INJECTION THERAPY FOR PLANTAR FASCIITIS

What is Plantar fascia pain?

The plantar fascia is a thick band of tissue that runs from beneath the heel bone all the way to the big toe. During walking and running, it is stretched as you push off the ground, and it creates an energy-saving, elastic recoil mechanism to propel you ahead. Sudden changes in activity, such as starting a couch to 5k programme, preparing for a marathon, or even walking a few more kilometres each day, can cause pain in the plantar fascia. It can strike men and women of any age, and it can linger for months. The majority of people report pain while getting out of bed in the morning, pain when moving after a lengthy period of rest, and pain during and after walking or exercising. The healing process might be hampered when the plantar fascia is continually injured (known as plantar fasciitis), resulting in a compromised plantar fascia. Plantar fasciopathy is the medical term for this condition.
What are the symotoms of Plantar fasciitis?
  • Stepping out of bed causes pain in the heal.
  • Walking causes pain in the heal.
  • During and after activity, there is pain in the heal.
  • Wearing flat shoes or going barefoot causes pain in the heal.

What other local conditions can present as plantar fascia pain?

  • Morton’s neuroma
  • Osteoarthritis in the middle of the foot
  • Bursitis of the heel
  • Tendonitis in the Achilles tendon
  • Nerve entrapment in Baxter
Plantar fascia vs Baxter’s nerve entrapment
A Baxter’s nerve entrapment occurs when a tiny nerve (the first branch of the lateral plantar nerve, commonly known as the Baxter’s nerve) is pinched between two muscles in the foot. When this nerve is pinched, it can cause severe, scorching pain, numbness, and pins and needles around the inside of the heal. A Baxter’s nerve entrapment can happen suddenly after a trauma or gradually over time. It is not gender or age-related, and it can strike anyone at any time.
 
Plantar fascia discomfort can develop gradually without being caused by trauma, but it is frequently linked to a rapid change or increase in activity, such as walking or exercise. Plantar fascia discomfort can also affect men and women of all ages.
 
The location and type of pain are crucial diagnostic indicators. Plantar fascia discomfort is felt under the heel, both when touched and when the foot is in contact with the ground. Sharp pain, numbness, or pins and needles on the inner part of the heal and foot are signs of a Baxter’s nerve entrapment. Pain might be continual or intermittent, and it can be felt even when you’re not moving.
  

What is Plantar fascia?

The plantar fascia is a fibrous band of tissue that runs around the bottom of the foot. It stretches all the way from the heel to the big toe. It aids in propelling you ahead whether walking or running. It is the most commonly injured structure in the foot, with over 10% of the population suffering from it at some point in their lives.
  

How do I know if I’ve Plantar fasciitis?
Plantar fascia discomfort is commonly described as a dull, throbbing, or searing ache that is aggravated when the plantar fascia is stretched after extended periods of rest.
Symptoms appear gradually, often without trauma, and are frequently overlooked for months. As a result, by the time treatment begins, this is usually a chronic problem.

Typical symptoms include;

  • Heel soreness when getting out of bed is a common symptom.
  • During walking
  • Walking barefoot or with flat shoes
  • When you are attempting to workout,

How do you know if you have plantar fasciitis?
Using a series of clinical tests, our expert team of clinicians at Joint Injections can accurately diagnose plantar fascia pain. Your foot posture, ankle and foot mobility, and muscle strength will all be evaluated. These tests help us figure out why you got plantar fasciitis in the first place and what treatment strategies you’ll need to get out of pain and back to normal as soon as possible. We’ll look at your lower back, hips, and knees to see if there are any contributing factors.

It is critical to obtain an accurate diagnosis in order to provide the best possible treatment. Plantar fasciitis can be caused by heel spurs and local nerve irritation. As a result, as part of your initial evaluation, a diagnostic ultrasound scan is performed. Imaging is used to assess the quality of the plantar fascia tissue, confirm the diagnosis, and determine the best treatment option for you. The diagnostic ultrasound scan will also reveal whether you have a plantar fascia tear. This happens when you get a sharp, sudden pain in your heel while doing something like running for a bus, playing rugby, or even just stepping off a curb. If you have a tear, some treatment options, such as steroid injections or shockwave therapy, may be unavailable, and you will likely need to be immobilised for a period of time.

What is the best way to treat plantar fasciitis
Your physiotherapist will prescribe you a bespoke set of exercises after your initial assessment; however, here are a few self-management tips you might want to try:

  • Taking a break from the symptoms that are bothering you
  • Exercises to strengthen the calf muscles include calf stretching and calf raising.
  • Using an orthotic insole, which is an off-the-shelf insole for your shoe.
  • Using a tennis or golf ball to roll the bottom of your foot

What should I do if conservative therapy fails?
There are a few more therapeutic choices to consider. These are some of them:

Extracorporeal Shockwave Therapy (ESWT) 
For addressing plantar fascia pain, ESWT is an effective, evidence-based therapeutic approach. It accomplishes this by desensitising irritated nerve endings and inflicting controlled micro-trauma, which activates the body’s natural healing mechanism.

Injection using Ultrasound Guidance
If nothing else works and the pain persists, a steroid injection may be necessary. Under the direction of a real-time ultrasound scan, a mixture of local anaesthesia and corticosteroid (a strong anti-inflammatory) is given. This ensures that the plantar fascia is precisely addressed. Guided injections are more accurate and effective at reducing pain than non-guided injections, according to research. Joint injection offers a team of physiotherapists and musculoskeletal sonographers with a wealth of experience. 

A referral to a podiatrist for a custom orthotic (a specialised inner sole for your shoes) or, in extremely rare situations, an orthopaedic expert for additional imaging (MRI) and possible surgical advice can be provided. Plantar fascia pain seldom need surgery; however, if a heel spur is present, surgery may be indicated. Your physiotherapist can discuss and arrange these possibilities with you.

Joint Injection’s experts are dual-trained, highly specialised physiotherapists and musculoskeletal sonographers with extensive experience diagnosing all foot and ankle disorders. We provide a ‘one-stop’ clinic, which means you’ll get an examination, a diagnostic ultrasound, and, if necessary, an ultrasound-guided injection.