If you’ve ever suffered with Plantar Fasciitis you know how excruciating it can be just trying to get out of bed in the morning. Taking that first step can feel like a someone is jamming a hot poker into the bottom of your foot. Most of the time, it gets a little better as you move about, but a nagging pain typically persists . . . All Day Long.
Forget about hiking with your Sweetie, a shopping spree with your girlfriends, or taking your grandkids to the Zoo. Unless you want to see the Zoo in a wheelchair.
If you’ve had foot, arch or heel pain, tried anti-inflammatories, but they DIDN’T work . . . Read on.
I’ll explain why they will NEVER fix the problem and what WILL solve your pain.
Here’s what you’ll learn in this article:
- Why traditional treatments for Plantar Fasciitis usually don’t solve the problem long term
- Plantar Fasciitis is now understood to be Plantar Fasciosis
- Why NSAIDS (non-steroidal anti-inflammatory drugs) and cortisone injections will never resolve Plantar Fasciosis
Janie’s Story . . .
Over a year ago Janie began having heel pain. No injury. She remembers just waking up with it one morning. After daily pain for several weeks, she went to see her doctor. The diagnosis was Plantar Fasciitis.
She was told to “try to stay off it” for a few weeks. (she wondered how she was supposed to do that . . . crutches?). And to “lose some weight.” Sounds like a bit of a conundrum, don’t you think? Lose weight but your exercise options are so limited.
Naproxen, a non-steroidal anti-inflammatory was prescribed. The side effects sounded a bit scary, but she was desperate and willing to take it short term, if it worked. It seemed that the drug eased the pain by about 25%. But Janie was still unable to take her 2 mile morning walks with her dog. And if she stopped the medication, the pain returned, full force. If inflammation was the problem, Janie wondered how she could just wake up one day in such pain. She had been walking at least 2 miles a day since she got her dog 6 years ago with no problems.
Next she tried seeing an orthopedist. X-rays were negative. Basically the same recommendations, rest and a “different” medication. Janie was, perhaps like you, fed up with the “drugs to cover up the pain” approach. So she gave massage and physical therapy a fair try. Both did help somewhat, until she stopped going . . .
After over a year of frustration, she decided to see a podiatrist. The podiatrist fitted her for foot orthotics and suggested a cortisone injection. Janie agreed to the orthotics but was afraid to have the injection in her foot. The orthotics didn’t help at all. Janie felt they may have made her pain a little worse, so she quit wearing them.
Janie says the pain has become unbearable, too intense to ignore. And the 15 pound weight gain isn’t helping her mood or her foot. Even the dog seems moody and looks a little rotund. So she’s ready to submit herself to the injection by the podiatrist. Wendy, a patient of mine is Janie’s sister. Wendy is a retired registered nurse, she knows what’s in store for her sister. Corticosteroids, a strong drug. Delivered via one gargantuan needle. The procedure often causes massive pain. Wendy has seen it performed many times (OUCH) and she is aware of the side effects. So it’s time to bring Janie to our clinic.
Once You Have Plantar Fasciitis, Will it Ever Go Away Permanently?
I’ve seen (and RESOLVED) hundreds of cases of heel pain. It is very common and a story such as Janie’s is typical. Usually by the time patients get to me they are frustrated and tired of recommendations that attempt to patch them up yet don’t solve the problem long term. Or give them their life back. Many people are led to believe that the condition is something that “never really goes away”. They are often told that they will have to give up walking the golf course and quit playing tennis. What? Take up shuffleboard at 49 years old?
If Your Diagnosis is Wrong, You Won’t Get the Right Treatment.
Much of the medical profession does not stay up to date with the latest research. Most doctors are quite busy trying to run their businesses. With the advent of managed care, clinics are cramming in as many patients per hour as possible. Understandable but Unfortunate.
The plantar fascia is a strong, thick connective tissue on the bottom of your foot. The plantar fascia ligament supports the arch of you foot and helps the bones of the foot absorb shock. It turns out that what has historically been thought to be an inflammatory condition (Plantar Fasci-itis, itis means inflamed cells or tissues) is actually a well documented degenerative process. (Plantar Fasci-osis, osis means cell death or necrotic tissue). There are numerous well-accepted, sound, peer-reviewed scientific studies showing that after 2 – 3 weeks of insult to tendons, inflammatory cells are no longer present.
The condition can happen to you if you have a flat foot or a high arch. The most common area of pain is on the sole of the foot near the heel, but pain can occur in the arch or on the inside or outside of the foot near the heel. X-rays may reveal a heel spur. In fact many of the patients I have treated have heel spurs. It’s unlikely that the spur is the cause of the pain, however. The spur develops from pulling of the plantar fascia on the calcaneus (heel bone).
So What Causes the Fascia to Degenerate?
One of the most common causes is the mis-alignment of the big toe (hallux). The posterior tibial artery supplies blood to the bottom of your foot. This artery passes under a structure called the flexor retinaculum. When the big toe is pulled toward your second toe (what a bunion typically looks like) there is tension in the retinaculum and blood to the sole of the foot may be restricted. This causes the tissues (plantar fascia) to degenerate.
Anti-inflammatory drugs are used for inflamed tissues. They will not regenerate dead tissue. So now you know why NSAIDS drugs and painful cortisone injections will NEVER fix Plantar Fasciosis in the long term.
What Should You Do If You Develop Heel Pain?
It’s fine to give R.I.C.E. a try for a few days or perhaps a week at most. However, for your best outcome, the time to institute the most efficacious treatment is immediately.
Here’s What I Do in The Office:
- IASTM. Instrument Assisted Soft Tissue Manipulation
- TDP Lamp. 33 Minerals, Infra-Red Heat
Here’s What I recommend for at Home Care:
- Personalized Healthy Eating Plan.
- Supplements. Including Curcumin, Omega-3 and others.
2. Rehabilitative Exercises, specific to the individual’s faulty mechanics
3. Correct Toes (toe spacers)
4. Recommendations for proper foot wear
http://www.podiatrytoday.com/article/6294 Should You Change Your Approach To Plantar Fasciosis?
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