EPAT/Shock Wave and Plantar Fasciitis

Plantar Fasciitis Treatment, Causes and Symptoms

• July 13, 2022

Plantar Fasciitis is a fairly common foot condition that affects approximately one in ten people every year.

Struggling with pain in the feet is not only difficult physically, but is also mentally challenging. Trouble moving around and performing normal day-to-day activities can be an incredible disruption in any person’s life.

Some forms of pain in the feet might be related to an inflamed plantar fascia ligament, which is why it’s important to know about plantar fasciitis treatment, causes, and symptoms.

What is Plantar Fasciitis?

The plantar fascia is a thick, fibrous ligament that runs along the bottom of the foot and connects the base of the toes to the heel. It supports the arch of the foot and acts like a cushion for movements such as standing, walking, running, and jumping.

Because of its location, the plantar fascia is under nearly constant wear and tear.

Over time, and even with sudden trauma, this soft-tissue can develop tiny stress-tears or might simply become inflamed as a result of the constant pressure it is required to sustain. This leads to pain and stiffness in the bottom of the foot and the heel.

It’s important to note that this condition occurs on the bottom of the foot and is much different than injuries causing pain on top of the foot.

Plantar fasciitis ranks among one of the most common orthopedic complaints regarding foot pain. Knowing some of the causes of this condition can help people improve the overall health of their feet.

What Causes Plantar Fasciitis?

In some rare cases, diseases such as rheumatoid arthritis or lupus can lead to issues with plantar fasciitis. However, inflammation of this ligament is more often associated with over use or certain physical activities that stretch the tissue too far.

People between the ages of 40 and 70 years old who live active lifestyles are at the greatest risk of developing plantar fasciitis.

SOME COMMON CAUSES OF PLANTAR FASCIITIS INCLUDE:

• A sudden increase in activity, such as starting to walk more often in a new job or not easing into a new running program
• Standing, walking, running, or jumping on certain surfaces that are too hard, or some types of artificial turf that have too much give or stretch
• Working in a physical vocation that requires long hours of standing or walking
• Poor fitting shoes, or footwear that’s inappropriate for particular movements and doesn’t provide enough arch support
• Physical issues with the structure of the feet, such as flat feet or high arches
• Being overweight can place increased stress and pressure on the plantar fascia

Recognizing the symptoms of plantar fasciitis, especially early on, can help people take quick action to avoid a prolonged struggle with the condition.

Common Plantar Fasciitis Symptoms

The primary symptom of plantar fasciitis occurs in the heel or on the bottom of the mid-foot.

Pain associated with this condition generally worsens over time, and though it more commonly develops in one foot, some people may experience the condition in both feet.

SYMPTOMS OF PLANTAR FASCIITIS CAN INCLUDE SOME OF THE FOLLOWING:

• Sharp pain or a dull ache in the heel or bottom of the mid-foot
• A painful sensation of warmth or burning from the heel toward to the bottom of the foot
• Pain that is usually worse after inactivity, such as early in the morning when taking the first steps of the day
• Experiencing pain when walking up stairs
• Pain at the heel and under the foot that dissipates throughout the day, as soft-tissue in the foot warms up, but then increases when activity is slowed or stopped

Because pain sometimes subsides with increased activity, many people are likely to ignore the issue until it becomes worse over time. Seeking treatment early can help reduce the downtime associated with plantar fasciitis symptoms and pain.

Plantar Fasciitis Treatment

Diagnosing plantar fasciitis requires a physical examination, a discussion about recent activity and noticeable symptoms. A physician may also want to review x-rays or an MRI to analyze the bones and soft tissue in the foot to rule out other possibilities.

Plantar fasciitis treatment approaches will vary based on the severity of pain, the amount of time the symptoms have been present, and how active a lifestyle someone lives.

EFFECTIVE PLANTAR FASCIITIS TREATMENT METHODS INCLUDE:

1. RICE METHOD

The RICE Method is a typical first step when noticing plantar fascia pain. RICE is short for Rest, Ice, Compression and Elevation and is useful for many types of injuries or pain.

Begin with resting the foot and applying an ice pack to the bottom of the foot and heel to reduce selling and relieve pain. A compression bandage will stabilize the foot, and elevating it above the heart will help decrease inflammation and pain.

2. ANTI-INFLAMMATORY PAIN MEDICATIONS

Non-steroidal anti-inflammatory medications, like ibuprofen (Advil) or naproxen (Aleve) can be purchased over-the-counter without a prescription. When used as directed, these will help reduce both pain and inflammation, and should work well while resting and icing the foot.

3. PHYSICAL THERAPY

A physical therapist can work with a person struggling with plantar fasciitis to strengthen the muscles in the lower leg, which help support and stabilize the foot, and take some of the stress off the plantar fascia.

Physical therapists can also address problems with a person’s technique that might be putting undo pressure on the ligament, as well as identify proper footwear for an activity that is causing an issue.

4. STRETCHING EXERCISES

Stretching exercises are an excellent treatment method for plantar fasciitis. Physical therapists will help patients slowly stretch the plantar fascia and the Achilles tendon. Once these exercises are learned, they can be practiced at home or work whenever necessary.

5. EPAT / SHOCKWAVE THERAPY FOR PLANTAR FASCIITIS

EPAT / Shockwave Therapy for plantar fasciitis recovery is the most advanced, non-invasive treatment method available. It speeds the healing of the tears in the plantar fascia ligament and decreases pain during healing.

STORZ Medical is the leading manufacturer of EPAT / Shockwave machines that provide low or high-energy pressure waves directed at the injured area to improve blood circulation and repair damaged tissue.

Extracorporeal Shock Wave Therapy is effective for treating a wide range of injuries and healing pain without drugs, needles, or anesthesia and is a preferred treatment method by many sports medicine doctors and podiatrists.

6. FOOT SUPPORT DEVICES

In some cases, foot support devices like night-splints or a walking boot can help reduce stress and pressure on the plantar fascia ligament, allowing inflammation and pain to ease. Shoe orthotics may also be suggested to help with issues like flat feet or high arches that may be causing plantar fasciitis.

7. CORTICOSTEROID INJECTIONS

Corticosteroid Injections are strong anti-inflammatory drugs that are sometimes used to decrease swelling and inflammation when other methods haven’t been effective after several weeks.

While it may be a necessary treatment option in some cases, this is a more invasive approach that should be limited to avoid cortisone injection side effects that may cause the ligament to become brittle.

8. PLANTAR FASCIITIS SURGERY

In severe cases, plantar fasciitis surgery, known as a gastrocnemius recession, might be recommended. The surgery involves extending the calf muscles in hopes of increasing flexibility and motion in the ankle and foot.

Surgery often comes with inherent risks and should be carefully considered after a detailed conversation with a doctor.

The plantar fasciitis treatment methods outlined here should work well to provide relief from the pain and help the healing process. They should be started early at the first signs of pain in the plantar fascia for a faster recovery.

Photo Credit: Plantar fascia photo courtesy of OpenStax College