Plantar Fasciitis Physical Therapy Methods

Written by Wang Cheng Lin
Orthopedics
Updated on September 26, 2024
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The most common clinical treatments for plantar fasciitis are, firstly, injection therapy, secondly, acupuncture, and thirdly, small needle knife therapy. Among these, injection therapy has the most noticeable effects, but it also has a significant problem. Since the injections contain steroids, excessive use of injection therapy can not only fail to alleviate symptoms but may actually damage the plantar fascia, leading to a worsening of plantar fasciitis symptoms. Therefore, it is crucial to limit the frequency of injection treatments to no more than once or twice a month. If the symptoms of plantar fasciitis do not improve significantly with physical therapy and the pain progressively worsens, then surgical treatment may be necessary. The goals of surgery are firstly to release the plantar fascia and secondly to remove bone spurs, thereby completely alleviating the symptoms of plantar fasciitis pain.

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Written by Cheng Bin
Orthopedics
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Is plantar fasciitis prone to recurrence?

First of all, it is necessary to explain that patients with plantar fasciitis, even after recovery, can easily relapse if they overuse their feet for a long time, or are exposed to prolonged cold and damp conditions. Therefore, plantar fasciitis is prone to recurrence. It is important to avoid long periods of weight-bearing walking, minimize local irritation, and never let the feet become cold. It is essential to persistently perform hot washes daily. During the hot wash, peppercorns and salt can be added to the hot water for washing, or external use of traditional Chinese herbs that activate blood circulation and remove blood stasis can be boiled and used for fumigation washes. Additionally, taking non-steroidal anti-inflammatory and pain-relieving drugs orally along with drugs that activate blood circulation and remove blood stasis can effectively treat plantar fasciitis. (Please follow the doctor's prescription for medication use.)

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Written by Guan Yu Hua
Orthopedic Surgery
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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.

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Written by Wang Cheng Lin
Orthopedics
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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.

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Written by Guan Jing Tao
Orthopedics
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Will plantar fasciitis cause pain on the top of the foot?

Generally speaking, it is not the case. Plantar fasciitis is mostly characterized by distinct pain at the point where the muscles and fascia on the bottom of the foot connect with the bones, especially during walking or other activities, where a clear pain point can be observed. Top-of-the-foot pain should not be ruled out as being caused by other reasons, such as soft tissue injuries on the top of the foot, gout, or local tissue damage due to accidental strains. Therefore, plantar fasciitis does not induce pain on the top of the foot, unless there are soft tissue injuries and inflammation in both the plantar and dorsal areas of the foot, which would result in corresponding pain in both areas.

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Written by Wang Cheng Lin
Orthopedics
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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.