PLANTAR FASCIITIS
What is Plantar fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia which
is a layer of dense connective tissue that begins on the heel bone
(calcaneus) and attaches to the base of each of the toes. Tight
calf muscles and high arched or flat feet are common attributable
factors. Pain in the heel whilst weight bearing is the main
presenting symptom. First few steps out of bed in the morning
causing pain in the heel is characteristic.
What are the treatment options?
- Orthoses or soft cushioned insoles
- Exercises to stretch your Achilles tendon and plantar
fascia
- Injection of a mixture of steroid and local anaesthetic into
the heel is effective.
Extra Corporeal Shockwave Treatment
Extra Corporeal Sound Wave Treatment (ESWT) is commonly used for
the treatment of soft tissue and bone disorders. Since last decade,
ESWT has been used for the treatment of painful tendonitis (tennis
elbow), plantar fasciitis (heel spur)
Equipment
The equipment used to deliver ESWT is highly advanced and is
been approved by NICE (National Institute of Clinical
excellence).
Mechanism of Action
The exact mechanism is not fully known. The Sound Waves are
focused on the target area. It is believed that micro-trauma caused
by the sound waves will increase blood supply to the area and heal
the inflamed area.
Treatment
The exact area of pain is identified, the computer is then set
to deliver high energy sonic pulses at a pre-determined intensity
level. The treatment lasts for 5-10 mins each sitting. It is
recommended to have 3 to 5 treatments at a weekly interval.
Recovery
Following the procedure, patients are asked to take rest for few
hours and use ice packs in the treated area. Within 24 hours the
patient is allowed to resume normal activities. Significant pain
relief was noted by 60-70% of the patients following the procedure
in 3 weeks. No immobilization is required.
Results
Clinical studies have shown a 60-70% success rate while using
ESWT to treat plantar fasciitis and other tendon problems involving
the foot and ankle. Using a VAS 0-10 (Visual Analogue Score 0 being
no pain and 10 being worst pain) 70% of patients treated have had a
reduction by at least 5 for their painful condition. No patients
have been made worse and no patients have developed complications
from the ESWT. Full clinical benefits are realized in 2-3 months
following the treatment.