The notorious name "plantar fasciitis" is well known to the public. The suffix "itis" implies that it is an inflammatory condition, and logically, the treatment should focus on anti-inflammation. However, plenty of research has shown that anti- inflammatory management is not beneficial for the condition.
In recent years, "plantar heel pain" has become a term used frequently. It generally describes the area of symptoms without specifying the cause, which we still do not fully understand .
Some people may suggest that a heel spur irritates the plantar fascia, but research has demonstrated that having a heel spur is not necessarily symptomatic. In fact, half of the subjects are pain-free and function well with a heel spur.
Some will propose that the cause of plantar heel pain is a form of tendinopathy, which is more convincing. We know that the function and composition of the plantar fascia are quite similar to those of a tendon. When we perform an ultrasound scan of the plantar fascia, some thickening (> 4 mm ) or hypoechogenicity may be found in individuals with plantar heel pain. Therefore, the term "plantar fasciopathy" is used. The name itself implies that the treatment focus should be similar to that of tendinopathy, which is true for the most updated guidelines for plantar heel pain.
For treatment, patient education comes first. Advice should be tailored to individuals. For instance, a runner should decrease his or her running volume. A patient who needs to stand for a long time during work and experiences triggering symptoms should rest in between , if possible. For overweight patients , losing some weight will be helpful for the condition.
Other treatments may include exercises to load the plantar fascia as tolerated (e.g., heavy slow resistance training, isometrics, etc., in a plantar fascia-stretched position), plantar fascia stretches , foot orthoses ( choose the one you find comfortable; both premade and tailor-made insoles provide similar symptom relief, so opt for a cheaper one), shockwave therapy, dry needling to the calf, corticosteroid injections, and surgery as a last resort.
I hope this blog will provide you with some information . If you are suffering from this condition, book a consultation; I am happy to help.