Symptoms
Plantar fasciitis manifests itself as foot pain on the sole of the foot in the lower (plantar) area of the heel, which occurs mainly in the morning with the first steps after getting up or after rest. The pain may also occur during the day and when weight is applied, for example, when standing for a long time. Because posture and movements are adjusted due to the pain, other discomforts may occur, for example, in the legs or back. Plantar fasciitis is unpleasant, is characterized by a long duration of the disease and can limit daily activities at work and during leisure time. It is one of the most common causes of heel pain.
Causes
Plantar fasciitis is a degenerative disease of the plantar aponeurosis. This is a subcutaneous and tight band of connective tissue that runs from the heel bone to the toes, connecting the bones and supporting the arch of the foot. The condition results from overuse of the feet. An inflammatory reaction does not appear to be involved, similar to tendon disorders, so it is less commonly referred to as plantar fasciosis. A heel spur can occur, but is not considered causative and it does not require surgical removal. Risk factors include:
- Standing occupations, e.g., salespersons, industrial workers, health care workers (e.g., pharmacists, pharmaceutical assistants), teachers
- Overweight
- Athletes, for example, in running sports, such as athletics or jogging.
- Hard shoes, business shoes
- Anatomy: flat foot, hollow foot, shortened calf muscles.
- Walking barefoot
- Hard ground
- Carry weight, e.g. backpack, tools, children.
Diagnosis
Diagnosis is made in medical treatment based on patient history and with physical examination. Imaging procedures are usually not required. Numerous other causes of foot pain must be excluded in the process. The associated specialist discipline is orthopedics.
Nonpharmacologic treatment
Plantar fasciitis is usually treated conservatively (without surgery). Therapy usually takes several months. If possible, the triggers should be influenced:
- Protecting the feet with various measures.
- Cold or heat treatment
- Good, soft, springy footwear or shoe inserts (soles).
- Stretching exercises (stretching exercises), Strasburg stocking.
- Physiotherapy
- Foot massage
- Taping
- Reduce excess weight
- Night bed rails
- Do not go barefoot
Drug treatment
Pain medication:
- Such as the NSAIDs or acetaminophen can be taken for short-term treatment of pain if there are no contraindications. Longer-term NSAID therapy is not indicated because of adverse effects.
Local treatment:
- For example, with a diclofenac gel, comfrey ointments or preparations with essential oils.
Glucocorticoids:
- Glucocorticoids are analgesic and anti-inflammatory and are injected locally into the tissues. Due to adverse effects, repeated doses are not recommended.
Botulinum toxin:
- Injection into the calf muscles to slightly reduce tone.