Heel pain is one of the more common problems affecting the foot and ankle. While there are several different conditions that can cause heel pain, plantar fasciitis is definitely the most common. Traditional and conservative treatments for plantar fasciitis are usually successful; about 90 to 95 percent of people with plantar fasciitis will recover fully with no lasting problems. Most people get better with the right combination of conservative treatments. These include: rest, icing, stretching, night splint stretching (this provides a prolonged stretch of the Achilles tendon and plantar fascia), use of over-the- counter arch supports or custom orthotics when appropriate, physical therapy (including various modalities such as laser light therapy, ultrasound treatment, iontophoresis, soft tissue mobilization, etc.), and cortisone injections are sometimes useful (but are used sparingly). For feet that don’t get better with these methods, a period of immobilization in a walking boot or a cast can help the plantar fascia tissues to heal.
For the unlucky five percent of people suffering from chronic plantar fasciitis that does not improve with conservative treatments, there are some newer advances in treatment approaches that provide some alternative choices. The TOPAZ procedure requires no open incision, and involves the insertion of a thin probe through tiny pin-holes in the skin. The TOPAZ probe is inserted directly into the plantar fascia tissue, and is designed to break up scar tissue and encourage a healing process.
Another minimally invasive option is PRP (platelet-rich plasma) injections, which have increased in popularity lately. Tiger Woods has been accused of receiving PRP injection as an adjunctive procedure to his recent knee surgery. This involves drawing some blood, and spinning it down with a centrifuge system. This produces a very concentrated batch of cells that enhance the healing process. This concentrate is then injected into the desired area of treatment; in this case, it is injected into and around the plantar fascia.
Ultimately, if pain persists and the plantar fasciitis continues to be disabling, surgical intervention can sometimes be used to correct the problem. Using an endoscopic approach with a very small one centimeter incision, a portion of the plantar fascia is released, thereby alleviating the tight tension in this band of tissue. This is done very cautiously, as an over-aggressive fascia release can result in a progressive flattening of the arch.
There are some new, improved techniques in the treatment of chronic plantar fasciitis. Fortunately, these are minimally invasive in most cases, and require minimal downtime. If you are suffering from chronic plantar fasciitis, consider an evaluation and discussion with your physician.
University Foot and Ankle Institute Valencia is located at 26357 McBean Parkway, Suite 250 in Valencia. For more information, please call 661-260-1180.