Plantar fasciitis, here is the most suitable therapy

What is the plantar fasciitis? When does it occur? How is it treated? Are there alternatives to surgery? These and other questions are answered by the expert of the CDI (Italian Diagnostic Center).

All of us under the skin of the sole of the foot have a fibro-elastic structure that joins the anterior part of the foot below the toes to the lower edge of the heel. The onset of inflammation in this site determines the appearance of a burning type pain that the patient reports below the heel.

Plantar fasciitis: when does it occur? –

Typical of this pain is its onset in the morning at the first steps which gradually diminishes during the day and then recurs when walking again after sitting for a long time. It can cause real disability when walking due to the intensity of pain that often accompanies this inflammation. It is not a disorder typically related to sporting activities: it also occurs in sedentary people and at all ages.

What are the causes of plantar fasciitis? –

The cause is almost always mechanical due to the presence of a foot support defect characterized by cavity or flatness (pronated foot).These situations result in an abnormal stress that focuses on the insertion of the plantar fascia to the heel. Over time, a thickening of the plantar fascia occurs at its insertion point in the heel which reduces the elasticity of the fascia. To this thickening can be added the appearance of the so-called “calcaneal spur” which consists of a pointed projection of the calcaneus bone in correspondence with the insertion of the plantar fascia.

How is plantar fasciitis diagnosed? –

In order to make an accurate diagnosis, in addition to the orthopedic visit that identifies the typical site of this pain,a radiographic assessment of the foot under load in profile and an ultrasound study of the plantar fascia.

How to cure plantar fasciitis? –

Once diagnosed, the treatment of plantar fasciitis with or without calcaneal spur can be conservative or surgical. The conservative treatment involves the need to create a customized insole that corrects the defect in the support of the foot in order to reduce the stress on the fascia. A cycle of 3 Shockwaves sessions should also be associated with the application of the insole.

Infiltrations and the surgical approach –

In the face of failure, a traditional approach is suggested with cortisone-based infiltrations or in a more modern sense with on-site infiltrations with Platelet Gel (taken extemporaneously through a blood sample from the patient himself through a centrifugation process).In the face of any failure of conservative therapy, the solution can only be surgical. The novelty in this field arises from the use of the percutaneous technique. By means of a small incision of a few millimeters in the sole of the foot with special miniaturized instruments, the lower edge of the heel is reached at the point where the plantar fascia is inserted on the bone. Always percutaneously, the plantar fascia is partially disengaged and in the presence of a calcaneal spur it is eliminated by milling it. By partially detaching its insertion in the heel, the fascia relaxes and therefore by decreasing the tension the local pain ceases.

October 24, 2021 (change October 24, 2021 | 13:46)

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