Plantar fasciitis is an inflammation of a thick, fibrous ligament in the arch of the foot called the plantar fascia. The plantar fascia attaches into the heel bone and fans out toward the ball of the foot, attaching into the base of the toes. If this ligament is stretched excessively it will become inflamed and begin to cause pain. In severe instances the ligament can rupture resulting in immediate severe pain. If the ligament ruptures the pain is so great that the patient can not place weight on the foot. Should this happen, the foot should be elevated and an ice pack applied. An appointment with your foot doctor should be made at your earliest convenience. Sports such as tennis, racket ball, and aerobics can cause extreme tension on the plantar fascia resulting in small tears or rupture of the ligament. However, other less stressful activities can result in tears or rupture of the plantar fascia under the right set of circumstances. (For a more through discussion of the cause of plantar fasciitis see heel pain) One consequence of small tears in the plantar fascia is the formation of firm nodules within the plantar fascia, called fibromas.
Taking a through history of the course of the condition and physical exam makes the diagnosis of plantar fasciitis.
Treatment of plantar fasciitis is similar to that for heel pain. Cortisone injections, used in the treatment of heel pain, are not commonly used for the treatment of plantar fasciitis. The main emphasis of treatment is to reduce the forces that are causing the plantar fascia to stretch excessively. This includes calf muscle stretching, over the counter arch supports, and orthotics. Oral anti-inflammatory medications may be useful in controlling the pain.
San Marcos Foot and Ankle Clinic is excited to also offer a new treatment, Extracorporeal Shock Wave Therapy, for chronic plantar fasciitis "heel pain". Extracorporeal" means "outside the body". Shock waves are created by very strong acoustic (sound) energy. Your ESW treatment will be performed with a device called Dornier. The Dornier is a shock wave generator very similar to the shock wave devices used to treat kidney stones without surgery. The shock waves are created by a spark plus that is enclosed in a soft plastic dome filled with water. During ESW treatment, this dome is placed close against the heel so that the shock waves pass through the dome to the heel. ESW treatment has recently been found to be effective for treating chronic proximal plantar fasciitis.
Heel Pain - Treatment
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