FAQs on Plantar Fasciitis Treatment in Nashville TN

Plantar fasciitis is a painful foot condition, and it involves inflammation of the band of tissue that expands from the heel along the arch of the foot (plantar fascia). This condition is often associated with heel spurs, which affect around 70% of patients with this plantar fasciiitis. A heel spur is a small, bony projection that forms on the heel bone.

How common is plantar fasciitis?

According to statistics, 10% of the U.S. general population will have heel pain during their lifetimes. Of these individuals, more than 80% are active, working adults between ages 25-65 years old. A recent study by the Centers for Disease Control and Prevention (CDC) found that plantar fasciitis accounts for more than 1 million doctor visits each year.

Who gets plantar fasciitis?

Plantar fasciitis occurs mostly in middle-aged men and women, but it can affect people of all ages. This condition is more common in people who are overweight, those who have a rapid weight gain, and athletes. One recent study found that around 20% of runners experience plantar fasciitis.

What causes plantar fasciitis?

There are many causes of plantar fasciitis. These include:

  • Injury to the plantar fascia – The repetitive pounding of the foot causes damage to the fibrous tissue (plantar fascia) of the arch in athletes. Additionally, the ligamentous connective tissue becomes irritated from prolonged standing on a hard surface. This area of the foot is a major transmitter of weight across the foot. The plantar fascia ligament loosens and contracts with movement, but because of these things, it can easily become injured. Any repetitive stress on the tissue could lead to inflammation or tears, which results in moderate to severe pain.
  • Arthritis – Another common cause of plantar fasciitis is arthritis, which causes inflammation to develop in the tendons. This is common among older adults.
  • Wearing incorrect shoes – For many patients shoes are the cause of plantar fasciitis. Shoes that either do not fit properly or provide inadequate support can produce heel and plantar pain. In addition, walking or exercising in improper shoes can lead to impaired weight distribution, which produces stress on the plantar fascia.

What symptoms are associated with plantar fasciitis?

The main symptom of plantar fasciitis is pain perceived in the heel region of the foot. The pain is often severe upon rising in the morning, because the arch tissue tightens up with relaxation and rest. The pain of plantar fasciitis also occurs with prolonged standing and walking.

How is plantar fasciitis treated?

The treatment of plantar fasciitis depends on the severity of the problem and associated conditions. Options include:

  • Physical therapy – The physical therapist instructs the patient on exercises that stretch the plantar fascia and the Achilles tendon. In a recent study, physical therapy was found to have an 83% success rate for treating plantar fasciitis.

 

  • Night splints – During sleep, night splints are worn to stretch the arch of the foot and calf. These devices hold the Achilles tendon and plantar fascia in a lengthened position.

 

  • Orthopedic shoes – These have a cushioned sole and good arch support. Some patients benefit from the use of orthotic shoe inserts and heel cups.

 

  • Corticosteroid injections – Used to reduce swelling, the doctor injects a steroid medication into the plantar fascia on the side of the foot or into the heel region. Sometimes, an anesthetic is added for maximum effect. In a 2012 study, steroid injections proved an extremely effective treatment for this condition.

 

  • Extracorporeal shock wave therapy (ESWT) – To stimulate tissue healing of the fascia and heel, sound waves are used in ESWT. This therapy is reserved for patients with plantar fasciitis who do not respond to other treatments. Several studies show that ESWT is around 80% effective.

Resources

Alvarez R., Cross, G.L., Levitt, R., Gould, et al. (2002). Chronic proximal plantar fasciitis treatment results with the Ossatron ESW System. FDA Investigational Study P990086. Available at http://www.fda.gov/cdrh/pdf/p00086.html.

Hyer CF, Vancourt R, & Block A (2005). Evaluation of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. J Foot Ankle Surg, 44(2):137-43

McMillian, AM, Landorf, KB, Gilheany, MF, et al. (2012). Ultrasound guided corticosteroid injection for plantar fasciitis: Randomised controlled trial. British Medical Journal.

Riddle DL & Schappert SM (2004). Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int, 25(5), 303-310.

Rome K, Howe T, & Haslock I (2001). Risk factors associated with the development of plantar heel pain in athletes. The Foot, 11(3),119-125.