Plantar fasciitis is a disease of the overstressed ligament lining the inside of the foot fossa. It connects the metatarsal and heel bones, allows for the formation of the necessary arch of the foot, and enhances stability when walking. The popular name for the disease is heel spur.
In the International Classification of Diseases (ICD-10), pathology is included in the class of diseases of the musculoskeletal system and connective tissue, in the group “Other soft tissue diseases” with fibroblastic disorders. Has code M 72.2.
Initial changes in the fascia are associated with inflammation. It is localized closer to the heel bone. Plantar fasciitis occurs as a result of the loss of the ability of the fascia to independently cope with micro-tears due to tension and mechanical injuries to the foot.
Over time, degenerative changes begin in this area. The fascia loses elasticity, does not respond to stretching, and becomes denser. Calcium salts are deposited in the tissue. This creates an additional bony protrusion. This is a “heel spur”.
The fascia also pulls on the Achilles tendon, so the lower leg muscles suffer.
The pain is caused not by the “spur”, but by aseptic inflammation of the most powerful ligament in the body. Changes in the bone base are a consequence. It is necessary to treat initial manifestations without waiting for complications.
Plantar fasciitis develops from severe and prolonged overload of the ligament. Therefore, they suffer from symptoms of the disease in middle and old age. The disease is very often observed in people in the ballet profession, track and field athletes, and weightlifters.
The main reasons contributing to changes in the fascia are:
The symptoms of the disease are so typical that the diagnosis can be made independently. Plantar fasciitis manifests itself:
Sometimes patients experience foot cramps when trying to stand up or at night.
Diagnosis is based on an examination by a doctor, who identifies painful spots under the heel and swelling.
The x-ray shows growths along the edges of the heel bone.
Patients are not sure which doctor to contact if they have these symptoms. In territorial clinics, this pathology is dealt with by orthopedic traumatologists. If there is no such specialist, then make an appointment with a surgeon.
Palpation of the foot gives an idea of the density and degree of tension of the fascia
Treatment of plantar fasciitis must be combined with getting rid of the factors that led to the disease:
There are orthopedic shoes worn at night (splints). It allows you to relax the ligaments of the foot as much as possible.
To stretch a dense, thickened ligament, massage the arch of the foot, which can be done independently several times a day. To do this, you need to clench your hand into a tight fist and use your knuckles to massage the arch of your foot with very strong circular movements, then alternately straighten and pull your toes towards you.
The exercises involve stress on the extensor muscles. They should be done for 10 minutes 2-3 times a day.
Tension promotes gradual lengthening of the fascia
Physiotherapy helps relieve inflammation from the fascia and normalize metabolic processes. Apply courses:
In the treatment of plantar fasciitis, it is necessary to use painkillers and anti-inflammatory drugs in the form of tablets and ointments.
Ibuprofen and Naproxen have similar properties. Hormonal medications are used as prescribed by a doctor.
At home, you can rub your foot with ointments containing herbal and natural ingredients, and make compresses at night.
The surgical method is rarely used, only if a complete rupture of the ligament threatens.
Therapy with folk remedies complements massage and physiotherapy and is based on proven natural substances. Healers recommend topical use of ointments and compresses after a 15-minute foot bath with sea salt. It relaxes the muscles and enhances the penetration of ointment components through the skin.
You can add a few drops of iodine to the water.
For medicinal purposes, it is recommended to use baths made from a decoction of the peels of unripe walnuts.
The cinquefoil herb for the compress must first be prepared. To do this, grind the root, pour 2 full tablespoons? glasses of hot water and leave to infuse for 2 hours. After this, the steamed roots are ground into a soft mass and applied to the heel area. The compress is fixed with a bandage, surrounded with cellophane and a thick sock is put on. It is best to carry out treatment at night.
The following are recommended as the active ingredients of folk remedies: grated horseradish, crushed garlic, hot mashed potatoes.
Red elderberry tincture for rubbing is prepared from ripe or dried berries. They are filled with vodka and pre-infused in a dark place for 2 weeks. You can rub painful areas several times a day.
The same tincture can be prepared from the pulp of the sunflower head.
It is necessary to remember the possibility of an allergic reaction to medications and plant combinations. If itching or skin rashes occur, stop using the product and consult a doctor.
Various sources promise improvement after 6–9 months of treatment. Don't despair! Be patient and the expected result will definitely come.
Author: admin · Published 05/14/2017 · Updated 01/06/2018
Understanding the etiology of the problem and directing treatment accordingly is the key to successfully treating plantar fasciitis. Careful attention must be paid during the examination and physical examination to ensure that other possible causes of heel pain are not missed. A step-by-step, evidence-based approach to treatment will help achieve good results. In this article we will look at how to treat plantar fasciitis.
If your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis, an overuse injury that affects the bottom of your foot. A diagnosis of plantar fasciitis means that you have inflammation of the tough, fibrous bands of tissue (fascia) that connect your heel bone to the base of your toes.
You are more likely to develop this condition if you are female, overweight, or have a job that requires you to walk a lot or stand on hard surfaces. You're also at risk if you walk or run if you have tight calf muscles, which limit how far you can bend your ankles. People with very flat feet or very high arches are also more prone to plantar fasciitis.
The condition usually begins gradually with mild tenderness in the heel bone, often called stone bruise. You're more likely to feel it after (not during) your workout. The pain classically occurs immediately upon rising in the morning and after a period of sitting. If you don't treat plantar fasciitis, it can become a chronic condition. You may not be able to maintain your activity level, and you may develop symptoms of foot, knee, hip, and back problems because plantar fasciitis can change your walking conditions. Causes of severe foot pain.
Stretching is the best treatment for plantar fasciitis. It may help to try to keep weight on your leg until the initial inflammation goes away. You can also apply ice to the sore area for 20 minutes four times a day to help relieve your symptoms. Often, your doctor will prescribe non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen. Home exercises to stretch the Achilles tendon and plantar fascia are the mainstay of treatment and reduce the likelihood of recurrence.
In one exercise, you lean forward against a wall with one knee and heel on the ground. Your other knee is bent. Your heel ligament and arch of your foot are stretched when you bend over. Hold for 10 seconds, then relax and straighten up. Repeat 20 times for each painful heel. It is important that the knee is fully extended on the stretched side.
In another exercise, you lean forward onto a tabletop with your legs spread, one leg in front of the other. Bend your knees and squat down, keeping your heels on the ground as much as possible. Your heel ligaments and leg arches will be stretched. Hold for 10 seconds, relax and straighten up. Repeat 20 times.
About 90% of people with plantar fasciitis experience significant improvement after two months of initial treatment. You may be advised to use shoes with shock-absorbing soles or to have a ready-made device inserted into your shoes, like a rubber heel pad. Your leg can be glued in a certain position.
If your plantar fasciitis continues after several months of conservative treatment, your doctor may inject your heel with a nonsteroidal anti-inflammatory medication. Causes of foot pain when walking.
If you still have symptoms, you may need to wear a cast for two to three weeks or a positional splint while you sleep. In some cases, surgery is necessary for tissues with chronic tightness.
1. Take non-steroidal anti-inflammatory drugs. Pain relievers such as ibuprofen, naproxen, and aspirin can help reduce inflammation and provide some relief to your foot. Choose tablet or cream form. If you decide to take the pill, be sure to eat something beforehand. When using the cream, simply spread it on the affected area and let it soak.
2. Visit a physical therapist. Before moving forward with surgery to relieve the symptoms of your plantar fasciitis, consult with a physical therapist to determine if your condition can be treated with a stretching and rehabilitation program. An appointment with a physical therapist should be scheduled after exhausting all non-drug treatments listed above and before resorting to invasive medical procedures such as surgery.
3. Corticosteroid injections. Corticosteroid injections can relieve the symptoms of plantar fasciitis by temporarily reducing pain. However, these injections are not a long-term solution to the problem. Keep in mind that although they are much less invasive than surgery, the shots can still be painful. Excessive needling can also cause heel damage.
4. Take a course of shock wave therapy. This procedure sends sound waves into the painful area to relax the muscles in your leg. Shockwave therapy is usually prescribed for people who have not seen any results from home treatments for more than six to twelve months. Side effects include bruising, swelling, pain and numbness.
5. How to treat plantar fasciitis with surgery. Surgery to release the plantar fascia. If none of the above methods have helped relieve your symptoms within a year, plantar fascia release treatment may be needed to cure your symptoms. This surgical process ultimately releases tension and inflammation in the plantar fascial ligament by cutting off part of the ligament itself.
There are several risks associated with plantar fascia release surgery. These include: nerve breakdown or tunnel syndrome, development of neuroma, persistent heel pain and swelling, infection, long recovery time, and delayed ability to heal.
Perform at least three repetitions of stretches per day. But don't stretch too often. The most important times to stretch are before you take your first step in the morning and after a period of prolonged sitting.
Additional stretch, Achilles tendon stretch:
Plantar, or, as doctors say, plantar fasciitis, is one of the most common causes of foot pain in adults. How to cope with this disease?
Our expert is an orthopedic doctor, researcher at the Endocrinological Research Center of the Ministry of Health of the Russian Federation Sergei Gorokhov .
The main symptom of plantar fasciitis is pain in the heel area. It is felt most strongly after waking up: getting out of bed, a person can hardly step on his foot. Doctors call this phenomenon morning pain of the first step. If you overcome it and, despite the discomfort, start walking, it will decrease or even disappear. However, the pain may recur periodically throughout the day, for example when a person stands up after sitting for a while.
The cause of pain is inflammation of the plantar fascia. This is the name given to the layer of tough fibrous tissue that runs along the bottom surface of the foot. In fact, it is a ligament, and one of the longest and strongest in our body. It, like a cable, connects the heel bone to the metatarsal bones and at the same time supports the longitudinal arch of the foot.
There are several factors that can lead to plantar fasciitis. The most important is the development of flat feet. When the arch of the foot flattens, the plantar fascia becomes overstretched and develops microtears. The damage is especially pronounced in the place where the fascia attaches to the heel bone, so inflammation occurs here.
Another risk factor is whether a person is overweight, which increases the load on the plantar fascia. Fasciitis can also be triggered by a change in habitual physical activity, such as too intense exercise or heavy work.
If nothing is done, heel pain can last on average from 6 to 18 months. Then it may retreat, but soon returns again. Therefore, plantar fasciitis necessarily requires treatment - it is necessary to reduce inflammation and eliminate the cause of the disease. Several methods may be included in therapy at the discretion of the physician.
Stretching. This is gymnastics to stretch the muscles of the foot. The calf muscles also need to be worked out, because tension in them aggravates the course of plantar fasciitis. This is an effective way to reduce heel pain, but only if you exercise regularly.
Taking medications. Nonsteroidal anti-inflammatory drugs relieve pain, but they cannot be used for a long time due to a large number of side effects.
Wearing individual orthopedic insoles (orthoses). They are made from an impression specifically for each patient. It is important that the insoles are full-contact, that is, they adhere to the foot over its entire area. Only in this case will they restore the normal height of the longitudinal arch of the foot, due to which the tension of the plantar fascia will decrease, which means the pain will go away. Its severity decreases already in the first weeks of constant wearing of insoles. Today this method is considered the most reliable and gives a long-term effect.
Night tires. These are special orthopedic devices similar to a plastic boot. It should be worn at night to prevent stretching of the plantar fascia. Splints can reduce the pain of taking that first morning step. But they are quite bulky and not very convenient to use.
Shock wave therapy (SWT). Nowadays it is a fashionable technique that is used for various diseases. Plantar fasciitis is no exception. However, studies have shown that shockwave therapy does not always completely relieve pain and this effect does not last long. In addition, the procedure itself is painful, and the cost of the course of treatment is quite high.
Injections of corticosteroids into the site of inflammation. The drugs reduce pain, but have many side effects. In addition, with such an injection there is a risk of fascia rupture, especially in overweight people. Therefore, the technique is used only if other methods have not helped.
Operation. This is also an extreme measure, which is resorted to if conservative treatment has been carried out for six months, and the pain has not decreased. Part of the plantar fascia is excised and its tension is reduced. This reduces pain, but can lead to accelerated development of flat feet, which means new problems. If possible, it is better not to go through with surgery. Do not neglect the recommendations for gymnastics and wearing special insoles - this does not require much effort.
In this article we will talk about the treatment of plantar (plantar) fasciitis of the heel at home, about all the methods and features of this process.
Plantar fasciitis is a foot disease that occurs as a result of inflammation of the plantar fascia, which envelops the muscles of the arch of the foot. The result of the body's protective-adaptive reaction is injury to fibrous tissue due to stretching, heavy and regular load.
The role of the fascia is to maintain the foot in the correct position, and as soon as it begins to hurt, a person cannot move normally or engage in physical activity. If the problem is just beginning, then you can figure out how to treat plantar fasciitis at home. In case of increased and already intolerable pain, they resort to drug therapy. Let's look at these issues in more detail.
The main reason is the heavy load on the foot, so dancers, gymnasts and other athletes are often susceptible to this disease.
Flat feet are another cause of pain. It can be congenital, due to an insufficient amount of connective tissue during the formation of the foot, or acquired, as a result of wearing low-quality shoes.
Arthritis, arthrosis and vascular disease in the legs also affect the normal nutrition of fibrous tissue, limiting the flow of essential microelements for metabolism.
People who are overweight need to think about losing it. Only by eliminating the original cause of fasciitis can you get rid of it forever.
Symptoms of heel spurs are important signs that help in determining the overall picture of the disease and in the fight against it.
Heel fasciitis, or otherwise plantar, plantar fasciitis in an advanced stage can only be treated with medication. This includes therapy with non-steroidal anti-inflammatory drugs in tablets and ointments: Motrin, Indomethacin, Aleve, Diclofenac and its analogues, Advil. They contain the active ingredients ibuprofen and aspirin. The course of treatment is long but effective.
Injection procedures with the introduction of corticosteroids are also practiced: hydrocortisone or betamethasone. Such hormonal medications with a powerful anti-inflammatory effect can damage the fascia and result in acquired flat feet and chronic pain.
Treatment of plantar fasciitis is possible with homeopathic remedies when there are no bone spurs yet. In addition to the anti-inflammatory effect, preparations based on plant extracts improve the elasticity of the ligaments, which leads to a reduction in pain during mechanical impact on the foot.
Plantar fasciitis is effectively treated using devices that affect the diseased area only mechanically - ultrasound (phonophoresis), current (iontophoresis), laser, magnetic field; Shock wave therapy is improved with the use of corticosteroids: betamethasone, hydrocortisone and disprospan.
Physiotherapeutic methods are successfully used in complex and conservative treatment of foot diseases.
In the initial stages of the disease, you can use proven methods of traditional medicine: compresses, ointments and applications.
Plantar fasciitis, which is supposed to be treated at home, responds well to the correct application of compresses:
So, what folk remedies are used for compresses:
The given recipes are medicinal components of compressors, which must be applied according to the following rules:
Treatment of fasciitis at home is practiced by taking a variety of baths:
Plantar fasciitis, which can be treated at home (photo below), can be treated with application overlays. This procedure helps to use all the forces of nature from natural ingredients, nourishing the tissue with microelements important for it.
An effective application is considered to be a mixture of mountain wax and paraffin. They are heated to 40 °C, mixed, applied to the sore spot, wrapped in a warm cloth and put a plastic bag on the leg. Leave the application for half an hour.
Unfortunately, it is not possible to cure complex shaped plantar fasciitis with overlays, but using them in complex therapy will be useful.
Plantar fasciitis: treatment at home and in the hospital, may undergo additional procedures that are aimed at restoring fibrous tissue. These include:
Fasciitis of the sole, which can be treated at home, cannot be allowed to develop into a severe form, otherwise all methods will be powerless, which will lead to surgical intervention.
The plantar fascia not only performs a shock-absorbing function, but also reliably holds your foot in the correct position. When it becomes inflamed or injured, a sharp pain occurs that does not allow you to step freely on your heel.
You could be patient and forget, but the pain occurs again and again, appearing both after walking and after wearing your favorite stylish shoes. Yes, and it interferes with playing sports. It becomes obvious that the problem needs to be fixed.
Plantar fasciitis can be treated at home and responds well to it. True, if you carry out the procedures systematically.
Unless you are lazy, you don’t know how to treat inflammation with fasciitis. After all, a heel spur, which is what people call the disease, is a fairly common phenomenon. According to statistics, fasciitis occurs in one out of 10 residents. Pathology also has its favorite categories:
Therefore, you will hear enough advice, don’t doubt it. Whether they will be effective is the question. Be very careful with your choice, other methods are unsafe.
Both are appropriate. The doctor will examine you, confirm the diagnosis, and, if necessary, prescribe medications and physical treatments. But the recovery process can be significantly accelerated if you supplement the doctor’s prescriptions with treatment for plantar fasciitis at home.
By the way, experienced doctors themselves can give you some advice on this topic. The existing opinion that a doctor cannot cure a spur is wrong. The optimal solution in this situation is a competent combination of official and traditional medicine.
Let's look at how to treat plantar fasciitis with folk remedies based on medicinal herbs. You can resist - so your heel hurts, and then go on a hike to get grass! We hasten to reassure you: all the necessary herbs can be purchased at the pharmacy , fortunately they are not in short supply now. So, you can use:
All these herbs are used separately to prepare alcohol rubbing. It’s simple to prepare, but it can’t be done quickly – the infusion must sit for a week in order to gain a healing effect.
IMPORTANT! You should not use vodka with melon, cranberry or juniper flavors for infusions. Buy a clean, quality product. We do not recommend using moonshine. The medicinal effect of the herb is neutralized by contact with fusel oil.
Use the product every night, before bed. Rub the alcohol infusion on your heel, put on a warm sock and go to bed. A bandage soaked in infusion can serve as the basis for a compress.
Treatment of heel fasciitis with folk remedies can be carried out by applying compresses. This should be done at night, and done correctly.
Apply to dry, intact skin, without rashes, calluses, etc. Each compress layer should be wider than the previous one. When fixing the compress on the heel, do not bandage the ankle too tightly.
Now about what can be used for the first layer of compress, the medicinal component:
You can apply a compress to the heel at night. The number of procedures is determined individually - until the pain completely disappears. However, in case of ineffectiveness, more than 14 procedures without a break should not be done.
There are many recipes on how to treat plantar fasciitis with folk remedies based on homemade ointments. Here are simple and complex options:
The most simple homemade ointment is crushed unsalted lard . The bandage with the crushed mass is fixed on the heel, and a sock is put on top. Sebaceous ointment perfectly relieves pain.
An alternative to this remedy is a solid thin piece of unsalted lard, these can be purchased at the market from meat sellers.
We recommend preparing a very effective homemade ointment that will relieve you of pain in 5-7 procedures .
Use for rubbing a sore heel, do not use for compresses.
ATTENTION! This recipe is not suitable for smokers! Danger of developing an extensive allergic reaction!
A simple method for treating plantar fasciitis at home: regularly rub your heel with a regular felt boot . This rubbing helps to increase blood circulation in the sore area and relieve pain.
In conclusion, we would like to warn you against some recipes that are widely advertised on the Internet. They do not have any therapeutic effect, but they will add problems.
Therefore, when choosing a remedy to treat plantar fasciitis at home, remember to exercise reasonable caution. Better yet, discuss your chosen prescription with your doctor.
Plantar fasciitis is a common cause of heel pain. The disease manifests itself as pain and inflammation in the area of the plantar fascia, which connects the toes to the heel bone. The disease is dangerous because, in the absence of adequate treatment, a bone growth can form in the heel area, which is commonly called a heel spur. This pathology is very serious, in some cases it has to be treated surgically. Another common complication of plantar fasciitis of the foot is Achilles tendonitis.
With a heavy load on the foot, microtraumas can form in the fascia. Most often, they heal on their own if a person alternates exercise and rest evenly. However, frequent micro-tears and stretching of the fascia lead to its inflammation. The main risk factors that can lead to a disease such as plantar fasciitis are:
Plantar fasciitis has such severe symptoms that in most cases only if they are present can the disease be diagnosed. The most common manifestation of the disease is pain in the heel area. They usually appear while walking after sitting for a long time. In addition, the pain is quite noticeable in the morning, when the patient gets to his feet after sleep.
When walking for a long time throughout the day, after standing for a long time and climbing stairs, the pain intensifies significantly, and in the evening it is quite disturbing. When a heel spur occurs, the pain becomes so sharp that it can be compared to the sensations that a person feels when sharply pricked with sharp objects. Often with plantar fasciitis, hyperthermia and edema may occur.
In this case, especially if the disease affects both legs at once, it is necessary to do an examination to identify a concomitant cause (for example, rheumatoid arthritis or gout). Other characteristic symptoms that accompany plantar fasciitis are tingling in the legs while walking, back pain, and in some cases, swelling that occurs as a result of fluid accumulation in the ankle joint and heel area.
Plantar fasciitis, except in particularly difficult cases, is treated conservatively. Complex therapy is used, the main task of which is to eliminate the increased load on the feet. It is very important to replace tight and uncomfortable shoes with comfortable ones. If heel pain occurs, it is necessary to limit walking and give your feet a rest. If you have flat feet or pronation of the foot, you should purchase orthopedic insoles and special heel pads with indentations in the center.
Also, when treating fasciitis of the sole, it is advisable to wear orthopedic shoes that firmly fix the heel and prevent the sole from falling inward. You can purchase orthoses that are shaped like a boot. They are worn before bed because they hold the foot well at a special angle that stretches the plantar fascia, which helps it heal during the night. The formation of bands and shortening of the fascia is eliminated with the help of massage procedures and special exercises.
Also, when treating plantar fasciitis, it is very important to normalize weight, inflammation, eliminate diseases of the spine and joints, as well as all kinds of disorders in the circulatory system. Treatment of plantar fasciitis is successful using physiotherapy, which consists of warming procedures, laser therapy, and the use of ultrasound. In cases of severe inflammation and significant pain, fasciitis is treated with anti-inflammatory drugs that contain corticosteroids, for example, Diprospan or Flosteron.
For local treatment, the attending physician may recommend the use of “Golden Us” or “Dolobene” ointment or “Fasciitis stop” cream. In particularly severe cases that cannot be cured using conservative methods, surgical intervention is used, which consists of removing the bone growth and irreparably modified tissues.
There are a huge number of folk remedies and methods that eliminate symptoms and treat this foot pathology quite effectively. However, before using any of them, you should definitely consult with your doctor, who will tell you which one can be used in a particular case.
Plantar fasciitis is treated using concentrated salt baths. To prepare them, you need to dilute salt (2 full tablespoons) in hot water (1 l). The procedure time is 30-40 minutes. After finishing it, you need to wipe your feet dry and put on woolen socks.
A good way to treat fasciitis is to use birch buds. An alcohol tincture is prepared from them, which, in addition to the birch buds themselves (50 g), contains medical alcohol (100 g). The product must be infused for at least 3 hours. It is used to make compresses: a bandage soaked in it is applied to the sore heel twice a day (2 hours in the afternoon and evening).
You can try to cure the disease with a bath containing equal amounts of vinegar (9%), vodka and turpentine. All ingredients must be mixed and heated in a water bath. The sore heel should be kept in a container with this solution until it cools completely. Then you need to heat it up again and do the procedure again.
Potatoes will help get rid of the signs of plantar fasciitis. It needs to be cut into small slices and applied to the sore heels, securely secured with a bandage and wearing a woolen sock on top. This compress is usually done at night. If, after removing the bandage in the morning, it is discovered that the plates have turned black, this means that the potato is fighting the disease. Gradually, the pain will begin to subside, and the potato slices will begin to lighten. When treating plantar fasciitis with traditional methods, it will take a lot of time and patience. However, persistence helped many overcome the disease.
In order not to fall into the risk zone of plantar fasciitis, it is very important to monitor your weight, because extra pounds are an additional load on the fascia. The choice of shoes must be approached carefully: women should not often wear shoes or boots with too high heels; when choosing a purchase, they should pay attention to shock absorption and supination. Do not get carried away with walking barefoot on a hard surface. Since heavily worn shoes can cause foot pathology, they should be disposed of without regret.
If you feel pain or burning in your legs after an active day at work, you can use a cold compress to relieve such sensations. A bag filled with ice should be applied to the sore spot for 15-20 minutes. Some massage with ice, using a paper cup previously frozen with water. Massage movements are performed in the area where discomfort is felt for 3-5 minutes. Doing them regularly will help reduce inflammation and significantly reduce pain. To strengthen the calf muscles, Achilles tendon, and stretch the fascia, it is recommended to perform a set of special exercises.
Every year, hundreds of thousands of patients complain of pain in the heel area, wanting to get rid of discomfort and pain when walking. They are most often diagnosed with plantar fasciitis, which means inflammation of the plantar fascia. Sometimes this pathology is called a heel spur, which is not entirely true. The spur begins to form precisely against the background of inflammation of the plantar aponeurosis due to the saturation of the affected area with calcium salts. This is how a bone growth, an osteophyte, forms on the heel bone.
The plantar, or plantar, fascia is a connective tissue formation that is located between the bases of the last two metatarsals and the calcaneal tubercle. The main function of the fascia is to support the arch of the foot and protect the bone structures from mechanical damage.
When a person is in an upright position, the load on the plantar fascia is enormous, with the heel area experiencing the greatest stress. Increased pressure during walking, running and jumping, which can lead to microtears and trauma to the fascia, should be taken into account.
Normally, the consequences of mechanical impact go away on their own, but under the influence of a number of negative factors, an inflammatory process of an aseptic (non-infectious) nature can begin.
Most cases of heel fasciitis are treated conservatively, with only 5% of patients requiring surgery.
Heel fasciitis is a secondary disease that develops against the background of systemic pathologies, namely:
With overpronation, the inward tilt of the foot is more than 15°, which can, under certain conditions, provoke inflammation of the plantar fascia
The risk of developing fasciitis is increased by factors such as excess weight, pregnancy, and past infectious diseases (gonorrhea, chlamydia, etc.). The disease is more susceptible to women, in whom plantar fasciitis is diagnosed in 80% of cases.
Professional activities associated with constant stress on the feet, wearing tight and uncomfortable shoes, age and hereditary factors can also have a significant negative impact on the plantar aponeurosis.
As a result of regular overstrain, the fascia gradually becomes thinner and stretches. Since connective tissue is quite strong, it is able to perform its functions for a long time. However, once a certain limit is reached, the fascia cannot withstand it, and microcracks appear. The immune system, for its part, tries to extinguish the pathological focus, producing a large amount of biologically active substances and filling the damaged area with them.
Despite the absence of pathogenic organisms, the inflammatory process begins: vascular permeability increases and plasma outflow occurs. Swelling appears, which promotes even greater stretching of the fascia, irritation of nerve endings (pain receptors), and severe pain occurs.
The first and main symptom of fasciitis in the legs is pain, especially severe in the morning and after prolonged physical activity. It would seem that after rest it should be easier, but for some reason it is in the morning hours that a person feels the most severe pain. This is explained by the activation of the productive phase of inflammation, during which cells intensively secrete substances to heal microcracks and restore integrity. Since the regeneration process does not have time to complete, when standing on your feet, the fascia tissues are torn again.
If the treatment of plantar fasciitis is delayed, then degenerative changes occur in the structure of the plantar fascia - the gait changes, the person may limp or clubfoot, and when a bone spine forms, the pain syndrome increases.
Depending on the location of the inflammation, there are several types of foot fasciitis:
Nodular fasciitis, or plantar fibromatosis, is rare and is characterized by scarring of the fascial tissue. This is manifested by the formation of dense nodules at the bottom of the foot and flexion contracture of the toes. This type of fasciitis develops by analogy with Dupuytren's disease, which affects the hands.
Separately, there is a necrotizing form of fasciitis, the causative agent of which is the pathogenic bacteria Clostridium and hemolytic streptococcus. These microorganisms enter the human body through open wounds and cuts. The course of necrotizing fasciitis is characterized by rapidity and a pronounced clinical picture with the following symptoms:
The necrotizing form of fasciitis occurs extremely rarely, but requires prompt medical intervention. In the absence of help, every third victim dies.
To make a diagnosis, the doctor uses functional tests and refers for instrumental studies. To assess the condition of the musculoskeletal system, reflexes, muscle strength and tone, sensitivity of the surface of the soles, coordination of movements and the person’s ability to maintain balance are tested.
To confirm the preliminary diagnosis, radiography is performed; in some cases, magnetic resonance or computed tomography may be required.
With timely access to a medical facility, most patients can be helped with medications and physiotherapeutic methods. Orthopedic products are used to fix the foot in an anatomically correct position.
The drugs of choice for the treatment of plantar fasciitis of the foot are glucocorticosteroids. These medications can “extinguish” foci of inflammation, relieve swelling and dull pain. In addition, drugs based on corticosteroids enhance the effect of other medicinal substances that the patient takes.
To relieve pain, hydrocortisone is administered to the patient directly into the lesion.
The anti-inflammatory effect of GCS is due to several factors, the main one of which is the ability to suppress the activity of phospholipase A2. Once in the body, steroid hormones improve microcirculation at the site of inflammation, cause a narrowing of the lumen of the capillaries and reduce fluid exudation. Thus, the spread of inflammation slows down and the pain goes away.
Additionally, topical agents can be prescribed - non-steroidal anti-inflammatory ointments and gels. These include Ibuprofen, Indomethacin, Diclofenac, etc.
In parallel with drug treatment, physiotherapy is carried out - electro- and phonophoresis, ultrasound, UHF, shock wave therapy. The latter method is especially effective for chronic fasciitis, as it stimulates the regeneration of damaged tissue.
Indications for surgical intervention are the following:
The essence of the operation is to excise part of the plantar aponeurosis to relieve inflammation and reduce tissue tension. Both open and endoscopic methods are used using local anesthesia
An incision is made in the plantar area just above the fat pad of the heel at the junction of the thick skin of the sole and the thin skin of the back of the heel. Sometimes the incision is made directly along the sole, at the bottom of the foot.
If an operation is performed using endoscopic instruments, then a small incision is required on one side of the heel, closer to the sole. Then there are two options: separation of the plantar aponeurosis from the heel bone or its dissection. In some cases, the doctor may remove part of the damaged fascia.
After all manipulations are completed, the skin surface is leveled so that the tension on the plantar fascia is minimal during the healing period. To avoid compression of the nerve endings, dissection of the adductor muscle of the first finger is possible - the question of its necessity is decided by the operating surgeon. If there is a bone spur on the heel bone, the thumb muscle is removed.
The rehabilitation period after surgery is about a month. To speed up the healing of the aponeurosis and postoperative incision, a splint or splint is applied to the foot. The leg is immobilized for two to three weeks.
After endoscopic surgery, a person can wear light shoes (soft slippers) immediately, and when the condition improves, switch to regular ones. The load on the foot should increase gradually, and running and jumping should be allowed no earlier than after three months.
If you treat fasciitis surgically, then, like any operation, complications may arise:
In extremely rare cases, the condition may worsen and the intensity of symptoms may increase.
A combination of traditional and traditional medicine for fasciitis can give excellent results, especially if the doctor approves of the methods chosen by the patient. Treatment with folk remedies does not always mean a long preparation of a drug from hard-to-find ingredients. In this case, there are several very simple recipes that require a minimum of time and effort.
To prepare tinctures, you can also take fresh raw materials, if possible.
These are alcohol rubs. You only need 2 components - vodka and dried herbs, which can always be purchased at the pharmacy. Plantain, celandine, chickweed, burdock, elecampane or dodder are suitable. You can use nettle, preferably harvested in spring. Each plant is used separately.
The resulting tincture can be used for rubbing or as a compress; the procedure should be carried out before bedtime. After rubbing with the product, put a warm sock on your foot.
Important note: to prepare the tincture, you should not use vodka with additives or moonshine, since fusel oils neutralize the healing effect of herbs.
The maximum effect of treatment can be achieved by following simple rules - do not overload your feet, wear comfortable shoes, and perform special exercises for the feet. Orthopedic devices – insoles, heel pads, orthoses – play an important role. Your doctor will definitely tell you about these products before treating fasciitis. Remember that the best therapy is prevention, and stay healthy!