Help for Plantar Fasciitis When your first few steps out of bed in the morning or after sitting a while cause severe pain in the heel of your foot, you may have plantar fasciitis (fashee- EYE-tiss). It's an overuse injury affecting the sole or flexor surface (plantar) of the foot. A diagnosis of plantar fasciitis means you have many microscopic tears in the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes. Sometimes plantar fasciitis is called "heel spurs", but this is not always accurate, since bony growths on the heel may or may not be a factor. Bone spurs themselves usually do not cause symptoms What causes plantar fasciitis?
The cause is usually some combination of tightness of the foot and the calf, weakness of the foot, change in arch, improper athletic training or stress on the arch of the foot. Also, too much use (running too far, too fast, too soon), shoes that don't fit, or certain play or work actions can hurt the plantar fascia.
How is plantar fasciitis treated? Rest is the first treatment for plantar fasciitis. Try to keep weight off your foot until the inflammation goes away.
Icing your heel after exercising, stretching, strengthening and working can help prevent inflammation.
Apply ice to the sore area for 20 minutes three or four times a day. This can be done with a frozen water bottle, an ice pack, or an ice bath. For an ice bath, fill a shallow pan with water and ice and soak your heel for 10 to 15 minutes. Keep your toes out of the ice water to keep the cold from hurting your toes.
Often your provider will advise non-steroidal anti-inflammatory medication (NSAID) such as ibuprofen (600 – 800 mg three times a day) or naproxen/Aleve (500 mg twice a day).
To decrease the stress on the plantar fascia, you may need to wear shoes with more arch support. You might even need to change the size of shoe you wear. Athletes and active people may need to spend less time doing actions that cause stress, like jogging, jumping or running. You may try purchasing an over-the-counter arch supports with heel cushioning to insert in your shoes. (Use in both shoes, even if just one heel hurts.) A good brand,
recommended by many Sport Medicine providers, is Spenco from Foot Locker, about $30 for the pair of inserts but they can be moved from shoe to shoe. You might need to loosen and remove the thin insert to keep your shoes fitting well. OR use a full length Dr Sholl’s with arch support – not just a heel cup.
If you are overweight, losing weight can help lessen your heel pain. If your job requires standing on a hard surface, use padding on the floor if you can. Keep your work shoes up-to-date.
Stretching --. Massaging your foot across the width of the plantar fascia before getting out of bed often helps lessen the pain from standing. Keep a towel by the side of your bed to loop over your foot and gently pull the toes toward you to avoid the sudden tearing of the fascia when you put your weight down.
Regular calf stretching will help your pain and help prevent future episodes of pain.
As last resort, you can purchase a night splint on the internet that will keep your foot flexed when you sleep to help healing.
Most people make a full recovery with these conservative treatments. If your plantar fasciitis continues after a few months of conservative treatment, a foot specialist may inject your heel with steroidal anti-inflammatory medications (corticosteroid). However, these are done only sparingly; there is a limit to the number of times cortisone may be given and a risk of weakening the muscle, fascia, and tendon tissue.
If you still have symptoms, you may need to wear a positional splint when you sleep. These can be found on-line or at your local pharmacy.
If you have any questions, please call your provider!
Yanceyville Primary Care Kathy Patterson, FNP-C 336-694-6969
GUÍAS DE PRACTICA CLÍNICA DE LA ASOCIACIÓN ESPAÑOLA PRIMERA DE SOCORROS EN ATENCIÓN PRIMARIA DR. JOSÉ GARCÍA SOUSA REVISOR INTERNO PROF. GILBERTO PRATT COMISIÓN DE GUÍAS DE PRÁCTICA CLÍNICA COORDINADORA Dra. Mildred de Lima FICHA TÉCNICA COORDINADORA: Dra. Mildred de Lima Médico Jefe de Registros Médicos. AUTOR: Dr. José García Sousa C
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