Plantar fasciitis: basic principles of treatment

Symptoms and causes of Plantar Fasciitis

The most common symptom of this pathology is pain in the heel. The pain can have varying degrees of severity. Usually, it is worse upon first rising to get out of bed in the morning, standing up after any long period of sitting, or after increased levels of activity (especially in non-supportive shoes). During the day, the feeling of pain varies in the heel: It can weaken, increase, become more severe with increased physical exertion, and disappear in a state of complete relaxation. The pain is a result of the inflammatory process from grueling physical activity, and therefore contributes to the trauma of the fascial apparatus of the sole. As a rule, inflammation is aseptic in nature (i.e., it does not involve a bacterial agent). 

It can be observed in the deposits of calcium salts in the microtraumatic fascia area with a long-term disease (the formation of osteophytes, or so-called "heel spurs").

The emergence of plantar fasciitis is caused by both existing diseases and certain predisposing factors, which create all of the necessary conditions for the rapid development and progression of the disease. Common causes of plantar fasciitis include:

Plantar Fasciitis Treatment

Plantar Fasciitis treatment must be comprehensive. Elimination of symptoms or restriction of physical activities won't yield the desired effects. It is important to understand that self-medication is unacceptable in such cases, since the process can drag out and become chronic.

Treatment should be started with the elimination of the causes (or limitation of the factors) that led to the damage to the fascia. A patient is supposed to remain completely off of his heel, and to minimize pressure on it. People involved in sports should stop training for at least two to three weeks.

A patient who has sharp pain is prescribed analgesics  — non-steroidal anti-inflammatory medicines in the form of ointments, gels, medical creams, and/or tablets or injections for systemic effects. If the pain is simply too intense and doesn't reduce with usual pain medications, then glucocorticosteroids are recommended.

It is desirable to choose comfortable footwear that could alleviate pressure on the foot. Special orthopedic insoles manufactured individually for a patient  — called "orthoses"  — are also an excellent option.

Physical therapy, which is often recommended after the pain is relieved, must not be abandoned. A special set of exercises for the feet helps the patient to restore their functions more quickly.
Plantar Fasciitis Treatment may also include surgical intervention. The reason for surgery is the presence of osteophytes, which can compress the nerves and vessels in the heel.

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