Plantar Fasciitis often causes tenderness, pain and swelling around the heel of the foot. Frequently it is a throbbing searing or piercing pain that is just on the heel of your foot without any tingling or radiation. It might feel like your heel is walking on a stone or you have a bruising heel pain. It can be especially bad when you take your first steps in the morning or after long periods of rest and then generally fades after about 30-45 minutes.
Plantar fascia tenderness worsens toward the end of the day. Plantar fasciitis usually has a slow onset of symptoms that can gradually worsen over time but a recent increase in body weight or activity changes can trigger Plantar Fasciitis.
The diagnosis is usually a clinical diagnosis: pain that is felt with the first steps in the morning is usually considered a strong factor in making the clinical diagnosis of plantar fasciitis.
Do you have Baxter’s Entrapment?
Baxter’s entrapment can present just like chronic Plantar Fasciitis. In fact, clinically it can be impossible to tell them apart. The only way to tell them apart is by an ultrasound guided diagnostic injection. Yet the treatments are completely different.
The vast majority cases of plantar fasciitis resolve within a few months with the correct conservative management (stretching program). But the longer you experience plantar fasciitis pain or delay seeking treatment, the less likely you will improve from conservative treatment.
For mild cases of plantar fasciitis, conservative management is usually effective in controlling the inflammatory process and reversing the damage (without needing any further treatments). In fact, conservative management is often effective in more than 80% of cases of plantar fasciitis, often resolving the pain within a few months.
Conservative treatments include an effective home stretching program, shock wave treatment, orthotics, ice massage, deep massage, night splints and medications.
One of the most effective treatments for plantar fasciitis is Shock Wave Treatment. We use a type of shock wave treatment called Extracorporeal Pulse Activation Technology or EPAT® which has been shown to be very effective when used in plantar fasciitis. Extracorporeal Pulse Activation Technology uses high frequency sound waves that are directed at the most tender part of the heel to promote healing. It is estimated that extracorporeal shock wave therapy is effective in resolving more than 70% of cases of persistent plantar fasciitis pain. Recent studies have shown that patients with heel spurs, edema or high pain scores respond better to EPAT®. EPAT® offers fast recovery allowing you to resume your daily living activities quickly.
For more chronic cases of plantar fasciitis, we recommend Platelet Rich Plasma treatment.
Platelet rich plasma (PRP) treatment is the injection of the patient’s own platelets to jumpstart the healing process for soft tissue injuries such as injured tendons, ligaments, muscles, joints and plantar fasciitis. The use of platelet-rich plasma injections for plantar fasciitis is relatively new.
Recent studies have shown platelet-rich plasma injections to be effective in treating Plantar Fasciitis. Platelet activation plays a key role in the process of wound and soft tissue healing, especially when inflammation is present. Concentrated activated platelets are injected into the abnormal tissue, causing a local inflammatory reaction which releases growth factors that stimulate healing, tissue regeneration and accelerate recovery. The activated platelets also increase local blood flow to assist in the treatment of a chronic injury and induce a breakdown of scar tissue, which may have been produced by the chronic inflammatory response.
Although Orthobiologic Cell Therapy is considered by some people to be experimental, various research studies show that some marrow aspirate concentrate and platelet rich plasma injections may provide excellent relief from joint and musculoskeletal pain and ongoing inflammation.