Diagnostics
In most cases of inflammation of the plantar fascia, conservative therapy is the primary goal. On the one hand, this includes insoles for shoes, which have a recess at the site of the heel spur or the area of origin of the plantar tendon, so that when the foot is put under strain, the load applied at this point is no longer as pronounced as before and this area can recover more easily. On the other hand, ointments are often applied locally, which have an anti-inflammatory and pain-relieving effect.
This can be applied to the inflamed area as required. In addition, depending on the intensity of the pain and the inflammation, an appropriate medication can be given together with a stomach protection prophylaxis to avoid pain peaks in the daily routine and a relieving posture. In addition to this, physical therapy in the form of ultrasound treatment is also possible.
The aim is to promote the healing of the inflammation through certain metabolic processes by means of the heat and vibrations in certain frequencies that are generated in the tissue. This treatment can take place in a physiotherapeutic practice. In addition, targeted stretching exercises of the plantar tendon and a night splint are intended to increase the durability, strengthen the tissue and counteract inflammation caused by excessive strain.
If the conservative therapy does not work, a surgical intervention can be considered. However, this is used extremely rarely, as it is not always sensible and a real improvement sometimes fails to materialize. If surgery is nevertheless indicated, e.g. if the therapy fails to be successful for more than six months, the following can be done: The connection between the plantar fascia and the tuber calcanei can be dissolved, but stability may be compromised.
Furthermore, the heel spur can be reduced. However, it is not normally removed, as this would not bring about any improvement and could possibly damage the plantar tendon unnecessarily. The operation can be performed either open or endoscopically and requires follow-up treatment.
