| By :
Nick Messe
Plantar Fasciitis, commonly known as a heel spur, is a painful irritation of the tendon that connects the heel bone to the toes. This tendon supports the arch of the foot. If it is damaged and becomes inflamed, it causes foot pain when standing or walking. While rest and proper arch support may help in some cases, long term problems require a foot doctor. Causes can include walking, standing or running for long periods on hard surfaces, and shoes that don't fit properly. A lack of flexibility in the achilles tendon or calf muscles can cause problems too. Some people's feet tend to turn inward when walking, and they have flat feet or arches that are too high. Obesity can also contribute to someone developing Plantar Fasciitis. People with plantar fasciitis usually experience foot pain immediately upon standing that eases temporarily after a few steps, then gets worse again as activity continues. Climbing or standing for long periods may make the pain worse. Many podiatrists advise people to avoid excessive exercise on hard surfaces and to get specially designed shoe inserts. Physical therapy such as stretching exercises and weight loss will help, as well as ice packs. Plantar Fasciitis takes time to develop and relief of the pain will also take time. It may take from 6 months to a year for patients to get relief. For those people who do not respond to standard treatments podiatrists may recommend shock wave therapy similar to the treatment used for kidney stones. Extracorporeal shock wave therapy (ESWT) is becoming a common alternative to surgery for the treatment of chronic plantar fasciitis. ESWT delivers a focused shock wave to the area. It works by inducing a trauma to the tissue which initiates a healing response by the body to the new trauma which will also repair the fasciitis. ESWT has been approved by the FDA since 2000 and is considered to be a safe, relatively non-invasive, treatment for chronic plantar fasciitis. There are currently two forms of ESWT being used, a low-energy and a high energy method. Low-energy ESWT treatments consist of three or more sessions. There is little or no pain associated with low-energy treatments. High-energy ESWT treatments can be very painful and usually require the administration of anesthesia. This may be a local block or a twilight general anesthesia. A Podiatrist is necessary for treatment of chronic plantar fasciitis. In such cases, simple rest and anti-inflammatory treatments have failed and surgery would have become the next step in the past. Today, most foot doctors will recommend ESWT instead. It is a good solution to circumvent surgery. It is mostly used after all other treatments have failed. EWST can be an expensive treatment that may not be covered by some insurance companies yet. However, unlike surgery, EWST will allow the patient to return to normal activity within a few days in most cases. It eliminates the possibility of post-surgery complications such as infection.
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