On average, a person will take about 10,000 steps each day. Our feet can take on a lot of stress as we move around throughout the day, but overuse can damage the tissues in the feet.
Plantar fasciitis is a common cause of heel pain in patients. The plantar fascia is a band of tissue that runs from the tip of the big toe all the way to the heel. It supports the arch of the foot and absorbs most of the stresses we place on our feet. Overuse can cause inflammation, or the plantar fascia may tear where it attaches to the heel.
Our foot and ankle surgeons, Dr. Aron Green, Dr. Eric Beights, and Dr. George Fahoury, frequently see patients with plantar fasciitis. We offer both surgical and nonsurgical treatment options for plantar fasciitis.
Symptoms of Plantar Fasciitis
It is estimated that heel pain will affect about half of the U.S. population at some point during their lives. The most common symptom of plantar fasciitis is heel pain that occurs within the first few steps of getting out of bed in the morning. This is because the foot typically relaxes into a pointed position when we sleep. This shortens the length of the plantar fascia, causing pain in the morning when the plantar fascia is stretched to a normal, extended position. Additionally, if the plantar fascia is torn, it may create scar tissue overnight in that shortened position. When you step out of bed in the morning, that scar tissue can tear, causing pain.
Heel pain may also occur after a long period of rest. Plantar fasciitis pain typically improves with activity during the day, but may return at the end of the day or after a period of strenuous activity or use.
There are several factors that can increase your chances of developing plantar fasciitis. Tight calf muscles can make it difficult to fully extend the foot, shortening the plantar fascia over time. Plantar fasciitis is common in runners and athletes that participate in high-impact sports. It can also develop as a result of new or increased physical activity. A flat foot may also increase the risk of plantar fasciitis.
Treatment Options for Plantar Fasciitis
In the majority of cases, plantar fasciitis will resolve within a year to 18 months with conservative treatment. However, surgical options are also available if conservative treatments are not effective at relieving heel pain.
Conservative treatment for plantar fasciitis involves the use of a night splint to hold the foot in an extended position while the patient sleeps. This can help to alleviate heel pain in the morning. Shoe inserts or custom orthotics may be recommended to help cushion the heel and reduce heel pain caused by standing or walking. Topical or oral anti-inflammatory medications may also help to improve heel pain throughout the day.
Physical therapy is very beneficial for patients with plantar fasciitis. Physical therapy focuses on stretching the plantar fascia and calf muscles to lengthen the tissues and improve range of motion. At Seaview, we offer physical therapy services on-site for the convenience of our patients.
Massage therapy can also be helpful for patients with plantar fasciitis. The Graston technique, a process in which the plantar fascia is massaged with specially-designed instruments, can help to break up scar tissue and promote the formation of healthy tissue.
Minimally Invasive Treatment
If conservative treatments do not relieve pain, more aggressive treatment options may be recommended. The latest treatment options for plantar fasciitis are minimally invasive and can help patients avoid or delay the need for surgical procedures.
Platelet-rich plasma injections are thought to stimulate healing in the plantar fascia because platelets contain proteins called growth factors that are integral to the healing process. During this procedure, the patient’s blood is placed in a centrifuge to separate the platelets from the rest of the blood cells. The highly-concentrated platelets are then injected into the injured plantar fascia to promote healing. Amniotic allograft injection can also be used to treat plantar fasciitis.
High energy ultrasound may also help to alleviate the symptoms of plantar fasciitis. Percutaneous ultrasound-guided needle tenotomy, a treatment in which a needle is inserted into the tissue to create small holes and increase circulation to the area, is also effective for some patients. The needle is driven under ultrasound guidance, just like it is done for a corticosteroid injection into the plantar fascia.
If conservative and minimally invasive treatments do not relieve a patient’s pain, surgery may be recommended. Your surgeon will work with you to determine the best option for you.
Endoscopic surgery for plantar fasciitis is possible, but it carries a higher risk of complication than open surgery. Endoscopic surgery may not address the full problem at the heel.
Open surgery for plantar fasciitis may involve a partial cut in the plantar fascia to relieve tension. Typically, the tissue is resected in the middle of the plantar fascia, leaving the outer bands of tissue intact to prevent the development of a flat foot. The abductor muscle may also be released to prevent Baxter’s nerve entrapment, which can cause pain. If heel spurs are present, they are typically removed during the procedure to prevent potential irritation.
Plantar Fasciitis Treatment in Jersey Shore and Central New Jersey
Our foot and ankle surgeons, Dr. Aron Green, Dr. Eric Beights, and Dr. George Fahoury, have over 35 years of combined experience in treating conditions like plantar fasciitis. Our foot and ankle specialists are available at all five office locations, and we offer physical therapy on-site for your convenience. If you would like to learn more about our services or schedule an appointment, please call (732) 660-6200. We are happy to help!