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

Many people know firsthand what plantar fasciitis is - the people call this pathology nothing more than a "heel spur". This disease develops due to overstretching of the ligament that lines inside foot pits. This ligament connects the calcaneus and metatarsals together, creating the arch of the foot necessary for stability while walking.

Plantar fasciitis, or plantar fasciitis, is an inflammatory condition. It is initially localized in the region of the calcaneus, 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 the 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 a violation of gait, up to the development of permanent lameness. In addition, a person with such a pathology experiences severe pain while walking, and subsequently at rest.

Causes

Most often, this disease affects people in old age, since the main reason for it lies in the 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 inflammatory changes first occur in the fascia of the foot, and then degenerative ones, are:

excess weight (and as a result, excessive stress on the feet);
prolonged wear shoes with high heels, as well as tight and uncomfortable shoes;
inflammatory and degenerative diseases of the joints;
and other gait disorders;
circulatory disorder lower extremities due to a disease such as atherosclerosis obliterans.

The treatment of this disease begins precisely with the establishment of the cause of its appearance, since the "" itself is a consequence of inflammatory and degenerative changes in the fascia, and trying to treat it various methods, including folk, the result can not be obtained. By influencing the cause of the pathology, it is possible to treat it quite successfully, moreover, by conservative methods.

Clinical manifestations

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:

aggravated by prolonged walking;
occurs when you try 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 gives to the fingers and to the muscles of the lower leg;
has a sharp character, as if a person stepped on some kind of cutting object.

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

development of foot deformity with the formation of contractures, which occurs due to shortening of the fascia and a decrease in its mobility;
convulsions in the area calf muscles, as well as the muscles of the foot, 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 noted in the affected area of the fascia. skin. The general condition of a person is usually not disturbed.

All these symptoms impair the quality of a person's life. And if the disease is not treated in a timely manner, it can lead to disability of the patient.

Diagnosis and treatment

Before starting the treatment of the disease, it is necessary to conduct a diagnosis. A person with the above symptoms 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, feel the foot to determine the location of the pain, and also prescribe an x-ray. In the picture, you can see bone growths in the calcaneus.

Treatment of a disease such as plantar fasciitis is conservative and surgical. Fortunately, to surgical methods doctors resort only to extreme cases when conservative methods fail or when the disease is too advanced. In most cases, within a year, the treatment of this disease gives a good result with a complete cure for the patient.

As mentioned above, the treatment of the disease must begin with the elimination of its cause. In particular, if the cause is excess weight, it is necessary to switch to proper nutrition and add physical activity to your daily routine. If the disease arose against the background of playing sports, you need to reduce the number of loads or completely abandon this type of sports activity and replace it with another one.

Sometimes you have to change your profession, for example, if the disease has developed due to the fact that a person, by the nature of his activity, spends a lot of time on his feet. In addition, wearing special orthopedic shoes, or the use of special orthopedic insoles that reduce pressure on the heel, is indicated.

Also, the treatment involves the use of a plaster splint to fix the leg during sleep, or, in cases of severe deformity, the use of a plaster cast.

Fascia massage also gives excellent results, allowing you to eliminate areas with limited mobility and develop a ligament. There is also a certain set of exercises for stretching the muscles of the extensor muscles of the foot, which makes it possible to improve blood circulation 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 recurrence of the pathology.

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Diseases with similar symptoms:

Flat feet is a kind of deformation of the foot area, in which its arches are subject to lowering, as a result of which there is a complete loss of their shock-absorbing and spring functions. Flat feet, the symptoms of which are such basic manifestations as pain in the calf muscles and a feeling of stiffness in them, fatigue when walking and standing for a long time, strengthening 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 the blood vessels. Inflammation narrows the lumen blood vessels, because of this, blood flow is disturbed, and these are favorable conditions for the formation of blood clots. If the blood flow is disturbed, the organs do not receive the necessary amount of oxygen and nutrients. This leads to the development various diseases. The inflammatory process can occur in any vessel - a vein or artery.

Plantar fasciitis is a common cause of heel pain. The disease is manifested by pain and inflammation in the plantar fascia, which connects the toes to the calcaneus. The disease is dangerous because in the absence of adequate treatment in the area of \u200b\u200bthe heel, a bone outgrowth can form, which is commonly called a heel spur. This pathology is very serious, in some cases it is necessary to get rid of it surgically. Another common complication of plantar fasciitis of the foot is Achilles tendinitis.

Causes and risk factors

With a large load on the foot, microtraumas can form in the fascia. Most often, they heal on their own, if a person evenly alternates between stress and rest. However, frequent micro-ruptures 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 sports or dancing, during which there are increased loads on the heel bones and tissues adjacent to them.
Changes in the biomechanics of the foot. If a person suffers from flat feet, unevenly distributed weight causes an overload of the fascia.
Excess weight, which additionally loads the foot and deforms the arches.
Professions that require a long stay on your feet. Factory workers, construction workers, teachers, couriers, mail carriers, and other people who walk or stand a lot due to the nature of their work are prone to developing plantar fasciitis.
Diseases of the spine, such as scoliosis, which causes the center of gravity of the body to shift. In this case, the load on the legs increases, which can cause pathology of the feet.

Main symptoms

Plantar fasciitis is so severe symptoms that in most cases, only if they are present, it is possible to diagnose the disease. 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 up after sleep.

With prolonged walking throughout the day, after a long standing and climbing stairs, the pain increases significantly, and in the evening it bothers you quite strongly. When a heel spur occurs, the pain becomes so sharp that it can be compared to the sensations that a person feels when sharp pricks are made with sharp objects. Often, with plantar fasciitis, hyperthermia and edema may appear.

In this case, especially if the disease has affected both legs at once, it is necessary to do an examination to identify concomitant cause(eg, 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, which occurs as a result of the accumulation of fluid in the ankle joint and heel area.

Treatment Methods

Plantar fasciitis, except for particularly difficult cases, is treated conservatively. Applies complex therapy, the main task of which is to eliminate the increased load on the feet. At the same time, it is very important to replace tight and uncomfortable shoes with comfortable ones. If there are pains in the heel, it is necessary to limit walking and give the legs a rest. If you have flat feet or, you should purchase orthopedic insoles and special heels with recesses in the center.

Also, in the treatment of sole fasciitis, it is desirable to wear orthopedic shoes that firmly fix the heel and restrain the sole from falling inward. You can buy orthoses that are shaped like a boot. They are worn before bed because they hold the foot well at a special angle at which the plantar fascia is stretched, which helps it heal at night. The formation of strands and shortening of the fascia is eliminated with the help of massage procedures and special exercises.

Also, in the treatment of 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 when using physiotherapy, which consists in conducting warming procedures, laser therapy, and the use of ultrasound. At severe inflammation and significant pain, fasciitis is treated with anti-inflammatory medicines, which contain corticosteroids in their composition, for example, Diprospan or Flosteron.

At local treatment the attending physician may recommend the use of Golden Mustache or Dolobene ointment or Fascit stop cream. In particularly severe cases that cannot be cured with conservative methods, applies surgical intervention, which consists in the removal of bone outgrowth and irreparably altered tissues.

Popular folk remedies

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

Plantar fasciitis is treated with 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 One 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 a day and 2 hours a day).

You can try to cure the disease with the help of a bath, which includes equal amounts of vinegar (9%), vodka and turpentine. All ingredients must be mixed and heated in a water bath. The sore heel should be in a container with such a 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 must be cut into small plates and applied to sore heels, securely fixed with a bandage and put on a woolen sock on top. Such a compress is usually done at night. If, after removing the bandage in the morning, it turns out 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 plates will lighten. In the treatment of plantar fasciitis folk methods it will take a lot of time and patience. However, perseverance helped many to 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 should be approached carefully: women should not often wear shoes or boots with too high heels, when choosing a purchase, you should pay attention to depreciation and supination. Do not get carried away 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 working day, a cold compress can be used to relieve such sensations. A bag filled with ice should be applied to the sore spot for 15-20 minutes. Some do 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. Their regular implementation will help reduce inflammation and significantly reduce pain. To strengthen the calf muscles, the Achilles tendon, as well as stretching 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 maintain the arch of the foot (longitudinal). Standing, the fascia is under pressure from almost half the weight of the human body, that is, for more time it is under constant load. Regular functioning of the fascia is subject to mini-tears, which are able to grow together during the time when a person is resting.

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

Causes

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

Over time, in the area of attachment of the heel fascia, a bone exostosis is formed, 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 onset of symptoms associated, for example, with unusual sports activity or a change in casual shoes. Various foot deformities and overweight also predispose to the development of plantar fasciitis and heel spurs.

main reason disease is a small injury to the PF.

Signs and symptoms of heel spurs

The most important and main symptom of a heel spur is pain on the heel.

The patient has associated symptoms.

Associated symptoms and signs of a heel spur:

In the early stages of the progression of the disease, the patient develops pain after a long walk or run. When resting on the heel, the pain may appear worse.
Feelings of discomfort in the affected area begin to torment the patient, starting in the morning. When moving throughout the day, pain decreases, but in the evening they resume anew, this occurs as a result of the daily load on the leg. Pain intensifies during the period of changing weather conditions (rain, snow).
Over time, calcium accumulates in the heel zone, the general condition of the body worsens. The pain begins to appear during rest, in a dream. 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 the spur has formed on both legs, then crutches will be needed, the patient cannot move independently.
It is outwardly impossible to see the spur, but in advanced cases, swelling (bruising) develops in the wound area, while the patient's body temperature rises.

Symptoms

Plantar fasciitis has such pronounced symptoms that in most cases, only if they are present, the disease can 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 up after sleep.

The most common heel spur or plantar fasciitis is pain in the area of the calcaneal tuberosity. Pain and swelling are more localized inner surface heels.

Pain syndrome more pronounced in the morning when getting out of bed. Heel spurs or plantar fasciitis are typically characterized by morning stiffness and pain with the 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 a heel spur or plantar fasciitis to affect both feet at once. Among people involved in sports, the disease is often found in 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 is so characteristic symptoms that it is simply impossible not to notice it or confuse it with any other disease.

Increased pain occurs:

v morning time when the patient begins to take the first steps, getting out of bed;
when climbing stairs;
after prolonged standing in one place;
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 area of the Achilles tendon.

Painful sensations that provoke plantar fasciitis often develop slowly over time. A sick person may experience lameness, he loads a healthy foot more, which in the future cannot withstand such a load and acquires inflammatory process sole aponeurosis. There were situations when both feet suffered from this disease.

The disease is diagnosed with the help of ultrasound of the soft tissues of the foot. But before visiting a doctor, you can identify fasciitis on your own. It is this disease that is indicated by sharp sharp pains in the morning, which gradually weaken, and intensify again at night.

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

The main symptom of plantar fasciitis is soreness in the heel area, and one heel is most often affected. If not carried out timely treatment and continue to put pressure on the legs, then after a while the inflammation may begin on the second leg.

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

Consider the features of fasciitis. Pain in the heel is more pronounced at the beginning of the load, that is, when getting out of bed, with the first steps after rest.

Doctors even gave the name of such a feature - "pain of the first step." Therefore, the symptoms of pain most often appear in the morning.

When a person "diverges", the symptoms decrease. On the early stages the pain goes away and does not manifest itself until the person gives heavy load on the muscles of the legs and heel.

With progression, the symptoms of pain may appear during the day with sudden movements, long standing or sitting, or not disappear at all, but slightly weaken. In advanced cases, in order to cure the pathology, the patient is discharged sick leave.

The pain itself manifests itself in the area of \u200b\u200bthe sole of the foot, closer to the heel. In addition to pain, there is muscle stiffness, burning or, conversely, numbness. V 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 spur is diagnosed and treated by an orthopedic traumatologist. The diagnosis is established by the doctor after a comprehensive clinical examination and clarification of the history of the disease.

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

By itself, a heel spur is not the cause of the development of pain, it simply accompanies plantar fasciitis.

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

Inflammation of the plantar fascia begins due to its excessive and regular stretching and overload. Therefore, runners and people who are forced to spend the whole day on their feet are more susceptible to the development of pathology. Other risk factors for fasciitis include:

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

The surgeon should diagnose and prescribe treatment for plantar fasciitis. Although everyone can suspect that they have these problems. The first sign is morning pain in the legs in the area of the arch of the foot, which decrease in the evening. A doctor can confirm the diagnosis after examining the Achilles tendon and triceps calf.

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

The surgeon confirms the assumptions about the disease after examining the foot, palpation of the plantar aponeurosis. The most accurate diagnosis is by MRI. With pathologies of the plantar aponeurosis, edema is visible on the pictures. Also, this study allows you to see hidden fractures, fibromas or neuromas of the nerve of Baxter, which helps to avoid misdiagnosis.

To begin with, the doctor studies the patient's medical history, obtaining information about when the pain began, about the area of \u200b\u200bits localization and when it becomes the strongest. After that, he collects information about the lifestyle of the patient, 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 diagnosed diagnosis.

Considering all of the above, the risk group includes 40-70-year-olds who lead an active lifestyle, most often women. Runners, factory workers, waiters, and many other standing professions are also more likely to get sick.

Treatment for plantar fasciitis is given after comprehensive examination to rule out other pathologies. To make a diagnosis, the doctor examines the nature of the complaints, for which he conducts a survey, performs palpation and examination. To rule out torn ligaments, the doctor asks to perform flexion and extension of the foot, and also checks the ability to perform other movements.

In order not to be mistaken with the diagnosis, X-ray diagnostics is prescribed, which allows to exclude bone fractures. Additionally, magnetic resonance imaging and electromyelography may be needed. In general, imaging tests and patient interviews are often sufficient to establish a diagnosis.

If you find it difficult to get up every morning and it is difficult for you to start walking normally, then it is too late to talk about ways to prevent this problem. In such a situation, it is important to confirm plantar fasciitis disease.

Symptoms, prevention and treatment of this problem is the lot of surgeons. Do not engage in self-diagnosis, and even more so try to alleviate your condition.

Even with the first and single symptoms, it is better to visit a specialist.

The surgeon should diagnose and prescribe treatment for plantar fasciitis. Although everyone can suspect that they have these problems.

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

Patients with plantar fasciitis cannot bend the foot beyond the usual straight position, they cannot bring it closer to themselves. The surgeon also confirms the assumptions about the disease after examining the foot, palpation of the plantar aponeurosis.

The most accurate diagnosis is by MRI. With pathologies of the plantar aponeurosis, edema is visible on the pictures. Also, this study allows you to see hidden fractures, fibromas or Baxter's nerve neuroma. This helps to avoid misdiagnosis.

Treatment

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

Plantar fasciitis is treated with concentrated salt baths. To prepare them, you need to dilute salt in hot water (1 l) (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.

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 a day and 2 hours a day).

You can try to cure the disease with the help of a bath, which includes equal amounts of vinegar (9%), vodka and turpentine. All ingredients must be mixed and heated in a water bath. The sore heel should be in a container with such a 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 must be cut into small plates and applied to sore heels, securely fixed with a bandage and put on a woolen sock on top.

Such a compress is usually done at night. If, after removing the bandage in the morning, it turns out 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 plates will lighten. When treating plantar fasciitis with folk methods, it will take a lot of time and patience.

However, perseverance helped many to overcome the disease.

A heel spur and its characteristic symptoms can be accompanied by completely different diseases, so treatment should be aimed at eliminating both problems. It is not worth ignoring the symptoms of a spur on the heel, besides self-medicating, as this leads to health problems, and the reviews of patients with this disease only confirm this.

Treating a heel spur is not difficult. Treatment does not include surgical intervention, it is not the growth itself that causes pain, but the inflammatory process that occurs in the tissues around the spur.

Large spurs do not cause severe pain to the patient, and small, barely noticeable formations, visible with an x-ray, can cause severe pain, in which it is even difficult for a person to stand on his foot. The main methods of getting rid of unpleasant symptoms heel spurs 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, the use of painkillers, exercise therapy, wearing orthopedic insoles and other devices, as well as physiotherapy.

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

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

For heel spurs or plantar fasciitis, limited fasciotomy can be very effective. The operation consists in 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 complex and includes:

The use of painkillers and anti-inflammatory drugs (ibuprofen, naproxen, special ointments, corticosteroids).
Relaxation. It is necessary to limit or prevent everyday activities, which provoke the appearance of pain in the heel.
Gentle walking mode. Put on shoes immediately after getting out of bed, as in the case of walking barefoot, pain begins to intensify.
Wearing comfortable shoes. You need to wear models that perfectly absorb shock and support the arch of the sole. The best option will be sports shoes, as well as shoes with soft soles.
Physiotherapeutic procedures: exposure to laser, ultrasound, thermotherapy, shock wave therapy (with pronounced spurs);
Massage, performing special exercises. A couple of times a day, perform simple exercises to stretch the lower leg, mainly in the morning. Treatment, which includes exercise, aims to increase the flexibility of the ligaments and strengthen the muscles that support the arch of the foot.
The use of orthopedic devices - arch supports, heel clamps, night splints. Inserts help cushion the heel area. You can buy them in many stores that sell sports shoes and pharmacies.
Ice should be applied to the heel area to reduce inflammation and relieve pain.

Note! Do not refuse the drugs prescribed by your doctor if he confirmed that you have plantar fasciitis. Modern medicines can reduce pain and prevent further development illness.

For these purposes, the doctor will prescribe special orthopedic insoles and tell you how to do gymnastics. Without following these recommendations, you should not hope for recovery. Also, good results are obtained by using special orthopedic splints, which are superimposed on the night. Physiotherapeutic procedures have a good effect.

Fasciitis is best treated topically. For this, various

prescribed by the doctor. They can be chosen independently on the advice of a pharmacist at a pharmacy.

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

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

at night, you may be advised to apply Ortofen or Cortisone creams to the foot;
relieve the condition of the drug Ibuprofen, Diclofenac or Naproxen;
in advanced cases, only injections of corticosteroids help, but they only bring temporary relief, over time the pain may return.

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

Along with drug treatment, you can try on yourself the methods offered by Alternative medicine. They are aimed at reducing inflammation and preventing micro-tears that accompany plantar fasciitis.

The treatment period can take up to a year and require stretching of the plantar aponeurosis and Achilles tendon. To do this, the patient will have to constantly perform special exercises. As an add-on, a splint is applied to the foot (at night) to ensure its immobility in neutral dorsiflexion.

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

If you do not start treatment and endure pain, then they can last up to a year and a half, while periodically subsiding and reappearing. The longer fasciitis is left untreated, the more likely it is to end up on the operating table. The goal of treatment is to eliminate the inflammatory process and the cause of the pathology.

Despite 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, calf muscles. At home, other types of exercise therapy should be performed, the exercises for which the doctor will select.

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

Effective for the treatment of fasciitis is a recipe for baths with flaxseed and potato peels. 2 handfuls of flax seeds are taken and mixed with potato peels, 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 of the feet. warm water, while scraping off the keratinized skin.

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

You can reduce the manifestation of pain by prescribing a course of drugs NSAID groups- Diclofenac, Ibuprofen, Meloxicam. Ointments based on NSAID funds. To improve blood circulation and reduce inflammation, a massage course is prescribed, which must be combined with gymnastics.

Conservative methods

If you take modern techniques treatment, then kinesiology taping is distinguished. The method consists in 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 the load and increases the circulation of the lymphatic, intercellular fluid, and also stimulates blood circulation 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 foot. The action of the 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.

Both separately and in combination with insoles, you can use a night splint in the form of a plastic boot. The splint is put on at night and prevents stretching of the plantar fascia. Using this method of treatment, you can achieve a reduction in pain in the morning. Of the minuses, discomfort during use can be noted.

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

Do not stop taking medications prescribed by your doctor if he has confirmed that you have plantar fasciitis. Modern medicines 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, you should not hope for recovery.

Also, good results are obtained by the use of special orthopedic splints that are applied at night. Physiotherapeutic procedures have a good effect.

In many cases, anti-inflammatory drugs are indispensable. Often, doctors prescribe drugs "Diclofenac" or "Ibuprofen", or their analogues. If the disease has gone so far that a person cannot get out of bed on his own in the morning, and conventional drugs do not help, then injections of glucocorticoids may be prescribed.

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

Ibuprofen, Diclofenac or Naproxen drugs can alleviate the condition. In advanced cases, only injections of corticosteroids help. But they only bring temporary relief, over time the pain may return. Often such injections should not be given, because this can lead to a rupture of the plantar fascia.

Physiotherapy procedures

Treatment of plantar fasciitis with only painkillers and anti-inflammatory drugs will not be effective. It should be combined with stretching exercises, correct insoles in shoes and physiotherapy procedures.

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

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

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

Ultrasound treatment may also be prescribed. With this method, the tissues affected by the sensor warm up well. 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 burden on the fascia. The choice of shoes should be approached carefully: women should not often wear shoes or boots with too high heels, when choosing a purchase, you should pay attention to depreciation and supination.

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

Some do 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.

Their regular implementation will help reduce inflammation and significantly reduce pain. To strengthen the calf muscles, the Achilles tendon, as well as stretching the fascia, it is recommended to perform a set of special exercises.

To avoid heel problems:

regularly change sports shoes (sneakers, for example);
wear shoes with good cushioning in the heel or arch support;
lose excess weight, if any;
stretch the fascia, Achilles tendon;
do not run 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 pain in the heel during exercise.

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

Causes

Plantar fascia (plantar aponeurosis) is a dense connective tissue that attaches to the calcaneus and phalanges of the fingers. Its main function is the formation and support of the longitudinal arch of the foot. If a person is standing, half of their weight puts pressure on the plantar aponeurosis. A high load provokes its micro-ruptures in the area that is attached to the heel tubercle.

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

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

overweight;
playing sports in which there is a prolonged load on the heel or on the Achilles tendon;
flat feet or too high arch of the foot;
turning the foot inward while walking;
wearing uncomfortable shoes;
diseases of the musculoskeletal system;
trauma;
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. Unpleasant sensations arise or intensify with exertion. In the morning, they are most pronounced, then gradually subside. This is due to a rupture of the fascia that has grown together during a night's sleep. In addition, the pain intensifies after a long stay in a sitting position, when a person takes the first steps.

The formation of a heel spur can increase the symptoms of plantar fasciitis of the foot, as the bony growths press on the surrounding tissues. In many cases, osteophyte does not manifest itself in any way.

Diagnostics

Plantar fasciitis is diagnosed based on the analysis of complaints and examination. In addition, an x-ray 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 provide unloading of the plantar aponeurosis and eliminate soft tissue inflammation.

Unloading of the plantar fascia is achieved by reducing physical activity and occasional 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 carried out every morning after a warm-up. Regular exercise helps to lengthen the plantar fascia. As a result, pain is reduced and future injuries are prevented.

After physiotherapy exercises taping of the foot is carried out - the imposition of an elastic tape (teip) or a plaster to support the longitudinal arch and fix the aponeurosis. When applying the tape, it is necessary to increase its tension when it goes around the leg from below.

To increase the effectiveness of the 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. V daytime patients with fasciitis are advised to wear orthopedic shoes or insoles with an arch support and a recess in the center of the heel.

To relieve tissue inflammation and reduce pain, practice:

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? With severe discomfort and significant bone growths, the following methods are used:

injection into the tissues of the foot of glucocorticoids in combination with anesthetics;
shock wave therapy to destroy the heel spur;
laser or ultrasonic effect on inflamed tissues.

With inefficiency conservative treatment 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 can be aggravated due to a fracture of the heel spur.

Prevention

The main 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 genesis, localized in the heel area and characterized by a pronounced pain syndrome, aggravated by the load on the sore leg. The disease occurs in the elderly and younger people. The prevalence of the disease is low, which is explained by the anatomical protection of the fascia from inflammation. It is necessary to treat the pathological process as early as possible, without aggravating the severity of the disease. Treatment can be done 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, biological damage; perform the function of holding, fixing; provide the processes of nutrition, innervation, performance of functions.

On the foot, the fascia is of the most importance than in the rest of the body - in the heel area, the soles are subjected to maximum physical stress while walking, running. Because of increased loads in the area of \u200b\u200bthe 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 of thinning of the fascial sheath. Attachment of the fascia is carried out to the bones of the metatarsus I and V, from the other end - to the bones of the middle part of the foot. The aponeurosis has small holes 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 its 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 the formation of edema and pain.
Prolonged aseptic inflammation in tissues leads to an increase in degenerative processes, slow destruction connective tissue fascia, then the process goes to the bone.
Apart from mechanical causes possible accession of genetic mechanisms. The risk of the disease increases in individuals in whose families cases of connective tissue disease are recorded.
There are cases when the fascia is irritated from the outside, when as a result general pathology grows bone heel bone and a heel spur is formed, irritating the fascia.

It is necessary to treat the disease, starting with the elimination of these causes.

Predisposing factors

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

Treatment of pathology without an assessment of these factors may be meaningless.

Pathogenesis

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

Under the action of these factors, tissue tension and the formation of microtraumas occur. There is inflammation. As a compensatory reaction, defense mechanisms mediated by our immune system. Since there is inflammation in the body, cells that produce biologically active substances aimed at eliminating inflammation and its causes. The immune system is programmed for the fact that inflammation is caused by microorganisms, therefore 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 zone. Therefore, all these substances accumulate in the problem area, irritate the nerve endings and mediate the formation of edema and pain.

Plantar fasciitis mainly affects people over 40 years of age, women are more often ill, which can be explained by wearing shoes with heels.

Symptoms of the disease

The main symptom that causes inconvenience and trouble to patients is pain. Its localization may be different. More often this is the area of \u200b\u200bthe inner edge of the foot. Pain worries patients during 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. Feature of the disease - increased sensitivity thumb feet to pressure and the action of other stimuli, in this area the patient is also worried about the 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 strand that can thicken, thicken, grow together with the skin. A persistent flexion contracture is formed - the inability to straighten the muscles, ligaments, foot and toes. This condition greatly complicates the ability to walk, affects general condition sick, he loses the ability to lead a habitual way of life. More often one foot is affected, the possibility of spread and involvement of both feet in the pathological process is not excluded.

Diagnosis

The main symptom of the disease is pain in the foot and heel that occurs during exercise. The pain syndrome is also intensely expressed in the morning or after a long stay at rest, when pressure was not applied to the leg. In most cases, the diagnosis of plantar fasciitis is possible based on subjective data provided by the patient and physical examination findings. The decisive factor in the diagnosis belongs to the method of radiography. It is possible to use ultrasound or echography methods for diagnosis.

Treatment of plantar fasciitis

Treat fasciitis comprehensively. Everything medical measures 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 pathogenesis of the disease;
symptomatic treatment - aimed at the complete elimination or reduction of symptoms of the disease. This is a symptom of pain.

Etiotropic treatment includes activities:

causes are determined - wrong gait, inappropriate shoes, occupational hazards, and so on. These reasons are, if possible, eliminated;
if the cause of the disease is anatomical or functional disorders stop - they try to eliminate the overvoltage of individual sections with the help of orthopedic insoles, arch supports and pronators;
it is necessary to observe the regime of the day and the mode of walking: at the first signs of the onset and intensification of pain, give yourself a break until the pain subsides, minimize the time of walking on a hard surface.

Pathogenic therapy includes drug treatment, physiotherapy treatment, gymnastics and massage.

Medical treatment includes drugs that reduce inflammation. Effectively apply medicines in the form of ointments, gels, creams. These 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. With the severity of symptoms and clinics, systemically glucocorticosteroid drugs are prescribed to eliminate inflammation.

The most effective methods of treatment are physiotherapy procedures. 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, steroid drugs. Due to tissue heating, the permeability of blood vessels and tissues increases, more medicinal substance enters the area of inflammation;
shock wave therapy is used when a significant 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 pain medication. Can also be used in the form of ointments or tablets inside.

With the ineffectiveness of these methods of treatment, you can proceed to 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 prescriptions are followed. Then there is the possibility of restoring the function of the foot.

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 only exacerbate the problem.