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Posts for tag: plantar fasciitis

Plantar fasciitis is one of the most common complaints that we see in our practice.  The number of patients known to have the problem is estimated to be between six and seven million.

Many patients attempt to treat the problem at home prior to seeking treatment from a doctor which is fine unless the problem has been present for an extended period of time, usually between 3-6 months. That is when they often learn about Plantar Fasciopathy for the first time.

WHAT’S THE DIFFERENCE BETWEEN PLANTAR FASCIITIS AND PLANTAR FASCIOPATHY?

 

Plantar fasciitis is actually divided into conditions with two different treatment requirements. Acute plantar fasciitis is an inflammatory condition and is associated with irritation and inflammation of the plantar fascia at its insertion on the heel region.

After six months this develops into chronic plantar fasciitis, the problem actually changes and and is referred to as plantar fasciopathy. Plantar fasciopathy is non-inflammatory and there is a lack of blood supply to the region and the body thinks of the problem as being normal. This lack of blood supply results in the body not responding to the condition and therefore a lack of healing potential in the region.

IS PLANTAR FASCIITIS AND PLANTAR FASCIOPATHY TREATED DIFFERENTLY?

Treatment for these two conditions is very different and we would like to educate you on new and improved treatments for chronic plantar fasciopathy.

If plantar fasciitis is treated early and aggressively, it is often not very difficult to treat. Treatment options include stretching, night splints, oral NSAIDS, shoe modifications to a stiffer and stronger sole, added arch support or custom orthotics, physical therapy and cortisone injection therapy.

Chronic plantar fasciopathy, there is NO inflammation present and there is a chronic scar tissue formation in the heel region with the body not responding to the region. The goal of treatment is to INCREASE inflammation and return the body’s blood supply to the region to help with healing.

Typically conservative treatments used for acute plantar fasciitis do not usually work well in these situations.

CHRONIC PLANTAR FASCIOPATHY TREATMENTS

Our common treatments in chronic plantar fasciopathy include aggressive physical therapy with additional custom arch support and shoe modifications. However, in many cases, there is a need for noninvasive and minimally invasive therapy to increase blood to the region.

Treatment options plantar Fasciopathy

Treatment options cause an irritation of the region of the plantar fascia that’s non-responsive and lacking the healing blood supply. This will result in a return of blood to the area and take the chronic condition and make it more acute which can then allow the body to heal the region.

Shockwave Therapy (EPAT)

Shockwave therapy has been around for about 30 years and is basically a small jack hammer that is hitting the heel area and breaking up scar tissue. Much like someone hitting your shoulder over and over with a punch which causes inflammation, the concept of shockwave therapy is to cause minor damage to the region and increase blood supply. It is a treatment that can work well but is somewhat obsolete. The main benefit is that the treatment is fairly simple and does not involve injection or internal treatment.

Platelet Rich Plasma and Amniotic Injections

PRP and amniotic injections are used to bring the patient’s own blood cells and healing cells to the region of chronic injury. Both treatments help recruit cells necessary to heal and have a very strong result in our hands. These treatments work well but can be somewhat painful and moderate to severe cases of scar formation may not respond well to this treatment.

Radio Frequency Ablation (TOPAZ)

There is a group of patients who have such extensive plantar fasciopathy that the PRP and amniotic injection are not strong enough to treat. In such cases, radio frequency ablation was used to break up the scar tissue with a small needle probe. The previous treatments such as Topaz used approximately 20-30 small needle holes made through the skin on the bottom of the foot to break up the scar tissue on the sole of the foot.

 

The Tenjet System for Chronic Plantar Fasciopathy (Our practice is currently researching this new technology and looking at long term studies)

 

The Tenjet system releases a high-power water jet into the region of the plantar fascia scar tissue and damage. The system is used under ultrasound guidance and the water jet which breaks up the scar tissue is connected to suction and the scar tissue is sucked out after it is broken up by the water jet.

WHAT’S THE BEST TREATMENT OPTION FOR CHRONIC PLANTAR FASCIITIS TREATMENT?

The best treatment always depends on the patient and their individual condition. So the first thing we do is separate patients into two distinct groups, those with acute plantar fascia (suffering less than six months) and those that have truly chronic plantar fascia issues.

Acute treatment for Plantar Fascia patients includes:

  • Shoe modification/recommendations
  • Custom Orthotics
  • Physical therapy
  • Tapings
  • Oral NSAIDS
  • Possible steroid injection

In conclusion, if you have been suffering from acute or chronic heel pain then please visit our Sports Podiatrist at Carolina Foot Specialists so that we can figure out the cause of your heel pain and work on solutions to resolve your pain.

Dr. Andrew Saffer-CFS Mount Pleasant 843-654-8250

Dr. Adam Brown-CFS Charleston 843-225-5575

www.carolinafootspecialists.net

Modern-Plantar-Fasciitis-Treatment-Options-Explained

If you have suffered from chronic heel pain and your symptoms have not improved with traditional conservative treatments options then we may have a solution that will cure your heel pain for good.

We are offering a new treatment modality for chronic heel pain called (EPAT) Extracorpeal pulse activation technology. Intense pulse sound waves are introduced into the soft tissues to break up scar tissue and increased blood flow to the injured area. This procedure reduces pain and inflammation as well as stimulates your own bodies healing mechanism. 

The advantages of this procedure are:

1)Painless

2)No down time

3) No anesthesia

4) In office procedure

Typically, the procedures takes 5 minutes and is done weekly for three weeks.

After the treatment you will experience decreased pain and begin to have relief from symptoms which continues to improve over a 3-5 week period.

So, if you experience chronic heel pain make an appointment with our practice to see if you are a candidate for EPAT.

https://www.carolinafootspecialists.net/heel-pain.html

PRP (Platelet Rich Plasma)

Do you suffer from Chronic Heel Pain?

If so Carolina Foot Specialists will begin to offer a minimally invasive option for chronic stubborn plantar fasciitis.

A new state of the art treatment for chronic heel pain that our practice will offer is PRP (Platelet Rich Plasma) injections. The procedure is in the office setting under local anesthesia and involves taking a small amount of blood from the patient, similar to giving blood for a routine test. The vial of blood is subjected to very high speeds in a machine called a centrifuge. A yellow material is obtained containing cells called platelets, that are very abundant with factors that aid in healing. These growth factors are believed to decrease the inflammation causing plantar fasciitis. The platelets from the patient's own blood is injected into the area of pain in the heel. Patients are then fitted for a removable walking boot with light weight bearing to prevent putting excess weight on the heel for one week or less. After that, they advance to sneakers, and although the range of time for pain relief is variable, it can be appreciated as early as 10-14 days.


For more information please contact our office at carolinafootspecialists.net

The vast majority of Heel Pain is caused by a breakdown in the tissue (plantar fascia) that supports the foot.


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Dr. Brown and Dr. Saffer are looking forward about being trained in the latest state of the art diagnosis and treatment of heel pain. They both will be attending a two day regional meeting and will be learning from an innovative national Foot and Ankle surgeon on the latest diagnostic evaluation of chronic heel pain as well as minimally invasives surgically techniques to cure chronic heel pain.

Heel pain is not always plantar fasciits which is very important to understand. A good majority of the time it may be an inflammed ligament but it could be other causes such as a stress fracture, growth plate injury in children, nerve injury, or bone tumor.

Dr. Brown and Dr. Saffer will blog in the next two months to educate our community on various causes of heel pain, conservative treatment options, and newer minimally invasive techniques to help cure chronic cases. They will both discuss the upcoming training and newer state of the art evaluations and treatments for the various forms of heel pain.

Carolina Foot Specialists is passionate about healing foot and ankle pain especially our patient population that suffers from heel pain.