Do you have foot and heel pain?

Case: A 45 year old female complaining of right heel pain came into Scottsdale Sports Medicine last week. The pain began several months ago, and was primarily located on her right heel and radiated throughout the bottom of her foot. She described the pain as sharp, present within the first few steps she took in the morning, with exercise and worsened if she was on her feet for longer periods. The only relief she noticed was with rest but the discomfort quickly returned once she was back on her feet.

Plantar fasciitis is known as the most common type of foot/heel pain. This condition is when a thickening of the band of tissue known as the plantar fascia occurs, which is under the heel, resulting in significant pain.

Diagnosis of plantar fasciitis is made through physical assessment and analysis of the symptoms experienced. Imaging such as x-rays/MRI and even Musculoskeletal Ultrasound (done at SSMI) might be used.   Though many people blame plantar fasciitis for their foot pain, it is essential to get a medical diagnosis in order to rule out other causes such as arthritis or an acute injury and other diagnoses such as nerve entrapment, stress fracture may present similarly.

The people most at risk for developing plantar fasciitis include:

  • Middle aged or older
  • Participate in activities that put a lot of stress on your feet
  • Flat footed or not wearing supportive shoes
  • Overweight
  • Athletes

All stem from a biomechanical error in the kinetic chain. Meaning, evaluation of the patient from head to toe to find some mal-alignment or muscle imbalance which essentially provokes the plantar fascia and thus the flexor side of the extremity including the achilles, calf and hamstring all the way up the erector spinae (long back muscle), etc.  

Treatment for plantar fasciitis can range depending on the severity. Early conservative treatment methods include: ice to reduce inflammation, rest and massage, targeted stretching of the plantar fascia, wearing appropriate footwear that supports the arch and ankle, physical therapy to address the biomechanical error and make corrections, and anti-inflammatories. Another treatment that can be considered with noted remarkable success is platelet-rich plasma injections. This is the treatment option that the patient chose and has had in the past for shoulder pain. You can read more about this type of treatment here (http://www.scottsdalesportsmedicine.com/content/platelet-rich-plasma-prp...).

 

Disclaimer:  Articles are based on real cases seen at Scottsdale Sports Medicine. The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. Please consult your medical professional for individualized healthcare.

 

References:

Goff J., & Crawford, R. (2011). Diagnosis and treatment of plantar fasciitis. American Family Physician 84(6): 676–82

Gupta, S. V., & Bandari, D. (2016). Autologous platelet-rich plasma injection in tennis elbow and plantar fasciitis. Current Orthopaedic Practice, 27(4), 405-408.

Mendes, A. (2016). An overview of plantar fasciitis. British Journal Of Community Nursing, 21(3), 160. doi:10.12968/bjcn.2016.21.3.160