How does one treat plantar fasciitis?

In the majority of cases, conservative treatment is adequate to cure the condition. Non-surgical treatments include night splints, crutches, specially designed arch supports and physical therapy. Most individuals do require some type of pain medication. If this fails, injection of corticosteroids may help. Recently extracorporeal shock wave therapy has also been found to be helpful in some individuals.

What is role of surgery?

Surgery is extremely rare and never the first choice. If your doctor recommends surgery then you need to get a new doctor. There is no surgical procedure that can help relieve the pain from plantar fasciitis, but you can rest assured, surgery can make your foot worse. The best way to avoid plantar fasciitis is to maintain a healthy weight, wear decent shoes and warm up slowly prior to starting a new exercise program.

What causes plantar fasciitis?

The causes of plantar fasciitis are many. Normally the plantar fascia acts like a shock absorber but if it is exposed to too much tension, the fascia develops small tears. The most common causes include:

Intense Physical activity: Plantar fasciitis is common in athletes such as joggers or long distance runners. Even standing all day or lifting weights can cause stress on the heel.

Arthritis: In some individuals, it is believed that arthritis along the tendon may lead to plantar fasciitis.

Diabetes: For some unknown reason plantar fasciitis is quite common in diabetics

Anatomy: Some individuals with flat foot or a high arch are also prone to developing plantar fasciitis

Poor shoe wear: Shoes that are thin soled or lack arch support increase the chance of developing plantar fasciitis.

Female sex: Females are more likely to have this disorder and it is most likely related to their elegant but uncomfortable shoes or sandals.

The diagnosis of plantar fasciitis involves a physical exam and a radiological test to ensure that one does not have a one spur.

What is plantar fasciitis?

Plantar fasciitis or heel pain is a common medical ailment in millions of individuals. The pain of plantar fasciitis is worse in the morning and burning in nature. As the individual starts to move around in the day time, the pain decreases but may return after long periods of standing or after getting up from a resting or seating position. Most individuals who develop plantar fasciitis are active in sports, middle aged, slightly overweight or pregnant.

What are symptoms of plantar fasciitis?

The classic symptom of plantar fasciitis is pain which comes on gradually. It is a burning pain and often sharp. The pain is often worse the first thing in the morning. In a few individuals, it may be associated with swelling around the heel.

Bunions and Surgery

What is role of surgery?

When all the above non-surgical treatments fail, surgery may be the only other alternative. Surgery involves removal of the swollen tissues and realigning the toe.

However, surgery is not always successful and bunions can recur. Recovery after surgery can take a few weeks and the course is also marked by difficulty in ambulation. Moreover, surgery requires time off from work, there is significant pain afterwards and the results are not guaranteed. More often than not, you will be worse off than what you started off. Finally, a number of orthopedic surgeons who do bunionectomy have poor technical skills. If you do decide to go for surgery, choose your surgeon well. There are no refunds for cock-ups., which are common in bone surgery.

Physical therapy includes wearing splints, ultrasound or whirlpool baths can help soothe the pain and assist in ambulation. There are a variety of splints available and they do help relieve pain. Often shoe inserts can help control abnormal movement of the foot. Shoe inserts can be acquired with or without a prescription

To prevent recurrences one should wear proper shoes and avoid high heels. The best advice for patients with bunions is to rest, limit activity, which worsens the symptoms, and obtain proper shoe wear.

More About Bunions

How is the diagnosis of bunion made?

The diagnosis of a bunion is straightforward. The physical exam is almost always diagnostic but most physicians will obtain x-rays to confirm integrity of the joint and presence of any underlying condition like arthritis or gout. Prior to any surgery, x-rays are essential.

How are bunions treated?

The earlier one seeks treatment, the less the chance of developing joint deformity. The treatment of bunions involves:

Rest and changes of shoes. Wearing wide shoes or sandals may help relieve pressure on the toe joint. There are many shoes, which are specially designed for bunions. One can even pad shoes around the toes to relieve pain and eliminate stress

Wear shoes that are comfortable and have plenty of toe space

The pain of a bunion is easily controlled with over the counter pain medications. Often some people find that applying a cold ice pack can relieve the swelling and joint pain.

In the majority of cases, conservative measures can help relieve the symptoms. However, a few percent of affected individuals find no relief from the above measures and may require alteration in foot care.

Injection of corticosteroids is widely done but only offers temporary relief. Less than 20% of patients with bunions benefit from steroid injections