fasciitis

Self-medication for fasciitis is the wrong choice

Inflammation of the fascia of the sole of the foot

Severe heel pain is quite common, limits mobility and causes significant discomfort. Often this pain is caused by plantar fasciitis, a condition that causes bone buildup. To avoid this problem, it is important to see a doctor and undergo diagnostic tests.

Plantar fasciitis is an inflammation of the plantar fascia, the connective tissue that supports the arch of the foot. It is not caused by bacteria and is caused by frequent overuse of the fascia. The pain syndrome is limited to the heel and sole of the foot and worsens with the first steps after prolonged rest. In most cases, plantar fasciitis forms on the posterior or inferior surface of the heel bone, resembling a spur. It most commonly occurs in people over 40 years of age, with women being more susceptible than men.

causes

The only proven cause of plantar fasciitis is occasional microtrauma caused by careless foot movements. Several factors can increase the likelihood of dystrophic changes in the plantar area:

– overweight;
– to be female;
– Standing or walking on hard surfaces for a long time;
– wearing shoes without instep (slippers, flip-flops);
– stagnation of blood circulation in the lower limbs;
– flat feet;
– Frequent heavy lifting.

Plantar fasciitis is commonly diagnosed in dancers, professional athletes, and runners.

species

Depending on the position of the knot, a distinction is made between:

– cranial fasciitis;
- intravascular fasciitis;
– related forms of fasciitis and myositis.

– nodular fasciitis;
– infiltrative fasciitis;
– Pseudosarcoid fibromatosis;
– nodular fasciitis
- proliferative fasciitis;
– Pseudosarcomatous dermatofibroma.

causes

Nodular fasciitis occurs when fatty tissue bulges through the deep fascia. Until recently, this pathology was considered a reactive process with unclear etiology. However, recent studies indicate that it is a clonal neoplastic process that is usually self-limiting.

- Subcutaneous growth over a short period of 3-6 weeks;
– spontaneous regression;
– Lesion usually reaches 3 cm in size.

When nodular fasciitis develops in the buttocks, some tissue tension is possible.

diagnosis

• Focused Shock Wave Therapy (UWHT) using a device directed at the site of greatest pain – 6 sessions, one every 4 days;
• Phonophoresis with hydrocortisone ointment on the entire heel – 10 sessions, one per day;
• Magneto-Laser Therapy – 10 sessions, one per day;
• Paraffin ozokerite applications on the feet – daily for 10 days;
• Anti-inflammatory ointment on left heel – twice daily;
• Individual orthopedic insoles;
• Restriction of physical activity during the treatment period.

After the first UVTF session, the patient noticed that the pain increased, but after the second session it had already decreased. After the third UWTF session, the woman was fitted with custom-made orthotics that allowed her to walk without pain.

At the last UWTF session the pain was gone. She said she was pain free in the morning too. She is happy with the results of this treatment.

Conclusions

A heel spur is a complication of another condition that causes heel pain. It is most commonly caused by inflammation of the plantar tendon or fascia. The most common causes are obesity, excessive physical activity, uncomfortable footwear (slippers, slippers, sneakers, etc.), orthopedic foot deformities (flat feet, club feet), foot and ankle injuries, hormonal changes (pregnancy, breastfeeding, menopause, etc.).

This clinical case proves that treating foot pain with flat feet alone is not a good idea. Physiotherapy is a quick and effective treatment for plantar spurs, and custom-made insoles compensate for flat feet and allow for permanent remission of symptoms.

prevention

To prevent plantar fasciitis from recurring, it is important to eliminate the biomechanical cause that led to the initial appearance of the condition. The patient may need to monitor their weight and/or follow the following recommendations:

• Wear high-quality footwear with custom-fitted insoles. Do not wear worn-out sports shoes. If you run, change your running shoes every 1,000 km.
• Practice self-massage – simple exercises using your own body weight and a small ball.
• Don't skip the warm-up before training, warm up your feet.

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Conclusions

So, the treatment strategy directly depends on the specific type of fasciitis and the peculiarities of the course of the disease. Our clinic has an impressive arsenal of techniques and treatment approaches.

In recent years we have successfully used shock wave therapy as one of the most effective methods in combination therapy.

Using shockwave therapy for fasciitis avoids hormone injections and surgery, which have serious side effects. Most patients notice results immediately after the first shockwave therapy session. Complete treatment is characterized by long-term side effects.

What is the disease?

The condition is better known as 'heel spurs'. However, the actual 'spur' or heel growth is a result of inflammatory and degenerative processes in the foot. Inflammation occurs when the heel fascia, which connects the toes to the heel, suffers a micro-tear.

The affected person feels a burning sensation when leaning on their heel, especially immediately after waking up. The pain occurs on the inside of the ankle, in the arch of the foot, during mechanical stress. Unlike ankle osteoarthritis, plantar fasciitis causes swelling of the ankle and inflammation of the Achilles tendon.

Plantar fasciitis makes every step difficult.

Who is at risk?

Not surprisingly, the risk group for osteoarthritis is the same as those most susceptible to this condition:

• Overweight people (excessive strain has a negative effect on the fascia);
• older people (with age, the fascia loses its elasticity, the metabolism slows down and the tendons and ligaments suffer);
• people with high stance and flat feet;
• People who have to stand on their feet for long periods of time at work;
• Professional athletes (runners and jumpers are at risk not only of post-traumatic arthritis, but also of fascial inflammation due to constant microtrauma);
• People diagnosed with hip or knee osteoarthritis or spinal diseases (in this condition the load on the foot is uneven).

Professional athletes are at risk from numerous joint diseases.

symptoms

The onset of plantar fasciitis is gradual. Over time, symptoms gradually worsen, usually over several weeks or months. The symptoms, which primarily include pain in the heel, initially only occur during physical exertion and then also occur in the morning when getting up and at rest. Patients usually report a burning or pulling pain under the foot or in the heel area. Sometimes they lead to difficulty walking.

Plantar fasciitis is usually caused by overloading of the longitudinal fascia. It often develops in connection with sporting activities, especially running or jumping. Plantar fasciitis occurs particularly frequently in the fourth and fifth decades of life, which is probably related to age-related wear and tear. Plantar fasciitis affects around ten percent of all athletes who participate in running sports. Other high-risk sports include basketball, tennis, football and dancing. However, there is no connection between the duration of the stress and the frequency of the symptoms.

If the fascia at the attachment point (insertion tendinopathy) becomes inflamed due to overloading, corresponding symptoms occur. Overloading occurs, for example, due to a shortening of the Achilles tendon. Inflammation of the bursa (bursitis) in the attachment area of the plantar fascia also causes pain in this area.

In addition, plantar fasciitis can also be caused by injuries. Even the smallest injuries sometimes cause damage to collagen fibers, leading to chronic inflammation.

Since plantar fasciitis is usually caused by overstretching of the untrained muscles and the associated tendons, doctors advise athletes in particular to always warm up their muscles well before exercising. Stretched muscles and tendons are less susceptible to inflammation or tears. Stretching exercises before and after exercise are helpful as a preventive measure. The same applies to activities that involve a lot of running or jumping - be it at work or in your free time.

How is plantar fasciitis treated?

Plantar fasciitis is one of the most difficult and unpleasant sports injuries to treat. Although there are many conservative and surgical treatment options, plantar fasciitis is more likely - in up to 20 percent of cases - to develop into a chronic condition.

To reduce the inflammation and pain of plantar fasciitis, treatment initially consists of alleviating or correcting the exercise regime.

Conservative treatments are effective for the majority of patients with plantar fasciitis and recovery is possible in 80-90 percent of cases. However, the course of the disease or the treatment process is often lengthy and lasts one to two years. Doctors advise athletes to severely limit their workload during this time. After surgery, about nine out of ten patients, including athletes, report an 80 percent improvement in their condition.

diagnosis

In most cases, the diagnosis is made on the basis of a clinical examination of the patient, that is, based on the subjective and physical symptoms.

Instrumental diagnosis is rarely required. It is necessary when the diagnosis is difficult to make or when the doctor needs to differentiate plantar fasciitis from other diseases.

The aponeurosis can be visualized using ultrasound or MRI. The main symptom is a thickening of the soleus tendon from normally 2-4 mm to 6-10 mm in the case of a heel spur. Ultrasound and MRI are also used to rule out other pathologies that cause heel pain.

Treatment of plantar fasciitis

In most cases, the treatment of plantar fasciitis is conservative. The following techniques are used:

Modification of physical activity. Reducing physical activity, even without treatment, leads to pain relief within 6 months.

NSAIDS. Pain medications. Contribute to pain relief, but have no influence on the long-term prognosis.

Therapeutic exercises (LFK). The exercises are designed to stretch the plantar fascia. They eliminate functional risk factors for heel spurs, such as: B. weakness of the short foot muscles or a strain of the Achilles tendon. The patient squats against the wall and walks up and down the stairs, placing only the front foot on the step.

Footwear. A stiff sole with a thickness of at least 5 mm and a heel of 2-3 cm is required. Changing footwear is particularly important for patients who are on their feet for long periods of time. Tight, worn, oversized, or uncomfortable shoes worsen plantar fasciitis symptoms.

Insole. Only custom-made insoles, not factory-made ones, are effective. Insoles are incorporated into the feet. They support the longitudinal arch of the foot and keep the plantar aponeurosis in a stretched state. This is a pathogenic procedure that reduces tension at the insertion site of the heel bone. Orthotics are more effective than insoles. They not only reduce symptoms, but also promote the patient's recovery (the aponeurosis gradually rebuilds itself).

Kinesio taping. A bandage (self-adhesive rubber band) is placed around the foot to limit the mobility of the arch and lengthen the fascia during the second phase of the step (when the foot rolls). This method is effective, but uncomfortable for the patient, and the bandage must be changed regularly. Therefore, it is mainly used as a temporary measure: to improve symptoms while waiting for the insoles.

Treatment methods for plantar fasciitis

This disease cannot be left untreated - even if the pain subsides for a while, it later returns with increased force. Therefore, the causes of the disease must first be eliminated: reduce stress (including weight-related), avoid high heels and tight shoes, and buy comfortable shoes with padded soles. The inflammatory process should then be eliminated. There are several ways to treat plantar fasciitis. In each case, the therapy is selected by the doctor. As a rule, the treatment is comprehensive.

First and foremost, it is necessary to relieve the pressure on the foot when walking. This is done with special footbeds and orthoses. Night splints – orthopedic devices in the form of a plastic shoe – can be an effective method, especially if the condition is not neglected. They are worn while sleeping. These devices (orthoses) prevent severe pain when standing up. Special exercises that stretch the foot muscles and exercise the calf muscles may also provide some relief.

Physiotherapy is an effective method. Doctors usually prescribe massages, heat massages, mineral water baths and mud packs. In complicated cases, treatment with ultrasound, low-intensity laser therapy and radiation therapy is indicated. Topical corticosteroids such as dipropane or flosterone are also sometimes administered.

If plantar fasciitis is complicated by a large heel spur, shock wave therapy (SWT) is prescribed. With this method, the affected area is irradiated with sound waves of the appropriate frequency generated by a special device. This treatment destroys the growths (dehydrates them) and begins the regeneration process of the surrounding tissue. The procedure is virtually painless and has recently become increasingly popular in orthopedics.

UHT treatment for plantar fasciitis is available at any Health Plus Medical Center clinic. The treatment helps to permanently overcome the disease, and a reduction in pain syndrome can be observed already after the first UHT sessions. Patients quickly return to their normal lifestyle.

Prevention of plantar fasciitis

There is no magic bullet for preventing plantar fasciitis. However, if you follow a few basic rules, your risk of developing the disease will be significantly reduced.

• If you decide to do fitness, you should distribute the load evenly across all body systems. A sudden shift from a sedentary lifestyle to an overly active lifestyle can wreak havoc on your fascia.
• Avoid uncomfortable footwear. Do not wear high-heeled shoes - the unnatural position of the foot can lead to injuries to the fascia.
• Watch your weight – excessive weight increases pressure on the foot. Not surprisingly, the diagnosis of plantar fasciitis is often made in overweight people.

Modern medicine can solve many problems, and plantar fasciitis is one of them. You can get rid of them at the Health Plus medical center. The latest Swiss equipment and modern techniques, including UWT, are used there. At the same time, the cost of UHT therapy in the Zdorovye Plus center is among the lowest in Moscow, so this method of treatment is accessible to all segments of the population.

Oleg Petrovich Tatarinov

High-profile doctor, neurologist, physiotherapist, UWT specialist, leading specialist in the Health Plus network.

medical experience above 40 years

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