5 Questions Guide Relief From Plantar Fasciitis Pain

Posted by Texas Foot Surgeons on Apr 18, 2018 10:16:16 AM

Non-surgical Options That Can Resolve Chronic Plantar Fasciitis Pain

Plantar fasciitis most frequent area of pain

Dr. Eric Pack Explains, "Plantar Fasciitis is a very common inflammatory reaction of the plantar fascia ligament which occurs from inadequate arch support. If your plantar fascia pain has lasted longer than eight weeks, ask yourself these 5 questions. The answers could uncover problems with your treatment."

5 Questions to Ask About Your Plantar Fasciitis Treatment

Plantar fasciitis arch pain and heel pain develop when the plantar fascia of your foot (the fibrous band of connective tissue that extends from your heel to your toes) becomes inflamed.

The plantar fascia becomes inflamed when,

  • its stretched beyond capacity because  the foot isn't getting the proper arch support, or
  • more pressure is placed on the arch than it is built to bear due to overuse or obesity.

Once micro tears occur in the plantar fascia, and the abnormal pressure on this ligament continues, it won't heal on its own and further complications develop.

1.  Has x-ray shown diagnosis of heel spur?

 Left untreated plantar fasciitis creates a bony growth, or heel spur, due to the excessive tension at the insertion point of the plantar fascia on the underside of your heel bone.  Heel spur pain is caused by the plantar fascia ligament pulling excessively on the heel spur due to inadequate arch support.

Heel pain heel spur


2.  Have you been diagnosed with Baxter's nerve entrapment?

Untreated plantar fasciitis can also cause entrapment of the medial and lateral plantar nerves and, or Baxter's nerve.  Baxter's nerve entrapment occurs when the plantar fascia becomes thickened from continued inflammation and compresses the nerve.  Neurological symptoms of Baxter's nerve entrapment include electrical tingling, burning, shooting, radiating type pain from the heel into the arch.


Heel Pain Compressed Nerve

3. Have you been diagnosed with medial or lateral plantar nerve entrapment?

Uncorrected excessive pronation cause the deep myofascial band of the abductor hallucis muscle to become tight up against the calcaneous bone (heel bone) and subsequently, the medial and lateral plantar nerves become compressed and painful.

Pronation supination view


4.  Have all potential causes of continuing plantar fascia pain been investigated and addressed?

The above sequence of progressive conditions associated with untreated plantar fasciitis or  the misdiagnosis of any one of these three conditions can be the cause of chronic arch or heel pain. 

Once pain and inflammation have resolved, conservative treatment modalities, particularly custom made orthotics and stretching exercises, are more effective with maintaining proper foot biomechanics and arch support for long term resolution of your foot pain.

5.  If  all footwear you use do not offer arch support needed to offload stress on your damaged plantar fascia, are you wearing orthotics for your foot type that can be used interchangeably in most footwear?

Patients with prescribed protocol of conservative treatment along with ultrasound guided corticosteriod injection therapy have reported they are pleased with results, statistically 95% of patients avoiding surgical intervention.  Successful long-term outcomes for these patients were dependent on a thorough diagnostic workup and strong compliance with utilizing proper arch support for their foot type, avoiding re-injury of the plantar fascia ligament.


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Topics: Plantar Fasciitis, Heel Pain, Arch Pain

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