The plantar fascia is a structure under the foot that connects the heel to the metatarsophalangeal joints (MTPJs) or commonly called the ‘balls of the feet’. Plantar fasciitis refers to inflammation of the fascia that produces symptoms.
The typical location of symptoms are where the fascia inserts into the heel bone, or just in front of this. Patients often report symptoms on standing first thing in the morning or after long periods of rest, as well as after long walks.
The thickness of the fascia can be measured using imaging for a firm diagnosis and can also help spot a tear or rupture of the fascia.
TREATMENT OF PLANTAR FASCIITIS
There are a number of treatment options available, although understanding the level of damage involved, how long (chronic or acute) symptoms have been present, and having detailed patient history and medications will help with the choice of appropriate treatments.
Treatments aim to reduce pain, reduce the aggravating mechanical load, and facilitate healing. Common treatments include:
- Orthotics (insoles) – these can reduce the repetitive aggravating mechanical load on the fascia and cushion the foot. They can be custom made to fit different footwear.
- Shockwave therapy (ESWT) – mechanical waves are administered to the site that decrease inflammatory mediators and produce regenerative tissue repairing.
- Steroid injection – this can bring down inflammation at the site of injection and therefore reduce symptoms. Care needs to be taken that there is no tear or rupture in the fascia, as this can often lead to further damage of the structure.
- PRP (platelet rich plasma) injection – Your blood is taken similarly to a blood test, and then spun in a centrifuge. This separates the plasma, white blood cells and platelets with growth factors. This is then injected into the site and floods the area with your own ‘healing’ cells.
Often a combination of the above treatments are used. Your podiatrist can discuss and help guide you through a suitable treatment plan.