throughout the day is also beneficial in reducing the inflammation.

A short leg walking cast can promote the healing and repetitive strain associated with plantar fasciitis. This cast can be worn for 6 months approximately. It fastens the healing process by limiting the ground reactive tensile forces acting on the fascia.

Cortisone injections or surgical management for plantar fasciitis

Exacerbating symptoms may arise the need for the consideration if conservative measures are not successful. If you feel that you are not able to manage the symptoms associated with plantar fasciitis, your doctor may recommend you cortisone injections.

  • Corticosteroid injections are beneficial in relieving pain that causes by inflammatory changes.
  • These injections should be given under proper judgment as multiple injections can cause plantar fascia rupture.
  • A surgical option is considered in case of recalcitrant cases of plantar fasciitis that limit activities of daily living or prevent participation in sports.
  • Plantar fascia released by the surgical method, followed by appropriate therapy, may reduce stiffness that was present in the median longitudinal axis.
  • Stiffness may occur in the median longitudinal arch that can reduce with surgical release of the plantar fascia, which is followed by appropriate therapy.
  • Surgical treatment also allows for pain-free walking and movements during daily activities.
  • The over release of plantar fascia by the surgical means (more than 30%) can cause extra pressure on the ligaments and bony structures that support median longitudinal axis.
  • More than 30% of surgical release of plantar fascia can also limit the ability of a subtalar joint to manage the weight on the foot.

The heel pain is the most common symptom of the plantar fasciitis. The most prominent one that is caused by plantar fasciitis is inferior one. Structural abnormalities, overuse, weakness, overweight, and training are some main risk factors of this condition. The ability of plantar fascia to absorb ground reactive forces can be reduced by the degenerative changes raised by repetitive and excess loads placed on the plantar fascia. Such degenerative changes may also limit the ability of subtalar joint to manage weight when the foot is in the position of toe-off. In many cases, conservative care has been found to be successful in alleviating or controlling symptoms related to plantar fasciitis. If conservative care is not effective, a cortisone injection may be useful in decreasing pain symptoms. In recalcitrant cases of plantar fasciitis, endoscopic conservative surgery is a viable option.

Botulinum toxin for Plantar fasciitis

Botulinum toxin or Botox has long been used for aesthetic purposes, but since the turn of century its utility has been expanded to treat spastic conditions. There are now a number of published researches who favor the use of botulinum toxin in the treatment of plantar fasciitis.

One research randomly divided and treated 36 patients with either the traditional steroid injections to the painful area of the plantar fascia or with Botox injections to the gastrocnemius & soleus muscle complex. Both treatment groups were asked to perform stretching exercises.

The results of the study show that the patients who received Botox injections displayed more rapid and sustained improvement over the duration of the study.

Therefore Botox injections could be effective treatment for treatment of plantar fasciitis. This will limit the side effects of corticosteroids on the body. The only drawback to this treatment is the relatively high cost of Botox injections as compared to a steroid injection.

Dry needling for plantar fasciitis

Dry Needling or Percutaneous Ultrasound Guided Approach to Plantar Fasciitis is a fairly new treatment for chronic plantar fasciitis. The advantage of this procedure is that it is a minimally invasive procedure that can be done in the office for patients suffering from chronic plantar fasciitis. It lasts for only 15 to 20 minutes.

The theory of dry needling is that it breaks up scar tissue which is present at the attachment of the heel. This minor trauma serves as a stimulus, allowing the body to recognize the injured tissue as an acute problem area initiating an acute inflammatory and repair reaction. As a result, this area that normally has poor circulation will have increased blood flow.

Initial results are promising and show up to 95% success rate. However more research is required as there is variation in success rate which may be due to faulty technique by some physicians as the exact rigger point for this procedure is still unknown.

How do cortisone injections work?

The corticosteroids in the cortisone injections produce the anti-inflammatory response at the site of pain and inflammation. Oral medications in severe heel pain are not usually successful because it has to go through the whole body. So, a cortisone injection, in right dosage, provides the required relief in pain and inflammation, right at the deserving site.

How long a cortisone injection takes to work?

Before the injection is effective, it takes 2 to 3 days normally, because the longer acting component of the cortisone is in a crystalline form and requires time after the injection to become usable by the body (the crystals need to “dissolve”). The pain and inflammation reduced dramatically after the injection has passed the threshold time frame.

Can I do the exercise after injection?

It is recommended that you take it easy for least 2 or 3 days after a cortisone injection. You should always discuss with your Doctor about any special plans for high-impact exercise such as running.

Plantar fasciitis socks or shoes. Are they helpful?

Plantar fasciitis patients are advised to massage their heels and feet and to put pressure of their heels several times a day till the pain has completely resolved. However, since most of us don’t have the time to do the aforementioned treatment aids, socks and compression sleeves along with arch support shoes and/or orthotic support can prove to be extremely valuable in the treatment. They would be beneficial for anyone who sits for long periods of time, or who prefers to use them over a night splint in order to keep the ligament stretched.

There have been limited professional studies proving the benefits of these compressions fasciitis socks in the reduction of pain or as a treatment option at all, however, there are many users in general who feel that it has been a worthwhile investment in their ability to reduce pain.

The benefits of wearing these socks are comfortable and hence can be worn around the clock. Some people might complain that these socks are too tight. It is advised to them that they should change the size of their socks.

What are the surgical procedures for plantar fasciitis?

Surgical procedures are not commonly needed for plantar fasciitis. Most people (~95%) are able to relieve pain in the heel without surgery. Surgery may be needed when nonsurgical treatment are failed to produce the desired effects and if heel pain hinders your daily activities. As per doctor’s recommendation, you should try nonsurgical treatments such as corticosteroids injections, before 6 months of that you think about surgery.

There are mainly two types of surgery for plantar fasciitis, such as:

  1. Plantar fascia release: In this procedure, doctor cuts the part of the plantar fascia ligament. The cut promotes and releases the tension on the ligament and relieves inflammation.
  2. Heel spurs removal or stretching or loosening specific foot nerves are other surgical procedures that can be considered in the treatment of plantar fasciitis. These surgical procedures are done in combination with plantar fascia release if there is heel pain lasting for long periods of time.

It was considered that heel spurs are responsible for plantar fasciitis. Now it is believed that heel spurs are the result of plantar fasciitis, not the cause of this disease. Many people with large heel spur never have heel pain or plantar fasciitis. So, surgery to remove heel spurs is rarely done.

What are some common facts about plantar fasciitis?

  • Inflammation of the plantar fascia ligament or plantar fasciitis is most commonly caused by strain injury causing micro tears to the ligament as it attaches to the heel bone or other areas of tightness on the sole of the foot.
  • In human body, the plantar fascia is the largest ligament
  • The main symptoms of plantar fasciitis include heel pain, foot pain, stiffness, and tenderness.
  • One can diagnose plantar fasciitis on the basis of history of the condition as well as the physical examination.
  • An underlying disease can be a reason of plantar fasciitis, however, it is not necessary.
  • By avoiding re-injury and reduction in inflammation associated with plantar fasciitis can beneficial in treating the disease.
  • Plantar fasciitis is commonly mistaken for Baxter’s neuritis, which is a nerve entrapment in the heel.
  • When the condition chronic plantar fasciitis lasts for one year, it can become plantar fasciitis due to a vascular scarring of the plantar fascia.
  • Plantar fasciitis is painful due to poor blood supply to the scarred tissues and is resistant to treatment that reduces inflammation typically applied for plantar fasciitis.

How long does it take for plantar fasciitis to heal completely?

There is no fixed time for plantar fasciitis to heal because every person’s plantar fasciitis is different, so you may face shorter or longer healing time depending upon the severity of your condition. Generally, pain due to fasciitis can last anywhere from two to three weeks. However, in some cases pain can last up to six weeks because this is how long it takes for the soft tissue to repair itself. If it lasts for more than 6 weeks without any response to treatment, doctors think about employing invasive procedures.

Another factor that determines the duration of pain is whether you are taking any steps to improve pain and functionality of your foot or not? The worst thing is taking no medication or home remedies. Rest is good, but you should also be actively trying to heal the condition. Taking steps to reduce inflammation can shorten healing time for your Plantar Fasciitis

As a general rule, the earlier you begin treatment for plantar fasciitis, the less time it takes to recover.

Do Yoga Toes work for Plantar Fasciitis?

Yoga Toes are rubbery devices. They separate the toes from each other and are designed to affect the muscles of the feet like a workout or massage affects other parts of your body. They are

They extend the shortened Achilles tendon in plantar fasciitis and improve the foot arch, hence reducing the pain associated with plantar fasciitis.  They can’t completely rid a person of a foot ailment; however they can help significantly decrease foot pain.

This device is not useful if the fasciitis is due to any structural deformity, therefore one should go to a podiatrist before using this remedy.

Home remedies for Plantar Fasciitis

There are a number of home remedies available for the treatment of plantar fasciitis. If you resist taking medicine, then the following remedies maybe used by you.

Epsom salt for Plantar Fasciitis

Epsom salt which is basically magnesium sulfate crystals is a common treatment for plantar fasciitis. It has an anti-inflammatory action and hence reduces pain. It also helps in healing muscles and connective tissues of the body. Ideal way of using it is to put 2 to 3 tablespoons of Epsom salt in a small tub of warm water and then soak your foot in this water for 10 to 15 minutes, twice a day. Do this a few times a week for maximum benefits.

Turmeric for Plantar Fasciitis

Turmeric contains the compound curcumin which works as a strong painkiller. It too is an anti-inflammatory agent. A study by Davis et al., which was published in a June 2007 issue of the American Journal of Physiology found that curcumin can reduce both acute and chronic inflammation. Method for using it is as follows: Add 1 teaspoon of turmeric powder to a cup of milk and heat it over a low flame. Then add half teaspoon of honey and drink it daily before going to bed. If this doesn’t suit you, you can take curcumin supplements, 400 to 600 milligrams 2 times a day.

Vinegar for Plantar Fasciitis

Apple cider vinegar is a helpful health tonic which can be used for treating plantar fasciitis along with a host other morbidities. It is an analgesic, anti-inflammatory and anti-oxidant liquid. You can use this by adding 1 tablespoon of raw, unfiltered apple cider vinegar and 1 teaspoon of raw honey to a glass of warm water. Drink it a couple of times daily. Alternatively, you can mix 2 tablespoons of apple cider vinegar in a small tub filled with warm water and soak your feet in the tub for 5 to 10 minutes.

Ginger for Plantar Fasciitis

Ginger is a known anti-inflammatory and analgesic spice that can help battle plantar fasciitis.

Mix 1 tablespoon of grated ginger in 1 cup of water and then boil it for a few minutes. Then turn off the heat and wait for 10 minutes. Then pass the mixture through a fine mesh and drink the tea while it is still hot. Drink 2 to 3 cups of this tea daily.

Ginger can also be added in your diet. Another option is that like curcumin, ginger supplements are also available which you can take after consulting your doctor.

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