American Orthopaedic Foot & Ankle Society Offers Advice For Treatment Of Heel Pain

Main Category: Bones / Orthopedics
Also Included In: Pain / Anesthetics
Article Date: 27 Dec 2009 - 0:00 PDT


Holiday shopping and holiday feasting may make you a prime candidate for a case of plantar fasciitis. Prolonged walking or standing and an increase in body weight are two leading causes of plantar fasciitis, a painful overuse injury affecting the sole of the foot, warns the American Orthopaedic Foot & Ankle Society (AOFAS).

According to the AOFAS, plantar fasciitis typically starts gradually with mild heel pain. The pain classically occurs with the first step in the morning. Treatment options include stretching exercises, and modifying activities until the initial inflammation goes away. Ice application to the sore area for 20 minutes three or four times a day may also relieve symptoms. Your orthopaedic surgeon may also prescribe a non-steroidal anti-inflammatory medication. But your best course of action is a routine of home exercises to stretch the Achilles tendon and plantar fascia.

Benedict DiGiovanni, MD, Associate Professor, Department of Orthopaedics at the University of Rochester Medical Center (NY) and active AOFAS member, treats many patients with plantar fasciitis. He offers the following suggestions on treatment options. "A key component of a plantar fascia specific stretching program is when it is performed and how often. Based on findings from our research work, I instruct patients to perform the stretch prior to the first step in the morning and prior to weight bearing after periods of inactivity, such as sitting for lunch or driving in the car. Most patients will perform the stretch 4 - 5 times per day for the first month of treatment, and then as needed based on symptoms. Patients are also instructed to stretch the Achilles tendon twice a day, morning and evening. In addition to stretching exercises, we suggest ice, over the counter anti-inflammatory medicine, and inexpensive over the counter soft arch supports."

Plantar fasciitis has been known to side-line major league athletes such as the recent case with New York Giants quarterback Eli Manning. Ninety percent of people with plantar fasciitis improve significantly after two months of initial treatment. Shoes with shock-absorbing soles or over the counter arch supporting inserts may help alleviate pain. Another treatment protocol is taping the foot to support the arch and plantar fascia. If heel pain continues after a few months of conservative treatment, your orthopaedic surgeon may suggest heel injections with steroidal anti-inflammatory medications. Walking casts or positional splints are other options for treatment of plantar fasciitis.

Treatment of plantar fasciitis is important because it has the potential of turning into a chronic condition. Plantar fasciitis may prevent you from keeping up with your current level of activity and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis changes the way you walk.

The AOFAS website www.aofas.org contains public education resources on the treatment of plantar fasciitis including a specific stretching program to alleviate the pain. The site also features a surgeon referral service that makes it easy for patients to find a local orthopaedic surgeon specializing in foot and ankle care.

Source
American Orthopaedic Foot and Ankle Surgeons

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