Cover image talking about plantar fasciitis

Plantar Fasciitis: Its Causes and Ultimate Treatment

Plantar fasciitis is pain on the bottom of the foot in the heel area or front of the heel due to a tear in the plantar ligament. Fasciitis is treated in many ways. Follow us to know more.

Profile of plantar fasciitis

Pain that limits a person's movement and prevents them from performing their tasks is the worst. Plantar fasciitis leads to severe pain in the bottom of the foot at the heel area, preventing the patient from walking.

The sole in humans consists of the skin of a thick fat pad that helps bear the body's weight, followed by the plantar fascia that supports the foot while walking.

The plantar fascia is in the form of a broad ligament that connects the heel of the foot to the origin of the toes. This fascia is flexible, stretchable, and bears the pressure (such as body weight) applied to it.

Plantar Fasciitis occurs as a result of overloading or walking in a wrong and uncomfortable way, which leads to lacerations and inflammation, causing severe pain in the soles of the patient's feet.

Image showing a ligament tear leading to plantar fasciitis
A tear in the ligament leads to plantar fasciitis

Many methods are used to treat plantar fasciitis to relieve the symptoms caused by it. Still, conservative treatment and rest with physical therapy remain the basis for treatment in plantar fasciitis.

Symptoms of plantar fasciitis

Symptoms of plantar fasciitis include plantar pain, characterized by being sharp in the heel area and developing gradually. It may be noticed in front of the heel, i.e., in the middle of the sole.

This pain extends to the top of the heel and hinders the patient from walking. The pain of plantar fasciitis is worst upon awakening, with the first steps of the day being painful (pain on the bottom of the foot when getting up) or after a long rest.

Pain is not felt during exertion and is immediately intensified after rest. The pain is predominantly affected by one foot, and in a few cases, it affects both feet together, and because of the stiffness of the heel, it becomes difficult to climb stairs.

Image showing symptoms of plantar fasciitis
Symptoms of plantar fasciitis

Causes of plantar fasciitis

The leading cause of pain in plantar fasciitis is small tears in the supporting ligament that forms as a result of excessive tension and stretching due to the frequent use of this ligament. Thus the site of these tears gets the inflammation that causes pain in the heel.

It is not related to the presence of a bony spur in the foot (Heel nail or calcaneal spur) with fasciitis pain. Previously, this belief was prevalent, but it was discovered that a very small percentage of those who have a bony spur in the bones of the foot suffer from pain and plantar fasciitis has nothing to do with it.

Causes and predispositions of plantar fasciitis

  • Gender: Women are more likely than men.
  • Age: Plantar fasciitis is most common in people between the ages of 40 and 70.
  • Wearing uncomfortable or unsupportive shoes for the foot arch leads to excessive pressure on the plantar fascia ligament.
  • Weight gain: due to increased load on the feet and thus on the ligament at the heel.
  • Athletes: more common. Especially marathon runners.
  • Deformities of the toe: One of the most critical diseases here is flat feet and high arches.
  • Pregnancy: Some episodes of plantar fasciitis may occur during pregnancy.
  • The tendon of the foot that is stretched from behind is called the Achilles tendon - and if it is excessively stretched, it may lead to plantar fasciitis.
  • Occupation: Some professions require standing on the feet for long hours, which lead to plantar fasciitis and heel pain due to weight pressure for a long time.

Diagnosis of plantar fasciitis

The doctor diagnoses plantar fasciitis clinically by asking the patient about the symptoms he suffers from and conducting some clinical examinations in the clinic.

However, this does not preclude requesting imaging tests, such as x-rays, to deny fractures or bony protrusions, as they may cause pain similar to heel pain in plantar fasciitis.

Sometimes we may need an ultrasound or magnetic resonance imaging to detect the presence of thickening of the fascia and confirm the diagnosis of plantar fasciitis if we suspected the diagnosis at the beginning in the patient's case.

Plantar fasciitis treatment

The ligament tear that causes plantar fasciitis and heel pain are often treated at home with conservative treatment. In chronic cases, we may resort to more rigorous procedures, and surgeries can be performed in Turkey for patients intractable to conventional treatment.

Conservative treatment in plantar fasciitis

It is the treatment of plantar fasciitis at home without needing a doctor. It is considered the main line of treatment, whether it is combined with other therapies or relied on alone, and includes the following:

  • Rest is the most important in treating the patient's heel pain in plantar fasciitis to allow healing of the tears in the fascia or tendons by reducing pressure and walking. Increasing pressure on it worsens the rupture and causes inflammation of the tissue at the bottom of the foot.
  • Pain relievers: Among the most commonly non-steroidal anti-inflammatory drugs such as ibuprofen.
  • Medical shoes: It is essential to wear shoes with a sole that supports the foot's arch, as it relieves the load on the plantar fascia and thus allows it to recover.
  • Corsets, splints, or medical stockings: Some corsets can be worn to support the foot arch and relieve the patient from the pain of plantar fasciitis.
  • Ice packs: They may help relieve heel pain caused by plantar fasciitis and are used four times a day, each for 15 minutes.

Plantar fasciitis should resolve within several months of home remedies and rest.

Image illustrating how to conservatively treat plantar fasciitis
Conservative treatment in plantar fasciitis

Non-surgical treatment in plantar fasciitis

It would be the next stage of treatment if the traditional medicine of plantar fasciitis did not help more than once in relieving the pain of inflammation of the bottom of the foot and relieving the pain of your heel. It includes the following:

Physiotherapy in TurkeyPhysiotherapy includes a set of exercises under the supervision of specialists to relieve pain and prevent its recurrence by strengthening the muscles and ligaments in the leg and sole through activities determined for you according to your condition.

These exercises lead to a lengthening of the Achilles tendon, thus relieving the tension on the plantar fascia, thus reducing the tears in the ligament that formed it. The heel pain does not return to the patient.

Image showing rolling a roller on the sole of the foot to treat plantar fasciitis
Physical therapy exercises for plantar fasciitis
Image showing a physical therapy exercise for plantar fasciitis
A physical therapy exercise for plantar fasciitis

Cortisone injection: Cortisone injection at the pain's site helps relieve it. The injection is done with the help of echocardiography to ensure that the injection is in the correct place in the heel. Repeated injections are not recommended because this may cause disruption and damage to the plantar fascia.

Ultrasound shock wave therapy in Turkey: The treatment principle is based on directing sound waves (similar to echo waves) that stimulate cell growth and heal ligament tears in the patient’s heel, thus relieving pain in the heel.

Doctors determine Bimaristan Medical Center What line of treatment is appropriate for your condition based on your symptoms and their severity. Contact us For optimal treatment of plantar fasciitis and heel pain.

Surgical treatment of plantar fasciitis in Turkey

Suppose the patient suffered from pain in the bottom of the foot at the heel due to plantar fasciitis for 6 to 12 months and was committed to the previous treatment (conventional and non-surgical). In that case, the ultimate solution for plantar fasciitis must be resorted to, which is surgery.

Surgery to treat heel pain in patients with plantar fasciitis includes more than one type. Still, the two most important types of operations are Gastrocnemius recession and plantar fascia release.

Gastrocnemius recession

If a patient with plantar fasciitis suffers difficulty flexing his foot and heel pain, this operation suits him. As the surgical lengthening of the muscle and tendon relieves tension on the plantar fascia and thus relieves pain, this operation has proven to be very successful for many patients.

Plantar Fascia Release

This procedure is either open or endoscopic. In it, the surgeon separates the plantar fascia from the heel bone, thus relieving the tension on it and healing the ligament that forms it, in addition to treating the heel pain of the patient. (The calcaneus is one of the bones that form the tarsus of the foot, the most prominent bone among them, and it is colloquially called the heel).

This operation may have some side effects caused by fasciotomy so the treatment will be based on the patient’s condition and the appropriate procedure.


Sources:

  1. healthline
  2. Johns Hopkins
  3. NHS

Frequently Asked Questions:

Plantar fasciitis heals if the instructions and home remedies are followed within several months. And it would be best if you did not make any effort or increase the load on the plantar fascia during the recovery period.

If you are planning for treatment in Turkey
you can talk to us here.

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