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Plantar fasciitis
What should I do if plantar fasciitis is very painful?
Plantar fasciitis is mainly characterized by worsened symptoms after activity, with pain at the bottom of the foot, which tends to ease during rest. Typically, the most intense pain occurs when stepping down for the first time in the morning or when the affected foot bears weight painfully, possibly due to tension in the plantar fascia. This condition frequently arises in individuals who wear leather shoes or high heels for extended periods, stand for long durations, or walk on cobblestone pathways in flat shoes. Pain occurs when the plantar fascia is tense and gradually worsens, but rapidly alleviates when the fascia relaxes upon resting. Local heat application is recommended as it promotes dilation of the surrounding vessels, effectively stimulating blood circulation and thereby easing the symptoms. Additionally, it is suggested to reduce the amount of time standing and the frequency of activities, and to rest as much as possible in bed. Recovery is typically slow, generally improving gradually over about 3-4 weeks. For significant pain, medications that promote blood circulation and alleviate pain may be taken. If necessary, encapsulation therapy can be performed. In cases where repeated treatment is ineffective, fasciotomy might be considered, which can impact the function of the foot to various extents, yet the benefits outweigh the downsides and might be the last treatment option chosen. Many patients find that rest, along with medications that promote blood circulation and alleviate pain, physiotherapy, heat application, electric baking, massage, and others, help in alleviating the symptoms.
Plantar fasciitis etiology
The most common cause of plantar fasciitis is excessive weight-bearing walking, which leads to a type of nonspecific chronic aseptic inflammation of the plantar fascia, resulting in pain on the medial side of the foot when weight-bearing. This is the most common reason. The second cause is degeneration, which is most commonly seen in middle-aged and elderly female patients. The degeneration of the fascia can cause pain and may also be accompanied by heel spurs. Currently, there are two main treatments for plantar fasciitis. The first is conservative treatment, which includes rest, acupuncture, and local injection therapy to relieve pain. If conservative treatment does not work after more than six months or the condition gradually worsens, then surgical treatment becomes necessary. Surgical treatment can remove local inflammatory tissue and release the plantar fascia to achieve the purpose of relieving pain.
What causes plantar fasciitis?
Plantar fasciitis is mostly caused by prolonged standing, such as wearing high heels or leather shoes for extended periods. The fascia remains tense under these conditions, leading to tenderness in the sole's fascia upon examination. Pain tends to intensify while walking or bearing weight and alleviates when resting as the fascia relaxes. It is best to diagnose and treat this condition early. Applying heat, reducing the movement of the affected limb, and avoiding tension in the fascia are advisable. Consuming medications that invigorate blood circulation and relieve pain can also help, generally improving symptoms within 7 to 10 days. Recovery might be slow in some cases due to fascial damage. Furthermore, repeated pulling or tension from standing and working can lead to recurrent episodes. Rest is recommended for such individuals, and wearing softer sports shoes during activities can be beneficial. Resting and taking blood-invigorating medications usually lead to gradual recovery. For severe cases ineffective with conservative treatment, surgical cutting of the fascia may be performed to relieve pain. (Please use medication under the guidance of a professional physician.)
How to completely cure plantar fasciitis?
Plantar fasciitis clinically has no method that can achieve a radical cure. Only through surgical treatment can the recurrence rate be reduced, but it cannot be completely cured. Of course, the effects of surgical treatment are definitely more significant than conservative treatment. The first step in surgical treatment is to release the plantar fascia, and the second step is to remove bone spurs, as a significant portion of patients with plantar fasciitis have concurrent bone spurs. Of course, during the surgical process, it is necessary to remove bone spurs. The third step involves drilling into the heel bone to decompress it, as some patients also suffer from high pressure in the heel bone. Therefore, the surgery aims to decompress the heel bone by drilling, thus further alleviating pain in the heel and foot. However, if rest is maintained post-surgery, and strenuous activities are avoided, it can significantly reduce the chances of recurrence of fasciitis, but surgical treatment is not a cure-all method.
Is physical therapy useful for plantar fasciitis?
Physical therapy for plantar fasciitis is quite effective. It can reduce local inflammatory reactions and increase local blood circulation, thereby promoting the recovery of the plantar fascia and alleviating pain. Generally, there are many types of physical therapy; currently, the most modern and commonly used is extracorporeal shock wave therapy, which has better effects than previous methods like electrotherapy and magnetic therapy. In addition to this type of therapy, local application of injections can also be used. Blocking injections can provide immediate pain relief, but their use is limited to once or twice a month at most, as excessive use can damage the plantar fascia and exacerbate pain.
Can plantar fasciitis be treated with moxibustion?
Plantar fasciitis can be alleviated by moxibustion to relieve foot pain, but solely relying on moxibustion may not be very effective. In treating plantar fasciitis, it's important first to understand that the main causes of the condition are excessive loading, over-exertion, and degeneration of the fascia due to aging. The primary treatment for this condition is rest, avoiding excessive exertion. At the same time, other treatments such as shock wave therapy, acupuncture, or local injections can also be utilized. If conservative treatments have been applied for over six months without relief of pain, or if the pain gradually worsens, surgery may be needed to provide relief.
What department should I go to for plantar fasciitis?
Plantar fasciitis refers to the aseptic inflammatory reaction of the plantar fascia caused by prolonged exercise or activity, which results in pain and restricted movement. If plantar fasciitis occurs, it is recommended to seek treatment in the orthopedics department of a formal hospital. Based on the symptoms, an appropriate treatment method should be chosen. Initially, it is important to rest and avoid excessive activities. Additionally, the application of non-steroidal anti-inflammatory drugs can help relieve symptoms and reduce inflammation, facilitating the restoration of walking and functional abilities.
Do you need to take an X-ray for plantar fasciitis?
Patients with plantar fasciitis need to have imaging done, as many people with plantar fasciitis also develop heel spurs. Therefore, imaging can be used to check if the patient has heel spurs. In addition to imaging, it is also necessary to perform color ultrasound or MRI. These examinations can reveal local edema in the plantar fascia, indicating some damage to the plantar fascia, and even the presence of aseptic inflammation. It is also necessary to combine the patient's medical history, physical examination, and clinical signs to diagnose plantar fasciitis comprehensively. However, imaging is a very necessary part of the examination process.
How is plantar fasciitis treated?
The treatment of plantar fasciitis currently is divided into two methods in clinical practice. The first method is conservative treatment, which includes rest, avoiding strenuous exertion and excessive weight-bearing walking. It can be managed with physical therapy, massage, acupuncture, physiotherapy, and local block injections. If conservative treatments do not improve the condition or even if the pain progressively worsens over more than half a year, severely affecting daily life, surgical treatment may be necessary. The objectives of surgical treatment are firstly to release the plantar fascia and secondly to remove bone, as a significant portion of patients with plantar fasciitis also have heel spurs; therefore, the surgical procedure involves the removal of these bone spurs to alleviate the pain.
Plantar fasciitis clinical symptoms
The clinical manifestation of plantar fasciitis primarily involves pain on the inner side of the foot when bearing weight, particularly severe during excessive weight-bearing activities. This pain can significantly affect your posture while walking and has a substantial impact on daily life. Currently, there are two main treatments used clinically. The first is conservative treatment, which mainly involves rest, local injections, electrotherapy, magnet therapy, and acupuncture to alleviate the pain. If conservative treatment fails to yield results after more than six months and the pain progressively worsens, surgical treatment becomes the only option. Surgical treatment includes releasing the plantar fascia, removing bone spurs, and eliminating inflammatory tissue around the plantar fascia to relieve pain.