Plantar fasciitis

As Plantar fasciitis is a disease of the plantar fascia on the foot. Overweight people and runners are particularly affected by it.

What is plantar fasciitis?

Plantar fasciitis is noticeable through pain in the middle part of the calcaneus. Especially after getting up in the morning or after longer breaks, the pain becomes more pronounced.
© designua - stock.adobe.com With the plantar fascia (Plantar aponeurosis) is a tendon plate located on the lower side of the foot. It extends from the heel to the ball of the foot. The function of the plantar fascia is to ensure the longitudinal arch of the foot. At the same time, it counteracts the lowering of the arch of the foot.

If it comes to a disease of the plantar fascia, doctors speak of one Plantar fasciitis. Pain occurs on the sole of the foot and at the transition to the heel. Plantar fasciitis is the most common cause of pain in the heel area. Around 10 percent of all people are affected by this foot condition once in their life. The disease is more common in women than in men. The frequency of plantar fasciitis also depends on the body mass index and the age of the person affected. In addition, about 70 percent of all patients suffer from obesity.

causes

Plantar fasciitis is usually an inflammation. However, overloading the plantar fascia can also be responsible for the disease. The inflammation of the plantar aponeurosis is caused by the permanent irritation of the tendon plate. Misalignments of the foot, weak foot muscles or muscular imbalances have a positive effect on the development of plantar fasciitis.

Plantar fasciitis often occurs in runners who suffer from flat feet. Flatfoot causes constant overstretching of the plantar aponeurosis. This leads to overstimulation and, in the further course, to inflammation of the plantar fascia. Something similar happens with runners with a hollow foot. Without a longer break, there is a risk of chronic pain.

People with different leg lengths or overweight people are also frequently affected by plantar fascia. It is not uncommon for the foot disease to occur in people who have to stand for long periods of time.

Symptoms, ailments & signs

Plantar fasciitis is noticeable through pain in the middle part of the calcaneus. Especially after getting up in the morning or after longer breaks, the pain becomes more pronounced. Plantar flexion occurs in the foot during a rest period. The plantar fascia is shortened a little. If the patient rolls his foot while walking, the plantar aponeurosis expands again. This process in turn causes pain.

Usually the pain subsides a short time later. However, if the foot is put under pressure for a long time, it can increase again. Plantar fasciitis is unilateral in 70 percent of all patients. In the remaining 30 percent, however, it occurs on both sides. Around 80 percent of all those affected also have tension in the Achilles tendon. In addition, most patients have difficulty bending their foot.

If the plantar fasciitis persists over a long period of time, there is a risk of heel spurs forming. This is a small outgrowth of bone that appears on the heel bone and points in the direction of the toe.

Diagnosis & course of disease

Plantar fasciitis is usually diagnosed based on its typical symptoms. These include the tenderness of the soles of the feet and heel pain in the morning hours. Further examination measures are usually only carried out if conservative therapy is unsuccessful or if injections are to be made.

X-rays often reveal a heel spur. The same applies to fatigue fractures or tumors, which can also be a reason for heel pain. Another diagnostic method is sonography (ultrasound examination). With its help, a thickening of the plantar fascia can be determined.

Alternatively, examinations such as skeletal scintigraphy or magnetic resonance imaging (MRI) can also be considered. The course of plantar fasciitis is generally positive. The foot complaint usually improves after a year. It doesn't matter which therapy is used.

Complications

Untreated plantar fasciitis can become chronic and cause persistent, severe pain. Conservative therapy for the disorder is usually very lengthy and takes several months, but complications are usually not to be expected. In about every twentieth sufferer, conservative therapies do not lead to the desired success - these include in particular shoe insoles and physiotherapy as well as non-steroidal anti-inflammatory drugs to combat pain.

Then a surgical procedure can be useful, even if it is not a common treatment method. The operation involves a number of risks. So it is possible that the pain after the surgical procedure is stronger than before and spreads to the metatarsus. This development is particularly to be feared if the entire plantar fascia was severed during the operation.

If the surgeon injures the tendon plate, flatfoot can develop. In addition, there are a number of nerves in the foot area that can be affected by surgery. This can lead to chronic pain that is worse than that of the original illness. A loss of mobility in one or more toes is also not impossible.

As with any operation, general operational risks can also arise. The wound can become inflamed and in the worst case lead to sepsis. It can also leave painful or unsightly scars. Vein thrombosis as a result of surgery is another possible complication.

When should you go to the doctor?

Since plantar fasciitis does not heal itself, this disease must always be examined and treated by a doctor. Only with early diagnosis and treatment can further complications be avoided. As a rule, the life expectancy of the person affected is not negatively affected by plantar fasciitis.

In the case of plantar fasciitis, the doctor should be consulted if the person concerned suffers from severe pain in the feet. The pain can also spread to the entire leg and have a very negative effect on the everyday life of the person concerned. The Achilles tendon is also negatively affected by the disease and can tear. If the pain in the feet occurs over a longer period of time and does not go away on its own, a doctor must be consulted in any case.

Plantar fasciitis is usually treated by an orthopedic surgeon or a sports medicine specialist. In general, it cannot be predicted whether there will be a complete healing.

Treatment & Therapy

There are several options available for treating plantar fasciitis. Physical treatment is particularly effective. It includes stretching exercises for the plantar fascia and the Achilles tendon. These measures can improve the symptoms after two months. LowDye taping is also part of physical therapy.

A tape bandage is applied around the foot to support the longitudinal arch. This results in a pressure reduction on the plantar aponeurosis when walking. Special foot massages can also be used to relax the muscle fascia and improve blood circulation.

The use of orthoses is also helpful against plantar fasciitis. With this method, the patient receives orthopedic insoles for his shoes. The orthotics counteract overpronation of the foot. At night, the patient can also wear leg braces. These prevent a plantar-fixed foot position.

Pain relievers, such as nonsteroidal anti-inflammatory drugs, are also given to help manage the pain. If conservative therapy is unsuccessful, corticosteroids can be injected into the diseased foot. This method is successful after a short time. However, there is a risk of fat loss in the heel. This in turn increases the risk of a plantar fascia tear.

An extracorporeal shock wave therapy is another possible treatment option. Its aim is to stimulate the body to develop positive inflammation. Only one percent of all patients have to undergo surgery after unsuccessful conservative treatment.

prevention

Runners can prevent plantar fasciitis by exercising well and regularly. Stretching and strengthening exercises are also considered helpful. It is also important to avoid being excessively overweight and standing for long periods.

Aftercare

In most cases of plantar fasciitis, patients have very few or no special follow-up measures available. First and foremost, a doctor should be consulted with this disease so that an early diagnosis and thus rapid treatment can be initiated. Therefore, the earlier a doctor is consulted, the better the further course of the disease will usually be.

Self-healing cannot occur with plantar fasciitis. Most of those affected depend on various medications. A regular intake and the correct dosage must always be observed. If anything is unclear or if you have any questions, a doctor should always be consulted first. A doctor should also be contacted in the event of side effects.

In many cases, those affected should wear a bandage on their feet to relieve the foot and prevent further discomfort. Foot massages can also be very helpful and significantly alleviate the symptoms. Some of those affected are dependent on family care in their everyday lives, although psychological support can be very helpful in many cases. Usually, plantar fasciitis does not reduce the life expectancy of those affected.

You can do that yourself

With plantar fasciitis, some self-help measures are possible, which make everyday life easier for the person affected and can also accelerate the healing of the disease.

If you are overweight, this must be reduced, as being overweight promotes plantar fasciitis. The person concerned should pay attention to a healthy diet. Sports activities should be designed in such a way that they do not put excessive strain on the feet and legs. In general, the lower extremities should no longer be subjected to excessive stress. In some cases, inserts can also be worn in the shoes to relieve the discomfort.

Plantar fasciitis is also often treated with medication and pain relievers. It is important to ensure that it is taken regularly and that it may interact with other drugs. The movement can be increased again with the help of physiotherapeutic exercises, whereby these exercises can also be performed in your own home. It is advisable to stretch and straighten the extremities, although strength exercises can also be helpful. The patient should avoid standing for long periods of time with plantar fasciitis. Regular checks by a doctor are also useful.