Plantar fasciitis is a disease that evolves favorably in most cases. About 90% of patients improve significantly in the first two months of treatment. However, it may take a long time for the symptoms to disappear permanently, in some cases up to a year. Unfortunately, in some cases, the pain can become chronic, especially if adequate treatment measures are not adopted.
Learn, how insoles treat plantar fasciitis foot pain
Plantar fasciitis – treatment
The treatment for plantar fasciitis should be performed by an orthopedic doctor after diagnosis. As we will see below, many options should be adapted individually to the patient in question. It is important not to give up treatments to avoid future complications, namely, heel pain whenever you do a load while walking.
The first-line treatment goes through changes in lifestyle. In thecase of obesity, the patient should lose weight to reduce the pressure exerted on the joint. If the patient does some physical activity, exercise should be restricted. Rest and limitation of physical contact with the soil should be performed. If there is no pain, the gradual return to physical activity can be resumed after 4 to 6 weeks of rest. In the acute phase, you should not force the walk. However, after the acute phase, the walk is beneficial.
The use of an orthopedic insole (“heel” or “heel cushion” in silicone or other material) allows the load to be distributed during the ride and thus ease the complaints. These orthopedic insoles can be easily purchased from pharmacies and specialty stores (orthopedic supplies).
The use of a “ walker boot ” developed to allow a better distribution of loads during walking can be a good option to use in the acute stages, allowing for relief of complaints. The use of a splint or nocturnal orthosis also contributes to the relief of pain.
The physical therapy through exercises specific stretching fascia of the plantar and Achilles tendon arean excellent option in the treatment. Physiotherapeutic treatment should preferably be performed with activities that allow the stretching (or stretching) of the plantar fascia and the gastrocnemius-soleus.
In situations of chronic heel pain (> 6 months) refractory to other methods of conservative treatment, shock wave therapy may be associated.
The prescription drugs (or drug) anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen, a rule in tablets or anti-inflammatory ointment allow relieve pain and reduce inflammation of the plantar fascia.
The patient should always take this medication as indicated on the prescription. Drug treatment may also, in more severe cases, include corticosteroid foot infiltration (dexamethasone or methylprednisolone or beclomethasone + lidocaine).
As a home or natural treatment, you can dostretchingexercises. Two simple exercises to relieve pain can be performed using a simple tennis ball and a towel. To do this, roll the foot over the ball and force the dorsiflexion (pull the foot up) with the help of the towel. In relieving the inflammation, it may be helpful to move the foot over a bottle of frozen water for 10 to 15 minutes. See pictures.
In the acute phase, applying ice (cold) two to three times a day directly to the heel for 5 to 10 minutes also helps relieve complaints. Note, however, that the application of ice in the non-acute phases does not bring relief, and in this case, it should apply heat (hot water, for example) that helps in relaxation of the muscles and fascia.
Shoes should be worn with a sole that allows shocks to be cushioned, as a rule, soft soles that allow better absorption of impacts with the ground. That is, you should avoid wearing shoes or tennis shoes that have a rigid sole. You should avoid walking barefoot, especially during the morning.
The patient should never under any circumstances self-medicate under penalty of worsening the clinical condition and should follow all the recommendations of the orthopedic doctor.
Should the above measures fail, what is rare should be considered as surgical treatment, as we shall see below.
Plantar fasciitis – surgery
The surgical (or operation) in the plantar fasciitis should be considered only in case of failure in conservative treatment, which occurs in about 5% of patients.
Surgery, called plantar fasciotomy, involves the release of 30 to 50% of the fascia fibers. The estimated success rate is between 70 and 80%, being superior in situations in which the release of gastrocnemius is associated.
This technique is indicated in situations of chronic pain (> 9 months) refractory to conservative treatment. Open surgery (if associated tarsal tunnel syndrome) or arthroscopy can be performed with equal effectiveness, allowing the latter a faster recovery.