Treatment and prevention of plantar fascitis or heel spur

Plantar fascitis of heel spur is a painful condition and is mostly age related, the cause is mainly inflammation of the plantar fascia and there are many risk factor associated namely increased age, obesity and faulty foot wear. The details of its cause, risk factors and diagnosis is give at Plantar fascia.

Treatment of plantar fascia is often symptomatic and is very tedious to satisfy the patient suffering from it.

Though there are are different modes of treatment which are described below :-

Conservative treatment of plantar fascitis or heel spur

The conservative treatment include local, oral and injectable analgesics, local corticosteroids and in rare case surgery.

Analgesics

In severe pain and in acute stage local ice application may relieve the symptoms, non steroidal analgesics like ibuprofen, diclofenac and now a days aceclofenac may be helpful to get rid of the pain, but these analgesics may cause gastric irritation. Cyclooxygenase II inhibitors like eterocoxib can be used for maintainence or for longer duration more safely.

Local Corticosteroid

Local corticosteroids may reduce the inflammation, thus can be used in acute condition. These may act by process called iontophoresis where local corticosteroids are absorbed by electric current. In severe case corticosteroid may be administered as injection in the fascia to reduce inflammation, but in most case pain in the foot may also be due to diabetes, thus either it should not be preferred or used cautiously, further it may also cause damabe or shrinkage of plantar fascia.

Surgery

In very rare case when the pain is unbearable and all the method fails then surgery is the choice in which the plantar fascia is detached from the tuberosity of calcaneum, but this may lead to instability of the longitudinal arch of the foot.

Newer approach for treatment of plantar fascia

There are now a days various form of arch support, special form of shoes having a cushion at the heel end. Other treatment include-

Extracorporeal shock wave therapy

The treatment is based on therapy by sound wave as used for diagnostic purpose in ultrasonography. Though this is used when other conservative method fails and the condition is not acute, however it is not tolerated well by many patients. Short wave diathermy is another method but rarely used now a days for this purpose.

Arch support

Orthotics or arch support are used in the form of specially designed shoes having a cushion at the heel which helps to distribute the pressure evenly to the sole and thus minimizing wear and tear. Now a days and there are many splints used to support the arch, these are even used at night during sleep and this prevents early morning pain.

Prevention of plantar fascitis or heel spur

In spite of attempting several measures to get rid of this painful condition, many patients doesnt get proper satisfaction, so the best approach is to take measures which can prevent development of plantar fascitis. The preventive measures include

Weight loss, so that the pressure on the heel shuld be minimized.
Proper selection of foot wear which should not be hard at heel end and should be comfortable.

Though many doctors dont prescribe exercise but mild walking specially early in the morning on wet grass has been effective in some patients.

Thus preventive measure is the best.
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