Description of Condition:

 

The plantar fascia is a thick fibrous tissue on the bottom of the foot which protects sensitive structures such as nerves, vessels, muscles and tendons and is also responsible for maintaining the arch of the foot.  When the plantar fascia becomes aggravated or inflamed, plantar fasciitis develops.  In many cases, plantar fasciitis is called “heel spur syndrome.”   Many people think that heel spurs are the cause of their foot pain, but the pain is actually caused by the inflammation or irritation of the plantar fascia. If untreated, plantar fasciitis can lead to a heel spur.    

 

 

Symptoms:

The symptoms of plantar fasciitis may vary among patients.  In many cases, a dull intermittent pain develops that eventually progresses into a sharp persistent pain.  The pain usually is the worst in the morning with the first steps out of bed or after long periods of sitting.  Depending on the activities throughout the day, the pain may increase or decrease.   It is most likely to increase during the beginning of athletic activities such as walking, jogging

or running.

 

Incidence and Causes:

Plantar fasciitis affects over two million Americans each year and as much as 10% of the population over the course of a lifetime.  Plantar fasciitis is caused by a number of factors and is a common sports injury among runners, walkers, and athletes.  Overweight people and those whose jobs require a lot of standing or walking are also at a higher risk for developing plantar fasciitis.  Other contributing factors include flat or high arched feet, worn out or improper shoes, jogging on sand, and increasing age.

 

Anatomy

Coming Soon

Procedure:

Before treatment begins, the source of the pain will be pin-pointed using ultrasound guidance.  The physician will then likely mark the area with an “X.”  Prior to the beginning of treatment, a local anesthetic will be administered.  Ultrasound gel is then applied to the foot and the therapy head of the treatment device.  Treatment then begins and lasts approximately 20-25 minutes. 

Post-Procedure Protocol:

After the shock wave treatment is complete, the foot is assessed for any side effects or complications.  Side effects that may be related to the ESWT treatment may include:

• Pain or swelling for a brief period following treatment
• Localized numbness, tingling or decreased sensation in the foot or at the site of shock wave delivery; and/or
• Minor bruising or small purplish spots on the skin on the foot or at the treatment site

Instruction on what steps should be taken to ensure the best possible results will be given by the physician.  He or she may limit athletic activities for several weeks after the treatment to ensure that there is no further injury to the foot.

Alternative Treatment Options:

During the early stages of plantar fasciitis, one or more of the following alternative measures may be utilized to relieve symptoms:

 

• Rest
• Physical therapy
• Heel cushions
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid injections
• Taping
• Shoe inserts, such as heel cups or insoles
• Shoe modifications
• Night-splinting
• Casting

 

If these treatment options are not effective (and other specific criteria is met), shock wave therapy or surgery may be recommended. One benefit of shock wave therapy over surgery is that it is conducted in an out-patient setting.  This means that the treatment is performed at a doctor’s office or clinic and an overnight stay in the hospital is not required.  Another significant benefit of shock wave therapy versus surgery is the recovery time is significantly lower, as are the side effects.