subject: Plantar Fasciitis Diagnosis & Treatment [print this page] The fibrous tissue surrounds muscle which separates various tissues of body and is referred to as the fascia. The bottom surface of the foot has a strip of this tough tissue which is referred to as the plantar fascia, stretching from the heel to the front of the bottom of the foot. Plantar fasciitis occurs when this ligament sustains micro tears and becomes inflamed. Plantar fasciitis is the most common cause of heel pain.
You may experience pain on the inside of the heel, the point where the plantar fascia inserts into the heel. The pull from the plantar fascia may often cause a small painful bone spur on the heel. Plantar fasciitis mostly occurs in people between 40 and 60 years of age. Plantar fasciitis can occur alone from injury or may be caused by disease. Sometimes plantar fasciitis occurs for unknown reasons. Foot Orthotics and regular stretch exercises will allow the inflammation to settle.
Diagnosis
The diagnosis of plantar fasciitis is usually made by clinical examination alone. The clinical examination may include checking the patients feet and watching the patient stand and walk. The clinical examination will take under consideration a patients medical history, physical activity, foot pain symptoms and more. The doctor may decide to use Imaging studies like radiographs, diagnostic ultrasound and MRI.
An incidental finding associated with this condition is a heel spur, a small bony calcification, on the calcareous heel bone, in which case it is the underlying condition, and not the spur itself, which produces the pain. The condition is responsible for the creation of the spur the plantar fasciitis is not caused by the spur.
Sometimes ball-of-foot pain is mistakenly assumed to be derived from plantar fasciitis. A dull pain or numbness in the metatarsal region of the foot could instead be metatarsalgia, also called causalities. Some current studies suggest that plantar fasciitis isnt actually inflamed plantar fascia, but merely an inflamed Flexor digitorum brevis muscle belly. Ultrasound evidence illustrates fluid within the FDB muscle belly, not the plantar fascia.
Treatment
Treatment options for plantar fasciitis include rest, massage therapy, stretching, night splints, motion control running shoes, physical therapy, Cold therapy, orthotics, anti-inflammatory medications, injection of corticosteroids and surgery in refractory cases.
Foot Orthotics, is the only non-surgical therapy to have been supported by studies rated by the Center for Evidence-Based Medicine as being of high quality. Landorf et al. performed a single-blind experiment in which patients were randomly assigned to receive off-the-shelf orthotics, personally customized orthotics, or sham orthotics made of soft, thin foam. Patients receiving real orthotics showed statistically significant short-term improvements in functionality compared to those receiving the sham treatment. There was no statistically significant reduction in pain, and there was no long-term effect when the patients were re-evaluated after 12 months. Off-the-shelf orthotics was found to be as effective as customized ones for acute (short term) plantar fasciitis. There is some evidence that taping may supply short-term relief, but the evidence is weaker than the evidence supporting orthotics.
Orthotics is prescribed for a variety of reasons, for example: to reduce pain, protect joints and muscles from injury during sport, provide comfort to arthritic joints, and improve balance and walking by compensating for any muscle weakness and protect damaged ligaments. Specialist made to measure footwear is prescribed for those that struggle to find good fitting footwear, the footwear design may include hidden support to improve balance and reduce pain.
Stride Orthotics provide custom designed supports to joints of the lower limb, e.g. lower leg splints, knee braces, ankle supports, specialist made to measure footwear and foot orthotics (insoles). The Orthotic supports are designed to support joints and muscles of the lower back, hip, knee, ankle, lower leg and foot.
by: Peter Petrelli
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