Plantar fasciitis is a common cause of heel pain. The disease is characterized by a manifestation of pain and an inflammatory change in the area of the plantar fascia connecting the toes to the bone on the heel. The danger of pathology lies in the fact that if there is no appropriate treatment, then the formation of a bone growth, called a spur, is possible. This pathology is quite serious, and in some individual cases it can be removed only by surgical treatment. Another common complication of fasciitis is Achilles tendon tendonitis.
What is plantar fasciitis
Plantar fascial fibromatosis is a pathology that manifests itself as a pathological process in the fascia, a ligament of a flat shape that covers the inner side of the fossa of the sole. It fixes the combination of bones - the calcaneus and metatarsal, the required gyrus of the arch of the foot is formed, and stability during movement is enhanced. Such a disease is also called a heel spur.
In the international classification of the disease (10-mb), plantar fasciitis is noted in the section of diseases of the musculoskeletal structure and connective tissue. Group - “Other soft tissue pathologies” with fibroblastic changes.
When a strong load on the feet is fixed, the formation of microtraumas in the sole is possible. Often, their healing is independent, with a uniform alternation of patients' load and rest. In this case, frequent minor injuries and stretching of the muscles of the foot leads to its defeat.
The main factors that lead to changes in the plantar fascia:
- Age category, gender - heel fasciitis is mainly observed in males who are more than 40 years old, in women plantar fasciitis is manifested somewhat less frequently.
- Long sports loads, dances, which can be accompanied by increased load on the bones of the foot, as well as with prolonged walking on a hard surface.
- Violation of biomechanics of the foot. When a person has flat feet, unevenly distributed body weight leads to overload of the plantar region.
- The reason for the pathology of the feet is also extra pounds, which additionally put pressure on the foot, overloading it.
- Occupational work requiring prolonged standing. People, by the nature of their employment, should stand or walk a lot, which leads to pressure on the foot, and as a result, to the development of plantar fasciitis.
- Feet can hurt due to diseases of the spine, such as scoliosis, which is manifested by a shift in the center of gravity of the body. The pressure on the soles is growing, which can cause pathology.
The risk group, when fasciitis develops, includes persons who wear tight, uncomfortable shoes worn from the inner edges. With constant microtrauma in the area of the plantar ligament, when exposed to adverse causes, it leads to pathological phenomena.
When plantar fasciitis forms, the symptoms and treatment will be determined by the timeliness of treatment for a pathological manifestation.
Fasciitis is a disease that develops slowly, so most people in the initial stages do not focus on the disease.
The etiology of the disease is characterized by shortening or contracture of the calf muscles and plantar ligament.
Plantar aponeurosis is considered the most common factor manifested by heel pain. Localization of pain passes along the lower surface of the sole. Often manifested after sleep, when the first steps are taken or if a person has not been loading a sore leg for a long time, giving it a rest.
Signs of pain, if there is fasciitis, pulsating, tingling, worse when moving with bare feet, on tiptoe, when you need to climb the stairs.
With damage to the plantar region is also observed:
- Swelling of the ankle, ankle.
- Syndrome of pain in the ankle, the site of the Achilles tendon.
- The presence of seizures in the foot, if the patient wants to step, or during sleep.
Fasciitis is characterized by increased pain discomfort, fixed at the end of the day, after an excessive pressure on the feet for the whole day.
Symptoms of the heel spur
The appearance of bone formation, provided there is no chronic factor in the development of the inflammatory phenomenon, has an asymptomatic course. Therefore, the detection of heel spurs is often involuntary when studies are conducted in connection with other indications.
When a spur is formed on the sole, the patient feels unbearable pain when moving, it is so sharp that it is compared with sudden injections with sharp objects, or with a nail. These feelings are due to the fact that compression of the soft tissues in the heel by osteophyte occurs.
The strength of discomfort with a plantar spur is revealed by the placement of the formation and only to a minimum extent by its size. The closer the growth to the nerve nodes, the soreness will be stronger. At the formation stage, when calcaneal fasciitis is formed, discomfort can go away for a certain period of time.
If plantar fasciitis is not treated, then the pain will appear in the heel and in a calm state.
Ignoring the therapy of fasciitis disease, or its incorrect prescription leads to the progression of the disease, the patient's gait changes, flatfoot may appear.
How to treat plantar fasciitis
Treatment of plantar fasciitis must begin with the sensations of the first signs of pathology, consult a doctor.
The diagnosis of plantar ligament disease is:
- Based on the inspection of the affected area.
- Clarifying the symptoms of the disease.
- Based on x-rays of the foot.
If fasciitis is not treated immediately, this will provoke the progression of degenerative and destructive phenomena in the foot area.
To exclude negative manifestations when fasciitis is observed, therapy in combination can. It will be required: to drink pills, applying ointment to the plantar area, as well to get rid of pressure on the limbs.
It is also important for the pathology of fasciitis:
- Review diet
- Get rid of extra pounds, since a large mass contributes to a worsening prognosis for various diseases of the joints of the legs, spine.
- Eliminate pressure on the heel of a sports character
- Apply orthoses
- The main directions in therapy
- Reduce the pressure on the plantar
- Stop the inflammatory course
If the therapy for fasciitis disease is selected correctly, this helps to improve the prognosis. An integrated approach to the initial and middle stages of fasciitis disease will allow you to completely recover.
With inflammation of the fascia, diagnosis and treatment are formed at a physical examination by a specialist. The doctor can identify pain zones under the heel, swelling. X-ray will show the growths on the sides of the foot bone, compaction.
Laboratory symptoms of a pathological manifestation will be absent, but there may be data that indicate muscle damage (creatine is excreted in the urine, muscle enzyme activity is increased).
The diagnosis of fasciitis is made in the presence of stiffness in the affected area of the fascia and numerous pain nodes, aponeurosis, characterized by a significant and progressive compaction of the palmar and plantar aponeurosis with the formation of contractures.
Many patients with a number of symptoms of fasciitis pathology do not know which doctor’s profile should be treated. In territorial hospitals, you can make an appointment with an orthopedist, who will provide the patient with all the information about the severity of the disease, fasciitis, listen to symptoms and prescribe treatment.
If such a specialist is not available in the clinic, then treatment of fasciitis of the sole is carried out by the surgeon.
Treatment methods include:
Treatment of the plantar region is carried out using painkillers and anti-inflammatory drugs. Drugs for pathology fasciitis can be in the form of tablets, creams.
Similar properties are observed in Ibuprofen, Naproxen. Your doctor may prescribe hormonal medication.
At home, ointments can be used to cure fasciitis, which contain plant and natural compounds, rubbing the plantar, as well as making lotions.
When plantar fasciitis is disturbing, treatment does not do without physiotherapeutic procedures. Physiotherapy of the heel spur will allow normalizing metabolic phenomena, eliminating the pathological course.
A number of procedures are used when fasciitis bothers:
To stretch a dense compacted ligament, the arch is massaged. You can massage yourself 2 times a day. Using a fist and knuckles, you will need to massage the arch of the foot with strong movements in a circle. After that, the socks are unbent and stretched over themselves.
Vacuum massage is carried out for various lesions of the foot, including heel spur, fasciitis.
The vacuum massage procedure to treat fasciitis is as follows:
- The patient needs to lie on his back, stomach. The pose should be comfortable to achieve maximum relaxation of the leg muscles.
- Banks must have a special configuration for this zone, but cans of the smallest sizes are also possible.
- Use 2-3 cans immediately, they are placed on the soft tissues of the ankle.
- The duration of the procedure takes 5-10 minutes.
- Treatment course up to 11 manipulations. Their conduct should be daily or every other day.
- When the cans are removed, you need to stroke the foot, and then shake it a couple of times.
Fascial therapy involves a massage procedure, represented by a combination of techniques of the West and the East. Being a general system, this massage is used to soft tissues of muscles and fascia, which are affected by spasms.
The main principle of fascial massage is the detection of a specific fascia zone, which is interconnected with a separate restriction of movement. After the discovery of such a zone, under the influence of a specific technique, the fascia point is precisely detected, and the therapist restores the fullness and painlessness of mobility.
If you use myofascial deep massage, then it is possible to normalize the fascia, to provoke the appearance of a viscerosomatic, somatovisceral reflex.
There are more effective ways to eliminate the fasciitis of the sole - manual therapy, which allows you to fully resume the affected structure of the ligamentous apparatus.
Such techniques are used to exclude fasciitis:
Thanks to the treatment of plantar aponeurosis with the help of manual therapy methods, the process of restoration of affected tissues starts. Resorption of scar tissue, restoration of the physiological functions of the fascia is observed.
Based on the research indicators, it can be concluded that the acupuncture treatment method, used for 4 weeks, provides significant pain relief.
This method of treating fasciitis involves stimulating certain points on the sole using needles.
For the treatment of plantar fascia in a short time and effectively eliminate the inflammatory process and relieve pain will help metals - copper, aluminum. It is recommended to put aluminum foil to the heel area. This application should be worn all day.
You can also heat any copper dishes and lean against the heel area. The time of the procedure is the complete cooling of the utensils.
Thanks to charging, a stretching of the connective tissue of the lower portion of the foot is observed, the elasticity of the plantar aponeurosis increases.
With regular gymnastic exercises:
- The plantar ligament will lengthen.
- The risk of injury is reduced.
- Connective tissue is strengthened.
- With dosed pressure on the plantar area, the pain of the affected area will decrease.
It is better to do exercises with a plantar spur in the morning. To carry out exercises when fasciitis bothers, it will take about 10 minutes, up to 2-3 times a day.
- Exercise 1 - roll a tennis ball, rolling pin on a hard surface.
- Exercise 2 - put a towel on the arch of the foot and pull the tips of the fingers towards you. You will need to stay in this position for a start for a couple of seconds, then longer.
- Exercise 3 - lean against the wall with your hands, place one limb near the wall, and throw the other back on your fingertips. It is necessary to try to pull the shin of the hind leg, landing it on the heel area, slightly bending the knee of the leg that stands in front.
Alternative methods for eliminating the pathological course in the fascia are not inferior in effectiveness to drugs from pharmacy chains. In addition, home-made medicines are many times cheaper.
Alternative medicine proposes the use of ointments, compresses to eliminate the pathology of fasciitis.
Effectively using ointments under the lotion to eliminate plantar pain.
To make one of these will require:
- Butter - 200 grams.
- Vinegar - 2 tablespoons.
An egg breaks, vinegar spills from above. The oil is melted, but not brought to a boil, and sent to the prepared products. Mixing the mixture is not necessary. The mass is closed with a lid and left for 3 days. After everything is mixed and used for its intended purpose.
The fabric is impregnated with the finished product, applied to the plantar zone, then gauze is applied and socks are put on. Fasciitis should be treated before the full use of the ointment.
Before applying creams and lotions to cure fasciitis, traditional medicine recommends taking baths.
For the procedure, such traditional medicine is used:
- Coarse sea salt - 2 tablespoons. In the bath, the heels are kept for 15 minutes.
- Iodine - 10 drops and salt - 3 tablespoons. In 3 liters of water with the addition of these products to carry out the manipulation of 10 minutes. After the bath, the plantar ligament is lubricated with iodine.
- The use of vinegar 9%, turpentine, vodka in an equal volume. The products are mixed and heated using a water bath. The affected leg is lowered into the mixture and held until it cools. After the solution heats up again and the treatment of the plantar zone is repeated.
The treatment course using the plantar ligament of traditional medicine includes the use of compresses.
You can cook night gadgets using such folk remedies:
- Use grass saber to cure fasciitis. Chopped root - 2 tablespoons need to pour ¼ cup of water, leave to stand under a table lamp. When 2 hours have passed, the softened roots are rubbed into a mushy mass, applied to the sole, securing with a bandage. A bag is put on top, then a sock. Lotion in the plantar area put for 10 hours.
- Elderberry infusion. Berries are superimposed in a 0.5 container and filled with alcohol. It is necessary to give the infusion to insist in the dark. Use a compress to eliminate fasciitis, you need daily.
It is possible to protect the plantar (plantar) fasciitis from adverse effects. By following simple recommendations, injury to the connective tissue can be prevented.
- Wearing comfortable shoes, selection of shoes, boots with a good insole, shoe, low heel. You can additionally use insoles and heels in shoes.
- Follow the doctor’s recommendations using orthopedic appliances, wear orthopedic shoes and don’t refuse special glides.
- Loads should be dosed.
- Watch for nutrition, weight.
- Timely conduct treatment of diseases of the joints, spine.
If pain occurs, swelling in the heel area requires immediate medical attention. This will allow to recognize plantar aponeurosis at the developmental stage and get rid of the disease with an integrated approach to therapy.
Factors provoking the development of the disease
These factors can contribute to the development of fasciitis, so they also need to take a closer look and correct any errors.
- First factor It is uncomfortable and cramped shoes, so it is better to wear sports shoes, or put a soft insole in it.
- Second factor is walking barefoot. If you like to walk barefoot, then you should stop doing this. At home you need to go exclusively in slippers.
- Third and last factor is overweight. Because of the excess, and so many different serious problems can appear, for example, diseases of the cardiovascular system, but there is also a huge load on the heel, because of this, the disease can worsen. Therefore, it is worth starting to lead a healthy lifestyle, eliminating fatty and floury foods from the diet and regularly playing sports.
How to relieve pain
In inflammatory processes, which is also plantar fasciitis, you can not soar and warm your legs.
To relieve pain will help not only cold, but also massage. In the category of gadgets for self-massage, there are also options abruptly and simpler.
One such massager from the American brand Moji can be attributed to the first. It is used for stretching and massage the fascia. The best effect is achieved if you first hold the device in the freezer to combine massage with cooling and anesthesia.
Более доступными аксессуарами для самомассажа стопы являются вот такие мячики, а из подручных средств – теннисные мячи и бутылки (подходящего диаметра) с ледяной водой.
There is a device that needs to be worn overnight - the “Strassburg sock” (named for its creator Dave Strassburg). He puts on a sore foot so that the foot is at an angle of about 90 degrees to the lower leg. Manufacturers promise that the use of the device reduces morning pain and accelerates recovery by stretching the fascia and muscles of the foot.
There are compression bandages specially designed for those who suffer from plantar fasciitis. In this case, pain is reduced due to the fixation of the foot in the anatomically correct position and the compression support of the vulnerable area.
Kinesioteiping can also help, but a professional should stick on tapes.
If you know that when you get to your feet in the morning you are guaranteed to be hurt, you can try to do a set of exercises (see the video below) without getting out of bed. They knead and stretch muscles and fascia, improve blood flow to the painful area.
As the experience of many runners who have encountered this problem shows, the most difficult thing in the treatment of plantar fasciitis is to stop training and give the foot a rest. Remember that peace during treatment is necessary and it will be easier to regain your running form than to recover without interrupting your workout.
Symptoms of plantar fasciitis
The most common symptom of the disease is sharp pain in the heel, which usually occurs when walking.
This pathology has a characteristic feature, which is pain in the first steps, immediately after waking up.
This factor appears due to the fact that at night, with a long rest, micro sprains on the ligaments begin to heal, and when a person begins to walk, the ligaments stretch again causing pain.
Also, pain may appear after a long stay in one position, after special physical exertion and, in principle, engaging in active sports. According to patient descriptions, pain with fasciitis is similar in sensation to pain when piercing the foot with a pin.
Also, with the development of the disease, dull pain may appear. As a rule, pain is manifested only in the plantar area of the heel. But in some cases, the back surface of the bone may also begin to hurt.
If fasciitis is in advanced form, then a person may even stop walking, since it is very difficult to move without stepping on the heel, this can also cause other diseases associated with socks and the outer part of the foot.
Anti-inflammatory drugs (not containing steroids) are taken to treat fasciitis. Of painkillers you can take:
- Hydrocortisone ointment,
- Ibuprofen (ointments and tablets),
- Indomethacin ointment.
Remedies will remove inflammation in the leg, and reduce pain. You also have the choice to use pills or creams.
If you decide to be treated with tablets, take them only after eating. And if you resorted to creams, then without any recipes, simply apply them to the inflamed area.
In case the symptoms worsen, then it is worth using corticosteroids (diprospan, phlosterone). Injections of this drug will temporarily relieve pain, but still do not forget that this is only a temporary solution to this problem.
The injections are quite painful, and if you abuse them, you can seriously damage the heel.
Before resorting to surgery, you need to visit a specialist physiotherapist. He will definitely tell you what needs to be done, and will be able to tell whether it is necessary to resort to such serious methods of curing the disease in general.
Contact a physiotherapist only after using all other (non-medical) treatments. You may not have to lie down on the surgical table at all, and other methods will help eliminate plantar fasciitis.
If, nevertheless, no methods could stop the development of the disease, then of course it is necessary to resort to surgical intervention, since this is the only remaining method. This procedure can completely eliminate inflammation in the ligaments and relieve sprain. With surgical intervention, part of the ligaments are removed, which eliminates fasciitis.
But not everything is so good, during the operation it is necessary to realize that there are a number of risks, the list of dangers associated with surgical intervention includes:
- neuroma development
- tarsal tunnel syndrome,
- constant sharp pain and swelling.
There is also a risk that the ability to regenerate wounds will slow for a long time after surgery.
It’s worth taking the operation seriously and will turn to really good specialists, remember that health is more expensive than money. Therefore, you need to go to a clinic with a good reputation.
The use of extracorporeal shock wave therapy
This method is a safer option than surgery. Treatment takes place by sending sound waves to the affected area, the method is aimed at relaxing the leg muscles.
This type of treatment is used only if the symptoms of fasciitis do not disappear after 6 months of treatment.
The procedure also has side effects, such as swelling of the treated area, numbness of the extremities and bruising. The method is not as aggressive as surgery, but also less effective.
Therapeutic exercise (6 effective exercises with plantar fascia)
There are complex exercises for the prevention of plantar fasciitis. Only 6 exercises will be listed.
In the first exercise, you need to lean against the wall and stretch out your arms. When you are sure that the leg is stretched as far back as possible, while the other should be slightly in front, transfer the weight to the hind leg.
Then, push the body forward, while not lifting the heels and stay in this position for 30 seconds until you feel a stretch.
In this exercise, you need to stretch your feet as far as possible, and then bend all your toes back with your hands, special attention should be paid to the thumb.
This exercise must be done alternating, that is, first bend the knee, and then do the exercise already with a straightened leg.
The foot should be kept in a state of tension, for greater efficiency. The exercise is performed in 10 repetitions, 2-3 times a day.
To complete this exercise, you need to take a small stool. Stand on a stool, put your hands on a stable support, an ideal option would be a wall. When you are sure that you can maintain balance, then start the exercise.
Stand on your toes and tighten your foot, in this position you need to stand for 30 seconds, and then return to its original position. The exercise is performed in 10 repetitions, 3 times a day.
To complete this exercise, take a small towel and spread it on the floor. Then try to lift it using only your toes. Hold the towel for about 30 seconds, and then slowly release and relax your legs. Perform 10 repetitions, 3 times a day.
This exercise is to stretch your feet so that your toes are in tension. Then lightly press on the fascia area and make circular movements.
This exercise should be done several times a day until a feeling of relaxation appears in the area of the arch of the foot.
For this exercise, you need to take a cold jar, for example with soda, or some small ball, and then press your foot on it and begin to roll on the floor in order to achieve relaxation of the arch of the foot. It is worth doing from 30 to 50 repetitions per day, so that the feet are relaxed.
Other treatments for the disease.
Other methods of treatment include massages, mud and mineral baths and warming rubbing. Also sometimes resort to the use of gamma therapy.
Gamma therapy is performed on radiotherapeutic units widely used in the field of oncology.
Some of the treatments are also used in advance to prevent fasciitis. Of these methods, you need to select a few:
- body support in an appropriate form,
- wearing comfortable shoes, and it’s better to have orthopedic shoes,
- Do not experience excessive physical exertion