Friday, June 20, 2008

Plantar fascitis update


Considered to be most often the result of a degenerative process at the origin of the plantar fascia at the calcaneus, Plantar fasciitis is a common cause of heel pain, which frustrates patients and practitioners alike because of its resistance to treatment. However, neurogenic and other causes of subcalcaneal pain are frequently cited. A combination of causative factors may be present, or the true cause may remain obscure. Approximately 10% of patients with plantar fasciitis have development of persistent and often disabling symptoms. Plantar fasciitis has been associated with obesity, middle age, and biomechanical abnormalities in the foot, such as tight Achilles tendon, pes cavus, and pes planus.
Management strategies are:
Nonsurgical treatment is ultimately effective in approximately 90% of patients. Nonsteroidal anti-inflammatory drugs, rest, pads, cups, splints, orthotics, corticosteroid injections, casts, physical therapy, ice, and heat.
Targeting tissue specific stretching: A poor response to treatment may be due, in part, to inappropriate and nonspecific stretching techniques. A recent study concluded, program of non-weight-bearing stretching exercises specific to the plantar fascia is superior to the standard program of weight-bearing Achilles tendon-stretching exercises for the treatment of symptoms of proximal plantar fascitis.

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