Plantar fasciitis is a very common problem I encounter in the out patient clinic as an orthopaedic surgeon. Plantar fascia is a structure which lies in the bottom of the foot, connecting the heel to the toes. Any swelling or inflammation of this tissue is referred to as plantar fasciitis.
Since the foot has to take the whole weight of the body while walking, an inflamed plantar fascia is bound to be painful, throwing your daily routine out of order. The first few steps in the morning are very painful, this is because the fascia contracts while you sleep at night. When you get up and take the first few steps, the fascia stretches causing excruciating pain.
What are the causes of Plantar Fasciitis?
Plantar fascia functions like a shock absorber for your body when you walk or run, supporting the arch of the foot. Excessive walking or standing , tissue tension or strain gives rise to small tears in the fascia. This occurring on a repetitive basis can lead to plantar fasciitis.
Who is prone to developing Plantar Fasciitis?
There are certain risk factors which increase the chance of experiencing this condition.
- Excessive tightness of the calf muscles, making its difficult to forward flex the ankle
- Over Weight/Obesity
- High arch foot
- Repetitive impact activity ( sports / home )
- Profession which requires prolonged standing
What are the symptoms of Plantar Fasciitis?
Pain while walking is the main symptom. This happens while getting out of bed in the morning, after prolonged sitting, prolonged walking. The pain is usually severe and stabbing in nature. Pain after and not during exercises is a classic finding.
Diagnosis and Treatment
The diagnosis is usually made clinically on examination. Rarely we need x-ray or MRI to rule out other causes. Occasionally x-rays reveal heel spurs. These are not to be blamed for the pain and are just an incidental finding.
In most cases, the condition of plantar fasciitis is treated with conventional treatments such as rest, ice packs on the affected area and also stretching.
Most patients are put on anti inflammatory medications for pain control. This helps to decrease the inflammation and keeps you mobile.
Monitored exercises for stretching and strengthening of the heel cord and fascia are taught to the patient and should be done by them every single day. Doing these exercises are very important and are non negotiable as far as treatment is concerned. The exercises are given out to the patient in the form of an handout.
Night Splints: If the pain is excessive, night splints help, as they stretch the fascia and hold it in a lengthened position overnight.
Orthotics: Custom made medial arch supports help relieve the pain while walking and should be used inside the shoes. There are special footwear available for those how dont want to use shoes.
Local Injections / Surgery
In some cases who do not respond to conservative management, local injections can be given into the inflamed region. This procedure is quick, easy and ensures dramatic pain relief. For severe recalcitrant cases surgical release of the fascia is the last option though rarely employed.
Plantar Fasciitis is a common condition which can really debilitate you. Its easily diagnosed and simple to treat, provided the treatment is followed religiously. If you are suffering from the above mentioned symptoms, please consult an orthopaedic surgeon. You can visit us or book an appointment, so that we can help take care of your pain.
About the Doctor:
Dr A.B Suhas Masilamani is one of the surgeons who has trained in USA and has come to work in India, He finished his MBBS and MS Orthopaedic training from Christian Medical College, Ludhiana. He then went on to clear his DNB Orthopaedics, pursuing fellowship training in United States later. His first fellowship was in Paediatric Orthopaedics at Montefiore Medical Centre, Albert Einstein School of Medicine, New York, USA. This was followed by a second fellowship in Adult Hip and knee joint replacement Surgery at Bronx Lebanon Hospital, Icahn School of Medicine at Mount Sinai, New York, USA.
He is one of the very few surgeons from the city to become a member of American Academy of Hip and Knee Surgeons (AAHKS). He is also a member of American Academy of Orthopaedics Surgeons (AAOS) and International Congress for Joint Replacement (ICJR).
About the Hospital:
A Multi Super Speciality Institution, 500 bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr. AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man. Sunshine has now become one of the best hospitals for many treatments including Orthopedic, Gastroenterology, Cardiology, Trauma and Neurology.