Plantar fasciitis: photos, symptoms and treatment. What is plantar fasciitis: symptoms and treatment of the pathological process of the musculoskeletal system

Many people know first-hand what plantar fasciitis is - popularly this pathology is called a “heel spur.” This disease develops due to overstrain of the ligament that lines the inner side pits of the foot. This ligament connects the heel bone and metatarsal bones, creating the arch of the foot necessary for stability while walking.

Plantar fasciitis, or plantar fasciitis, is an inflammatory phenomenon. It is initially localized in the area of the heel bone, and over time, deformation changes occur at the site of the lesion with tissue compaction and the appearance of a bone protrusion due to the deposition of salts in this place, which is popularly called a heel spur.

Note that this fascia of the foot is one of the strongest in the human body, therefore inflammatory processes in it lead to gait disturbances, including the development of permanent lameness. In addition, a person with this pathology experiences severe pain while walking, and subsequently at rest.

Causes

Most often, this disease affects elderly people, since its main cause lies in prolonged and excessive overload of the ligament. Also, some people have a professional predisposition to such a pathology, for example, athletes and people in the ballet profession.

The main reasons under the influence of which first inflammatory changes and then degenerative changes occur in the fascia of the foot are:

excess weight (and, as a result, excessive load on the feet);
long wearing high-heeled shoes, as well as tight and uncomfortable shoes;
inflammatory and degenerative joint diseases;
and other gait disorders;
blood supply disturbance lower limbs due to a disease such as obliterating atherosclerosis.

Treatment of this disease begins with establishing the cause of its appearance, since “” itself is a consequence of inflammatory-degenerative changes in the fascia, and trying to treat it various methods, including folk ones, you may not get results. By influencing the cause of the pathology, it is possible to quite successfully treat it, moreover, using conservative methods.

Clinical manifestations

The symptoms of a disease such as plantar fasciitis are pronounced, so it is usually not difficult to make a diagnosis. The main symptom is pain, which:

worsens with prolonged walking;
occurs when trying to step on the heel in the morning, and by the evening it becomes so strong that it forces the person to use a cane or crutches;
localized in the back of the foot, but radiates to the toes and calf muscles;
has a sharp character, as if a person stepped on some cutting object.

Of course, there are other symptoms of this disease that are not so obvious, but allow the doctor to get a complete picture of the cause of the pathology in a person. In particular, these are symptoms such as:

development of foot deformation with the formation of contractures, which occurs due to shortening of the fascia and a decrease in its mobility;
cramps in the area calf muscles, as well as foot muscles, which can occur both at night and in the morning when a person tries to get out of bed after a long period of rest.

It should also be said that the symptoms of a pathology such as plantar fasciitis can be supplemented by visual manifestations. Swelling and hyperemia may be observed in the area of fascial damage skin. The general condition of a person is usually not impaired.

All these symptoms worsen a person's quality of life. And if the disease is not treated promptly, it can lead to disability for the patient.

Diagnosis and treatment

Before starting treatment for the disease, it is necessary to conduct a diagnosis. A person with the symptoms described above should consult an orthopedist or traumatologist. If a person lives in small town where there are no such specialists, complaints should be addressed to a surgeon, who will conduct a visual examination, palpate the foot to determine the location of the pain, and also prescribe an x-ray. In the image you will be able to see bone growths in the heel bone area.

Treatment of a disease such as plantar fasciitis can be conservative or surgical. Fortunately, to surgical methods doctors resort only to extreme cases when conservative methods do not have an effect or when the disease is too advanced. In most cases, within a year, treatment of this disease gives a good result with a complete cure of the patient.

As mentioned above, treatment of a disease must begin with eliminating its cause. In particular, if the cause is excess weight, you need to switch to proper nutrition and add physical activity to your daily routine. If the disease occurs while playing sports, you need to reduce the amount of exercise or completely abandon this type of sports activity and replace it with another.

Sometimes you have to change your profession, for example, if the disease develops due to the fact that a person spends a lot of time on his feet due to the nature of his work. In addition, it is recommended to wear special orthopedic shoes, or use special orthopedic insoles that reduce pressure on the heel.

Treatment also involves the use of plaster splints to fix the leg during sleep, or, in cases of severe deformity, the use of a plaster cast.

Massage of the fascia also gives excellent results, allowing you to eliminate areas of limited mobility and develop the ligament. There is also a certain set of exercises for stretching the extensor muscles of the foot, which makes it possible to improve blood supply in this area and increase the mobility of the fascia. Exercises should be performed daily until recovery for 10 minutes a day, as well as after recovery to prevent relapses of the pathology.

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Diseases with similar symptoms:

Flat feet are a type of deformation of the foot area in which its arches are subject to lowering, resulting in a complete loss of their inherent shock-absorbing and spring functions. Flat feet, the symptoms of which include such basic manifestations as pain in the calf muscles and a feeling of stiffness in them, increased fatigue when walking and standing for long periods of time, increased pain in the legs at the end of the day, etc., is the most common disease affecting the feet.

Arteritis is the name of a group of pathologies in which inflammatory processes occur in blood vessels. Inflammation narrows the lumen blood vessels, because of this, blood flow is disrupted, and these are favorable conditions for the formation of blood clots. When blood flow is disrupted, organs do not receive the required amount of oxygen and nutrients. This leads to the development various diseases. The inflammatory process can occur in any vessel - vein or artery.

Plantar fasciitis is a common cause of heel pain. The disease manifests itself as pain and inflammation in the area of the plantar fascia, which connects the toes to the heel bone. The disease is dangerous because in the absence of adequate treatment A bone growth may form in the heel area, which is commonly called a heel spur. This pathology is very serious, in some cases it has to be removed surgically. Another common complication of plantar fasciitis of the foot is Achilles tendonitis.

Causes and risk factors

With a heavy load on the foot, microtraumas can form in the fascia. Most often, they heal on their own if a person alternates exercise and rest evenly. However, frequent micro-tears and stretching of the fascia lead to its inflammation. The main risk factors that can lead to a disease such as plantar fasciitis are:

Age and gender. Heel fasciitis most often occurs in men over 40 years of age; women get sick a little less often.
Excessive exercise or dancing, during which increased stress occurs on the heel bones and tissues adjacent to them.
Changes in foot biomechanics. If a person suffers from flat feet, unevenly distributed weight causes overload of the fascia.
Excess weight, which additionally loads the foot and deforms the arches.
Professions that require long periods of standing. Factory workers, construction workers, teachers, couriers, postmen and other people who, due to the nature of their work, have to walk or stand a lot, are predisposed to developing plantar fasciitis.
Diseases of the spine, for example, scoliosis, which leads to the body's center of gravity shifting. At the same time, the load on the legs increases, which can cause foot pathology.

Main symptoms

Plantar fasciitis is so severe symptoms, that in most cases only if they are present can the disease be diagnosed. The most common manifestation of the disease is pain in the heel area. They usually appear while walking after sitting for a long time. In addition, the pain is quite noticeable in the morning, when the patient gets to his feet after sleep.

When walking for a long time throughout the day, after standing for a long time and climbing stairs, the pain intensifies significantly, and in the evening it is quite disturbing. When a heel spur occurs, the pain becomes so sharp that it can be compared to the sensations that a person feels when sharply pricked with sharp objects. Often with plantar fasciitis, hyperthermia and edema may appear.

In this case, especially if the disease affects both legs at once, it is necessary to do an examination to identify concomitant cause(For example, rheumatoid arthritis or gout). Other characteristic symptoms that accompany plantar fasciitis are tingling in the legs while walking, back pain, and in some cases, swelling that occurs as a result of fluid accumulation in the ankle joint and heel area.

Treatment methods

Plantar fasciitis, except in particularly difficult cases, is treated conservatively. Applicable complex therapy, the main task of which is to eliminate the increased load on the feet. It is very important to replace tight and uncomfortable shoes with comfortable ones. If heel pain occurs, it is necessary to limit walking and give your feet a rest. If you have flat feet or, you should purchase orthopedic insoles and special heel pads with recesses in the center.

Also, when treating fasciitis of the sole, it is advisable to wear orthopedic shoes that firmly fix the heel and prevent the sole from falling inward. You can purchase orthoses that are shaped like a boot. They are worn before bed because they hold the foot well at a special angle that stretches the plantar fascia, which helps it heal during the night. The formation of bands and shortening of the fascia is eliminated using massage procedures and special exercises.

Also, when treating plantar fasciitis, it is very important to normalize weight, inflammation, eliminate diseases of the spine and joints, as well as all kinds of disorders in the circulatory system. Treatment of plantar fasciitis is successful using physiotherapy, which consists of warming procedures, laser therapy, and the use of ultrasound. At severe inflammation and significant pain, fasciitis is treated with anti-inflammatory drugs medicines, which contain corticosteroids, for example, Diprospan or Flosteron.

At local treatment The attending physician may recommend the use of “Golden Us” or “Dolobene” ointment or “Fasciitis stop” cream. In particularly severe cases that cannot be cured with conservative methods, applies surgical intervention, which consists of removing bone growth and irreparably modified tissue.

Popular folk treatments

Exists great amount folk remedies and methods that eliminate symptoms and treat this foot pathology quite effectively. However, before using any of them, you should definitely consult with your doctor, who will tell you which one can be used in a particular case.

Plantar fasciitis is treated using concentrated salt baths. To prepare them you need hot water(1 l) dilute salt (2 full tablespoons). The procedure time is 30-40 minutes. After finishing it, you need to wipe your feet dry and put on woolen socks.

In a good way How to treat fasciitis is to use birch buds. An alcohol tincture is prepared from them, which, in addition to the birch buds themselves (50 g), contains medical alcohol(100 g). The product must be infused for at least 3 hours. It is used to make compresses: a bandage soaked in it is applied to the sore heel twice a day (2 hours in the afternoon and evening).

You can try to cure the disease with a bath containing equal amounts of vinegar (9%), vodka and turpentine. All ingredients must be mixed and heated in a water bath. The sore heel should be kept in a container with this solution until it cools completely. Then you need to heat it up again and do the procedure again.

Potatoes will help get rid of the signs of plantar fasciitis. It needs to be cut into small slices and applied to the sore heels, securely secured with a bandage and wearing a woolen sock on top. This compress is usually done at night. If, after removing the bandage in the morning, it is discovered that the plates have turned black, this means that the potato is fighting the disease. Gradually, the pain will begin to subside, and the potato slices will begin to lighten. When treating plantar fasciitis traditional methods it will take a lot of time and patience. However, persistence helped many overcome the disease.

Disease prevention

In order not to fall into the risk zone of plantar fasciitis, it is very important to monitor your weight, because overweight– this is an additional load on the fascia. The choice of shoes must be approached carefully: women should not often wear shoes or boots with too high heels; when choosing a purchase, they should pay attention to shock absorption and supination. Do not get carried away with walking barefoot on a hard surface. Since heavily worn shoes can cause foot pathology, they should be disposed of without regret.

If you feel pain or burning in your legs after an active day at work, you can use a cold compress to relieve such sensations. A bag filled with ice should be applied to the sore spot for 15-20 minutes. Some massage with ice, using a paper cup previously frozen with water. Massage movements performed in the area where discomfort is felt for 3-5 minutes. Doing them regularly will help reduce inflammation and significantly reduce pain. To strengthen the calf muscles, Achilles tendon, and stretch the fascia, it is recommended to perform a set of special exercises.

The process of heel spur formation is complex. The main function of the calcaneal fascia is to support the arch of the foot (longitudinal). When standing, the fascia is under pressure from almost half the weight of a person’s body, that is, it is under constant load for more time. Regular functioning of the fascia is subject to mini-tears, which can heal during the time when a person rests.

But sometimes the tears do not have time to heal, this leads to aseptic inflammation, which is accompanied by pain in the heel. The body begins to react to such deviations in its own way; growths called heel spurs begin to form on the heel.

Causes

With age, the structure of the fascia changes. The fascia becomes less elastic and much thicker. As the disease progresses, the fascia becomes inflamed, especially where it attaches to the heel bone. Inflammation is accompanied by pain and swelling in the heel area.

Over time, a bone exostosis forms in the area of attachment of the calcaneal fascia, which in everyday life is called a heel spur. Inflammation of the plantar fascia sometimes accompanies diseases such as gout or Reiter's disease.

Usually the disease develops without any reason, but sometimes there is a sudden development of symptoms associated, for example, with unusual exercise or a change in everyday shoes. Various foot deformities and excess weight also predispose to the development of plantar fasciitis and heel spurs.

The main reason The disease is a minor injury to the PF.

Signs and symptoms of heel spurs

The most important and basic symptom of a heel spur is pain in the heel.

The patient exhibits concomitant symptoms.

Associated symptoms and signs of heel spurs:

In the first stages of disease progression, the patient experiences pain after prolonged walking or running. When placing weight on the heel, the pain may become more intense.
Feelings of discomfort in the affected area begin to torment the patient, starting in the morning. When moving throughout the day, the pain decreases, but in the evening it resumes again, this occurs as a result of the daily load on the leg. The pain intensifies during periods of changing weather conditions (rain, snow).
Over time, calcium accumulates in the heel area, and the general condition of the body worsens. The pain begins to appear during rest, during sleep. It's hard to even take a step.
The patient's gait changes, this happens at the subconscious level. The patient tries to reduce the load on the leg damaged by the disease. If a spur has formed on both legs, then crutches will be needed; the patient cannot move independently.
It is impossible to see the spur externally, but in advanced cases, swelling (bruising) develops in the wound area, and the patient’s body temperature rises.

Symptoms

Plantar fasciitis has such severe symptoms that in most cases only if they are present can the disease be diagnosed. The most common manifestation of the disease is pain in the heel area. They usually appear while walking after sitting for a long time. In addition, the pain is quite noticeable in the morning, when the patient gets to his feet after sleep.

Most often, a heel spur or plantar fasciitis manifests itself as pain in the area of the tubercle of the heel bone. Pain and swelling are localized more inner surface heels.

Pain syndrome more pronounced in the morning when getting out of bed. Heel spurs or plantar fasciitis typically include morning stiffness and pain when taking your first steps. The pain syndrome can be quite intense and constant. Scientists have found that women get sick more often than men.

It is not uncommon for heel spurs or plantar fasciitis to affect both feet. Among people involved in sports, the disease is often found in track and field athletes and dancers.

The most common signs of the disease include a feeling of stiffness and pain in the heel, which can be either dull or sharp. The disease has such characteristic symptoms that it is simply impossible not to notice it or confuse it with any other disease.

Pain intensifies:

V morning time when the patient begins to take the first steps, getting out of bed;
when climbing stairs;
after standing in one place for a long time;
as a result of intense activity.

Symptoms also appear:

burning sensation when supporting and transferring weight to the heel;
swelling of the ankle and ankle;
pain in the ankles and in the Achilles tendon area.

Painful sensations that provoke plantar fasciitis, often develop slowly over a long period of time. A sick person may experience lameness; he puts more load on the healthy foot, which subsequently cannot withstand such a load and acquires inflammatory process aponeurosis of the sole. There have been situations when both feet suffered from this disease.

The disease is diagnosed using ultrasound of the soft tissues of the foot. But before visiting a doctor, you can identify fasciitis yourself. It is this disease that is indicated by sharp sharp pains in the morning, which gradually weakens, and intensifies again towards night.

Note! The heel begins to hurt if you suddenly stand up after sitting for a long time. And if you press on the area of the arch of the foot, it will turn out to be soft and flabby.

The main symptom of plantar fasciitis is pain in the heel area, and most often one heel is affected. If you don't carry out timely treatment and continue to put stress on your legs, then after a while inflammation may begin on the second leg.

By the way, the disease tends to show symptoms for a long time while in acute condition, but over time, without proper attention and treatment, the pathology can become a chronic condition.

Let's look at the features of fasciitis. Pain in the heel area is more pronounced at the beginning of the load, that is, when getting out of bed, during the first steps after rest.

Doctors even gave this feature a name - “pain of the first step.” Consequently, pain symptoms most often appear in the morning.

When a person “diverges,” symptoms decrease. On early stages the pain goes away completely and does not appear until the person gives heavy load on the leg muscles and heel.

As pain progresses, symptoms may appear throughout the day with sudden movements, long periods of standing or sitting, or may not go away at all, but slightly weaken. In advanced cases, in order to cure the pathology, the patient is prescribed sick leave.

The pain itself manifests itself in the area of the sole of the foot, closer to the heel. In addition to pain, muscle rigidity, burning or, conversely, numbness are observed. IN acute period It becomes difficult for a person to climb stairs and walk for a long time, which affects the quality of life.

Diagnostics

Plantar fasciitis or heel spurs are diagnosed and treated by an orthopedic traumatologist. The diagnosis is made by a doctor after a comprehensive clinical examination and a history of the disease.

In about half of patients with plantar fasciitis, a bone spur (heel spur) is found on the surface of the heel bone.

The heel spur itself is not the cause of pain; it simply accompanies plantar fasciitis.

Magnetic resonance imaging allows you to more clearly see foci of inflammation in the plantar fascia, as well as exclude a number of diseases, which can also manifest as pain in the heel area. Another effective, inexpensive and simple method diagnosis is ultrasound. Ultrasound can accurately visualize thickening of the plantar fascia and confirm the diagnosis.

Inflammation of the plantar fascia begins due to excessive and regular stretching and overload. Therefore, athletes-runners and people who are forced to spend all day on their feet are more susceptible to the development of pathology. Risk factors for fasciitis also include:

overweight;
physiologically high instep of the foot;
presence of flat feet;
wearing inappropriate shoes;
diseases of the joints and blood vessels of the legs.

A surgeon must diagnose and prescribe treatment for plantar fasciitis. Although everyone can suspect these problems themselves. The first sign is morning pain in the legs in the area of the arch of the foot, which decreases in the evening. A doctor can confirm the diagnosis after examining the Achilles tendon and triceps surae muscle.

Note! Patients with plantar fasciitis cannot bend their foot beyond the normal straight position, they are unable to bring it closer to themselves.

The surgeon confirms the assumptions about the disease after examining the foot and palpating the plantar aponeurosis. The most accurate diagnosis is using MRI. In case of pathologies of the plantar aponeurosis, swelling is visible on the photographs. This study also allows you to see hidden fractures, fibroids or Baxter's nerve neuroma, which helps to avoid misdiagnosis.

To begin, the doctor studies the patient's medical history, obtaining information about when the pain began, the area where it is localized, and when it becomes most severe. After this, he collects information about what lifestyle the patient leads, and whether he has anatomical confirmations in the form of thin tendons or flat feet.

Ultimately, ultrasound and radiography, MRI and CT are prescribed to confirm the previously made diagnosis.

Considering all of the above, the risk group includes people 40-70 years old who lead an active lifestyle, most often women. There is also a high risk of getting sick for runners, factory workers, waiters and many other representatives of standing professions.

Treatment for plantar fasciitis is prescribed after comprehensive examination to exclude other pathologies. To make a diagnosis, the doctor studies the nature of the complaints, for which he conducts a survey, performs palpation and examination. To exclude ligament ruptures, the doctor asks you to flex and extend the foot, and also checks the ability to perform other movements.

In order not to make a mistake with the diagnosis, X-ray diagnostics are prescribed to rule out bone fractures. Additionally, magnetic resonance imaging and electromyelography may be needed. In general, imaging tests and interviewing the patient are often sufficient to establish a diagnosis.

If you have difficulty getting to your feet every morning and find it difficult to start walking normally, then it’s too late to talk about ways to prevent this problem. In such a situation, it is important to confirm the disease plantar fasciitis.

Symptoms, prevention and treatment of this problem are the lot of surgeons. You should not engage in self-diagnosis, much less try to alleviate your condition.

Even at the first and isolated symptoms, it is better to visit a specialist.

A surgeon must diagnose and prescribe treatment for plantar fasciitis. Although everyone can suspect these problems themselves.

The first sign is morning pain in the legs in the area of the arch of the foot, which decreases in the evening. A doctor can confirm the diagnosis after examining the Achilles tendon and triceps surae muscle.

Patients with plantar fasciitis cannot bend their foot beyond the normal straight position and are unable to bring it closer to them. The surgeon also confirms assumptions about the disease after examining the foot and palpating the plantar aponeurosis.

The most accurate diagnosis is using MRI. In case of pathologies of the plantar aponeurosis, swelling is visible on the photographs. This study also allows you to see hidden fractures, fibroids or neuromas of the Baxter nerve. This helps avoid misdiagnosis.

Treatment

There are a huge number of folk remedies and methods that eliminate symptoms and treat this foot pathology quite effectively. However, before using any of them, you should definitely consult with your doctor, who will tell you which one can be used in a particular case.

Plantar fasciitis is treated using concentrated salt baths. To prepare them, you need to dilute salt (2 full tablespoons) in hot water (1 l). The procedure time is 30-40 minutes. After finishing it, you need to wipe your feet dry and put on woolen socks.

A good way to treat fasciitis is to use birch buds. An alcohol tincture is prepared from them, which, in addition to the birch buds themselves (50 g), contains medical alcohol (100 g). The product must be infused for at least 3 hours. It is used to make compresses: a bandage soaked in it is applied to the sore heel twice a day (2 hours in the afternoon and evening).

You can try to cure the disease with a bath containing equal amounts of vinegar (9%), vodka and turpentine. All ingredients must be mixed and heated in a water bath. The sore heel should be kept in a container with this solution until it cools completely. Then you need to heat it up again and do the procedure again.

Potatoes will help get rid of the signs of plantar fasciitis. It needs to be cut into small slices and applied to the sore heels, securely secured with a bandage and wearing a woolen sock on top.

This compress is usually done at night. If, after removing the bandage in the morning, it is discovered that the plates have turned black, this means that the potato is fighting the disease.

Gradually, the pain will begin to subside, and the potato slices will begin to lighten. When treating plantar fasciitis with traditional methods, it will take a lot of time and patience.

However, persistence helped many overcome the disease.

A heel spur and its characteristic symptoms can be accompanied by completely different diseases, therefore treatment should be aimed at eliminating both problems. You shouldn’t ignore the symptoms of a spur on the heel, and you shouldn’t self-medicate, as this leads to health problems, and reviews from patients with this disease only confirm this.

Treating heel spurs is not difficult. Treatment does not involve the use surgical intervention, the pain is not caused by the growth itself, but by the inflammatory process occurring in the tissues around the spur.

Large spurs do not cause severe pain to the patient, but small, barely noticeable formations, visible with X-rays, can cause severe pain, making it difficult for a person to even stand on his leg. The main methods of getting rid of unpleasant symptoms heel spur and its treatment are physiotherapeutic procedures, special massage, as well as a variety of orthopedic devices that provide positive influence to unload the foot.

In the early stages of the disease, conservative treatment can be quite effective. Conservative treatment includes resting the foot, painkillers, exercise therapy, orthotics and other devices, and physical therapy.

Local injections of glucocorticoids can also be very effective. Most patients similar treatment brings relief.

If, despite the treatment, pain in the heel area persists for more than 3-4 months, then surgery can be considered.

For heel spurs or plantar fasciitis, a limited fasciotomy can be very effective. The operation consists of partial dissection of the plantar fascia and removal of the spur.

As practice shows, successful treatment foot fasciitis allows every 8 people to get rid of the disease within a year. If the treatment was effective, then in 95% it is possible to eliminate pain in the heel without surgery.

always comprehensive and includes:

The use of painkillers and anti-inflammatory drugs (ibuprofen, naproxen, special ointments, corticosteroids).
Rest. It is necessary to limit or prevent everyday activities that provoke the appearance of painful sensations in the heel.
Gentle walking mode. Put on shoes immediately after getting out of bed, as if you walk barefoot, the pain begins to intensify.
Wearing comfortable shoes. You need to wear models that perfectly absorb shock and have arch-supporting soles. The best option There will be sports shoes, as well as shoes with soft soles.
Physiotherapeutic procedures: laser, ultrasound, thermotherapy, shock wave therapy (for severe spurs);
Massage, performing special exercises. Perform simple calf stretching exercises a couple of times a day, preferably in the morning. Treatment, which includes exercises, is aimed at increasing the flexibility of the ligaments and strengthening the muscles that support the arch of the foot.
The use of orthopedic devices - arch supports, heel clamps, night splints. Overlays help cushion the heel area. You can buy them in many stores that sell sports shoes and pharmacies.
In order to reduce inflammation and relieve pain, ice should be applied to the heel area.

Note! You should not refuse medications prescribed by your doctor if he has confirmed that you have plantar fasciitis. Modern medicines can reduce painful sensations and prevent further development diseases.

For these purposes, the doctor will prescribe special orthopedic insoles and tell you how to do gymnastics. Without following these recommendations, there is no hope for recovery. Also good results are achieved by using special orthopedic splints, which are applied at night. Physiotherapeutic procedures have a good effect.

Fasciitis is best treated topically. For this purpose various

, which are prescribed by the doctor. You can choose them yourself on the advice of a pharmacist at the pharmacy.

Note! One of the most effective means local application Fasciitis stop cream is used in the treatment of plantar fasciitis.

To quickly alleviate the patient's condition, anti-inflammatory drugs are also prescribed. They help quickly relieve the pain caused by plantar fasciitis. Treatment, for which ointment can also be prescribed, is to reduce inflammation and prevent the appearance of micro-tears:

at night you may be advised to apply Ortofen or Cortisone creams to your feet;
the medications Ibuprofen, Diclofenac or Naproxen will ease the condition;
in advanced cases, only corticosteroid injections help, but they only bring temporary relief; over time, the pain may return.

Important! Corticosteroid injections should not be given frequently, as this can lead to rupture of the plantar fascia.

Along with drug treatment, you can try on yourself the methods offered by Alternative medicine. They aim to reduce inflammation and prevent microtears that accompany plantar fasciitis.

The treatment period can take a whole year, and the plantar aponeurosis and Achilles tendon will need to be stretched. To do this, the patient will have to constantly perform special exercises. As an addition, a splint is placed on the foot (at night) to ensure its immobility in neutral dorsiflexion.

You can do gymnastics at home, but you should consult your doctor before doing so.

If you do not start treatment and endure the pain, then it can last up to a year and a half, and periodically subside and reappear. The longer fasciitis is left untreated, the greater the risk of ending up on the operating table. The goal of treatment is aimed at eliminating the inflammatory process and the cause of the pathology.

Regardless of the chosen treatment option, gymnastics for the feet and ankles is mandatory. So, you can do stretching - gymnastics aimed at stretching the muscles of the foot and calf muscles. At home, you should also perform other types of exercise therapy, the exercises for which will be selected by your doctor.

The initial stage of treatment is to provide rest for the legs, you need to reduce the load, apply compresses at least 3 times a day.

A recipe for baths with flaxseed and potato peelings is effective for treating fasciitis. Take 2 handfuls of flax seeds and mix with potato peelings, after which the resulting mixture is poured with half a liter of water and boiled until thickened.

When the porridge has cooled, you need to keep your feet in it for 15-20 minutes. The procedure ends with rinsing the feet. warm water, in this case, the keratinized skin should be scraped off.

You can also use your own recipe from traditional medicine, if there are no contraindications.

Pain can be reduced by prescribing a course of medications. NSAID groups– Diclofenac, Ibuprofen, Meloxicam. Ointments based on NSAIDs. To improve blood supply and reduce inflammation, a course of massage is prescribed, which must be combined with gymnastics.

Conservative techniques

If you take modern techniques treatment, then kinesiological taping is distinguished. The method involves applying an adhesive breathable tape to the heel area. kinesio tape which reduces muscle pain. The essence of the treatment is to stretch the muscles with a tape, which reduces stress and increases the circulation of lymphatic and intercellular fluid, and also stimulates blood supply in the foot.

Here are some popular treatments for plantar fasciitis. A common method of wearing an orthopedic insole is an orthosis.

In order to make them, you need a cast of the leg. The effect of insoles is to reduce pain, improve blood circulation and eliminate inflammation.

If you wish, you can make orthopedic insoles with your own hands using old insoles, cotton balls and a bandage, following the instructions.

Either separately or in combination with insoles, you can use a night splint in the form of a plastic boot. The splint is worn at night and prevents stretching of the plantar fascia. Using this method of treatment, you can reduce pain in the morning. The disadvantages include discomfort during use.

Shock wave therapy is a popular treatment. Also, for severe pain, blockades using hormones and analgesics can be prescribed. In extreme cases, it is necessary to perform an operation in which part of the fascia is excised or other necessary manipulations are performed.

You should not refuse medications prescribed by your doctor if he has confirmed that you have plantar fasciitis. Modern medications can reduce pain and prevent further development of the disease.

For these purposes, the doctor will prescribe special orthopedic insoles and tell you how to do gymnastics. Without following these recommendations, there is no hope for recovery.

The use of special orthopedic splints, which are applied at night, also gives good results. Physiotherapeutic procedures have a good effect.

In many cases, anti-inflammatory drugs cannot be avoided. Doctors often prescribe the drugs Diclofenac or Ibuprofen, or their analogues. If the disease has progressed so far that a person cannot get out of bed on his own in the morning, and conventional medications do not help, then glucocorticoid injections may be prescribed.

To quickly alleviate the patient's condition, anti-inflammatory drugs can also be prescribed. They help quickly relieve the pain caused by plantar fasciitis. Treatment, for which ointment may also be prescribed, is to reduce inflammation and prevent microtears from occurring. At night you may be advised to apply Ortofen or Cortisone creams to your feet.

The medications Ibuprofen, Diclofenac or Naproxen can alleviate the condition. In advanced cases, only corticosteroid injections help. But they only bring temporary relief; over time, the pain may return. Such injections should not be given often, as this can lead to rupture of the plantar fascia.

Physiotherapeutic procedures

Treating plantar fasciitis with painkillers and anti-inflammatory medications alone will not be effective. It should be combined with stretching exercises, proper insoles in shoes and physiotherapeutic procedures.

Shock wave therapy is considered the most effective. It is most often prescribed to people who have chronic plantar fasciitis.

Treatment, in which tablets are used only for temporary relief of the patient’s condition, should lead to stretching of the fascia. But a comprehensive medication and physiotherapeutic approach can quickly get rid of the problem.

In addition, it will prevent future fascial tears, which means the patient will no longer feel pain in the morning.

Ultrasound treatment may also be prescribed. Using this method, the tissues affected by the sensor are well heated. As a result, inflammation decreases and pain subsides.

Preventive measures in the fight against plantar fasciitis

In order not to fall into the risk zone of plantar fasciitis, it is very important to monitor your weight, because extra pounds are an additional load on the fascia. The choice of shoes must be approached carefully: women should not often wear shoes or boots with too high heels; when choosing a purchase, they should pay attention to shock absorption and supination.

Do not get carried away with walking barefoot on a hard surface. Since heavily worn shoes can cause foot pathology, they should be disposed of without regret.

Some massage with ice, using a paper cup previously frozen with water. Massage movements are performed in the area where discomfort is felt for 3-5 minutes.

Doing them regularly will help reduce inflammation and significantly reduce pain. To strengthen the calf muscles, Achilles tendon, and stretch the fascia, it is recommended to perform a set of special exercises.

To avoid heel problems, you should:

regularly change sports shoes (sneakers, for example);
wear shoes with good cushioning in the heel area or arch support;
lose excess weight, if any;
stretch the fascia and Achilles tendon;
Do not jog on hard surfaces.

Plantar fasciitis is a disease that is caused by inflammatory and degenerative changes in the tissues of the plantar fascia and is accompanied by heel pain during exercise.

ICD-10	M72.2
ICD-9	728.71
DiseasesDB	10114
MeSH	D036981
eMedicine	pmr/107
MedlinePlus	007021

Causes

Plantar fascia (plantar aponeurosis) is a dense connective tissue that attaches to the heel bone and phalanges of the toes. Its main function is to form and support the longitudinal arch of the foot. If a person stands, half of his weight puts pressure on the plantar aponeurosis. High load provokes micro-tears in the area that is attached to the heel tubercle.

In many cases, while standing in an upright position (during sleep), injuries regress on their own. But under the influence of unfavorable factors, fascia ruptures recur. As a result, plantar fasciitis develops, the cause of which is constant microtraumatization of the aponeurosis, leading to aseptic tissue inflammation and pain.

Plantar fasciitis of the heel most often affects women over 40 years of age. The following unfavorable factors increase the likelihood of developing the disease:

overweight;
playing sports that place prolonged stress on the heel or Achilles tendon;
flat feet or too high arches;
turning the foot inward while walking;
wearing uncomfortable shoes;
diseases of the musculoskeletal system;
injuries;
gout.

Chronic plantar fasciitis over time can lead to the formation of a heel spur, a bone growth (osteophyte) that occurs as a result of the deposition of calcium salts.

Symptoms

The main symptom of plantar fasciitis is pain in the heel area. Unpleasant sensations arise or intensify with exertion. In the morning they are most pronounced, then gradually subside. This is due to the rupture of the fascia that has grown together during night sleep. In addition, the pain intensifies after a long period of sitting, when a person takes his first steps.

The formation of a heel spur can increase the intensity of the symptoms of plantar fasciitis of the foot as the bony growths put pressure on the surrounding tissue. In many cases, the osteophyte does not manifest itself at all.

Diagnostics

Plantar fasciitis is diagnosed based on an analysis of complaints and examination. In addition, radiography is prescribed, which allows you to detect a heel spur.

During the examination, plantar fasciitis is differentiated from diseases such as:

tarsal tunnel syndrome;
rheumatoid arthritis;
Reiter's syndrome and so on.

Treatment

Treatment for plantar fasciitis is determined by the severity of its symptoms. In mild cases, the main directions of therapy are to ensure unloading of the plantar aponeurosis and eliminate inflammation of the soft tissues.

Unloading of the plantar fascia is achieved by reducing physical activity and periodic rest while walking. The main methods of therapy are gymnastics, taping and the use of special devices for the foot.

The purpose of exercises for fasciitis is to stretch, strengthen and increase the elasticity of the aponeurosis. They must be done every morning after warming up. Regular exercise helps lengthen the plantar fascia. As a result, pain is reduced and future injuries are prevented.

After physical therapy The foot is taped - applying an elastic band (tape) or patch to support the longitudinal arch and fix the aponeurosis. When applying the tape, it is necessary to increase its tension when it bends around the leg from below.

To increase the effectiveness of treatment of plantar fasciitis at home, braces or orthoses are used - devices that fix the foot at a right angle. They are worn all night and do not allow the aponeurosis to shorten. IN daytime Patients with fasciitis are advised to wear orthopedic shoes or insoles with arch support and a depression in the center of the heel.

To relieve tissue inflammation and reduce pain, the following are practiced:

massage;
applying ice;
rubbing with warming and anti-inflammatory drugs;
mud applications;
warm foot baths;
analgesics – ibuprofen, acetylsalicylic acid, naproxen.

How to treat plantar fasciitis in severe cases? For severe discomfort and significant bone growths, the following methods are used:

injection of glucocorticoids into the foot tissue in combination with anesthetics;
shock wave therapy to destroy heel spurs;
laser or ultrasound effect on inflamed tissue.

If ineffective conservative treatment For plantar fasciitis, an operation is performed during which the osteophyte and altered parts of the fascia are removed.

Forecast

Plantar fasciitis has a favorable prognosis. In advanced cases, the course of the disease may worsen due to a fracture of the heel spur.

Prevention

Basic measures to prevent plantar fasciitis:

wearing orthopedic shoes;
adequate physical activity;
maintaining normal weight;
treatment of pathologies of the musculoskeletal system.

Plantar fasciitis is a pathological process of inflammatory origin, localized in the heel area and characterized by severe pain that intensifies with load on the affected leg. The disease occurs in older people and younger people. The prevalence of the disease is low, which is explained by the anatomical protection of the fascia from inflammation. The pathological process must be treated as early as possible, without exacerbating the severity of the disease. Treatment can be carried out at home.

Fascia is a sheath formed by dense connective tissue that covers muscle tissue, tendons, organs and branches - vascular and nervous. Strong connecting formations form reliable cases for these anatomical formations, protecting them from mechanical, physical, and biological damage; perform the function of holding, fixing; provide processes of nutrition, innervation, and performance of functions.

On the foot, fascia is more important than in other parts of the body - in the heel area, the soles are subject to maximum physical stress during walking and running. Because of increased loads in the area of the feet, the fascia is thickened and is called -. Its maximum thickness is in the middle part of the foot; towards the periphery, there is a tendency for the fascial sheath to become thinner. The fascia is attached to the metatarsal bones I and V, and from the other end to the bones of the midfoot. The aponeurosis has small openings through which the relationship between subcutaneous tissue, vessels and contents of the fascia.

Causes of fasciitis

Fascia is an element of a protective mechanism created by nature. If you neglect some rules, it is impossible to avoid the occurrence of fasciitis. Causes of fasciitis:

Excessive exercise stress, mediating a high mechanical load on the aponeurosis. Pressure on the fascia leads to tension and thinning. Thinning causes constant irritation of the periosteum, with which the fascia is intimately fused.
Excessive pressure and progressive thinning of the fascia leads to the formation of microcracks and tears in the tissues of the aponeurosis. An aseptic inflammatory process develops; the disease must be treated immediately. The word “aseptic” implies the absence of pathogenic agents. Inflammation causes swelling and pain.
Prolonged aseptic inflammation in tissues leads to an increase in degenerative processes, slow destruction occurs connective tissue fascia, then the process moves to the bone.
Besides mechanical reasons, the addition of genetic mechanisms is possible. The risk of the disease increases in individuals whose families have a history of connective tissue disease.
There may be cases when the fascia is irritated from the outside, when as a result general pathology is growing bone heel bone and a heel spur is formed, irritating the fascia.

The disease must be treated starting with the elimination of these causes.

Predisposing factors

In addition to the immediate causes of plantar fasciitis, there are factors that, under certain conditions, can provoke the development pathological process. These include:

Treatment of pathology without assessing these factors may be meaningless.

Pathogenesis

The plantar fascia is attached to the tubercle of the calcaneus on one side, as well as to the metatarsal bones toes The main load and weight of the human body during walking, standing, and running falls on this fascia. Predominantly the pressure falls on the area of the fascia of the calcaneus.

Under the influence of these factors, tissue tension occurs and microtraumas form. Inflammation occurs. As a compensatory reaction, defense mechanisms mediated by our immune system. Since there is inflammation in the body, cells that produce biologically are delivered to this area. active substances aimed at eliminating inflammation and the causes that caused it. The immune system is programmed to assume that inflammation is caused by microorganisms, so it begins to actively produce inflammatory mediators and immunoglobulins, which these microorganisms must destroy. But fasciitis is an aseptic inflammation; there are no microorganisms in this area. Therefore, all these substances accumulate in the problem area, irritate the nerve endings and mediate the formation of swelling and pain.

Plantar fasciitis mainly affects people over 40 years of age; women are more often affected, which can be explained by wearing high-heeled shoes.

Symptoms of the disease

The main symptom that causes inconvenience and trouble for patients is pain. Its localization may be different. Most often this is the area of the inner edge of the foot. Pain bothers patients while walking, especially for a long time. Possible morning pain. Frequent localization pain symptom– area of the arch of the foot; anterior, lateral and posterior surface of the ankles; heel area. The peculiarity of the disease is increased sensitivity thumb feet to pressure and the action of other irritants, in this area the patient is also bothered by a feeling of pain.

With plantar aponeurosis, pathological productive elements of inflammation are formed in the connective tissue of the fascia - nodules that tend to merge and form a cord that can thicken, thicken, and fuse with the skin. A persistent flexion contracture is formed - the inability to straighten the muscles, ligaments, foot and toes. This condition significantly complicates the ability to walk and affects general condition patient, he loses the ability to lead a normal lifestyle. Most often, one foot is affected; the possibility of spread and involvement of both feet in the pathological process cannot be ruled out.

Diagnosis

The main symptom of the disease is pain in the foot and heel area that occurs during exercise. The pain syndrome is also intense in the morning or after a long stay at rest, when there is no pressure on the leg. In most cases, diagnosis of plantar fasciitis is possible based on subjective data provided by the patient and objective examination data. The decisive factor in making a diagnosis is the radiographic method. It is possible to use ultrasound or echography methods for diagnosis.

Treatment of plantar fasciitis

Fasciitis is treated comprehensively. All therapeutic measures are divided into types:

etiotropic methods of treatment - aimed at eliminating the causes leading to the development of the disease;
pathogenetic therapy - acts on the components of the chain of disease pathogenesis;
symptomatic treatment - aimed at completely eliminating or reducing the symptoms of the disease. We are talking about a pain symptom.

Etiotropic treatment includes the following measures:

The reasons are determined - incorrect gait, inappropriate shoes, occupational hazards, and so on. These reasons are eliminated whenever possible;
if the cause of the disease is anatomical or functional disorders stop – they try to eliminate overstrain in individual areas with the help of orthopedic insoles, arch supports and pronators;
It is necessary to follow a daily routine and a walking routine: at the first signs of the onset and intensification of pain, give yourself a break until the pain subsides, minimize the time you walk on a hard surface.

Pathogenetic therapy includes drug treatment, physiotherapeutic treatment, gymnastics and massage.

Drug treatment includes medications that reduce inflammation. Effectively use medications in the form of ointments, gels, creams. Such drugs include Nimesulide ointment, Diclofenac derivatives - representatives of the group of non-steroidal anti-inflammatory drugs. Dosage form in the form of ointments it is easy to use at home. If symptoms and clinical signs are severe, systemic glucocorticosteroid drugs are prescribed to eliminate inflammation.

Physiotherapeutic procedures are considered the most effective methods of treatment. Among them:

ultrasound therapy – aimed at relieving inflammation and swelling;
phonophoresis and electrophoresis are carried out with drugs that have pronounced anti-inflammatory effects. These include calcium gluconate and steroid drugs. Due to heating of tissues, the permeability of blood vessels and tissues increases, a greater number of medicinal substance enters the area of inflammation;
Shock wave therapy is used when a significant size heel spur has formed on the heel, causing severe pain and discomfort.

At home, you can use baths with medicinal herbs, perform special gymnastics.

Symptomatic treatment is painkillers. They can also be used in the form of ointments or tablets orally.

If these treatment methods are ineffective, you can proceed with surgery. Surgical excision of the inflamed and deformed area of the aponeurosis is performed.

The prognosis of the disease is favorable if treatment is started in a timely manner and all doctor’s instructions are followed. Then there is the possibility of restoring foot function.

The main thing in the treatment of fasciitis is to identify the causes leading to its development. Only complete and extensive diagnostics, installation accurate diagnosis, properly selected combination therapy can lead to positive effects. Otherwise, no treatment will help you, but will only worsen the problem.