Plantar Fasciitis
How is plantar fasciitis treated? Everything about the causes, symptoms, diagnostic methods, and treatments for this condition.
Symptoms and Causes
Plantar fasciitis is the inflammation of the fascia, which is the thick tissue on the sole of the foot connecting the calcaneus bone (the heel) and the toes. While not serious, the pain often limits certain activities and decreases quality of life. Additionally, if not properly treated, it can lead to more serious problems.
There are two types of plantar fasciitis depending on its duration:
- Acute plantar fasciitis: This is the most common. It is characterized by sharp pain in the heel, usually worse when stepping down after getting out of bed, and tends to ease throughout the day.
- Chronic plantar fasciitis: The pain is constant and lasts for at least six months, potentially affecting walking and posture, which in turn impacts other parts of the body. In these cases, treatment is more complex.
It is a relatively common condition, yet the exact causes of plantar fasciitis are still not fully understood.
Symptoms
Plantar fasciitis manifests with very significant symptoms, including:
- Heel pain, especially when getting out of bed in the morning or after resting for some time.
- Pain in the plantar arch.
- Inflammation on the sole of the foot.
- Stiffness.
Certain activities, such as running or standing for extended periods, may aggravate these symptoms.
Causes
Plantar fasciitis is caused by excessive tension on the plantar fascia, which often leads to small tears. The exact causes of this tension remain unknown.
Risk Factors
Some of the factors that increase the risk of developing plantar fasciitis include:
- Being between 40 and 60 years old.
- Engaging in sports that put pressure on the heel (running, ballet, basketball, tennis, etc.).
- Obesity or being overweight.
- Foot anatomical alterations (flat feet or high arches).
- Spending prolonged periods standing.
- Wearing inadequate footwear.
Complications
In addition to causing chronic pain, if plantar fasciitis is not treated in time, it can lead to the formation of a heel spur (an abnormal bone growth in the heel).
Prevention
To prevent plantar fasciitis, it is recommended to reduce tension on the sole of the foot, so the following measures are advised:
- Avoid high-impact sports or practice them with appropriate footwear, paying special attention to warm-up exercises and post-exercise stretching.
- Maintain an adequate weight.
- Take breaks when standing for long periods.
Which doctor treats plantar fasciitis?
Podiatrists and orthopedic specialists diagnose plantar fasciitis. Treatment also involves physiotherapists and specialists in physical medicine and rehabilitation.
Diagnosis
The medical history and physical examination are the foundations of diagnosing plantar fasciitis. During this phase, the patient’s history and risk factors are reviewed. The foot's arch and flatness are examined, and any movement limitations are checked.
To confirm the diagnosis, imaging tests, such as X-rays, ultrasound, or MRI, are conducted to observe inflammation in the sole of the foot.
Treatment
The treatments for plantar fasciitis vary depending on the individual patient’s characteristics. In addition to recommending rest, the following approaches are commonly used:
- Medications: Pain relievers to alleviate pain and anti-inflammatory drugs to reduce swelling.
- Proper footwear: Shoes with cushioning and adequate arch support.
- Orthotic insoles: After assessing the foot and gait, personalized insoles are made to distribute pressure evenly across the foot’s sole.
- Night splints: These help keep the Achilles tendon and fascia stretched.
- Physiotherapy: Includes stretching exercises, taping to support the foot during critical moments, and massages to relieve tension.
- Shock wave therapy: Helps reduce pain, decrease inflammation, and promote the formation of new blood vessels (angiogenesis), aiding in faster recovery.
- Surgical intervention: A last resort when other treatments have not worked as expected. The procedure involves cutting a portion of the tendon. More advanced treatments, such as radiofrequency with the Topaz probe, avoid cutting the tendon and "reset" the healing process.
