Heel pain is a common foot and ankle problem resulting from many etiologies. Some of the conditions that may result to heel pain includes plantar fasciitis, Achilles or flexor tendonitis/tendonitis, bone spurs, Sever’s disease (mostly in children 8-14 years old), bursitis, stress fractures, inflamed tendons and many other conditions. The focus of this article on plantar fasciitis, causes, and recent approaches in the management of the condition.
Causes of Plantar Fasciitis
The causes of Plantar Fasciitis are multifactorial. Numerous factors such as flatfoot, obesity, advancing age, inappropriate footwear, decrease in ankle dorsiflexion, have been associated with plantar fascia disorders. Accurate diagnosis of Plantar Fasciitis require the use of new and accurate technology which can only be obtained from experts with the right diagnostic tools. Current diagnostic procedures for accurate diagnosis of Plantar Fasciitis includes Magnetic Resonance Imaging (MRI) which enable specialists to determine the extent of stress fracture. Other procedures includes imaging through ultrasonographic examination.
Current therapies for management of Plantar Fasciitis
Plantar Fasciitis is treated using both non-operative and surgical procedures. Operative procedures include Surgery typically includes open plantar fasciotomy, resection of the heel spur (when present), and release of the abductor hallucis fascia. Other approaches includes radiofrequency nerve ablation, and cryosurgery, have shown good clinical results. Extracorporeal shock wave therapy (ESWT) has also been applied in the treatment of some orthopedic disorders and has shown promising results for treatment of Plantar Fasciitis.
Plantar Fasciitis presents a major problem for heel pains. Other methods apart from surgical procedures includes NSAIDS (non steroidal anti-inflammatory drugs, Steroid injection/iontophoresis has shown significant improvement in the short term (1 month) treatment of Plantar Fasciitis. Also, steroid therapy, when coupled with plantar stretching, can provide efficacious pain relief; however, steroid injections should be combined with ultrasound monitoring to reduce complications.