Plantar Fasciitis (Heel Spur Syndrome)

Title: Plantar Fasciitis: Causes, Symptoms, and Treatment

Introduction: Plantar fasciitis is a common and often painful condition that affects the foot's heel. It occurs when the thick band of tissue connecting the heel bone to the toes, known as the plantar fascia, becomes inflamed or strained. Most peple refer to it as a heel spur. This blog will delve into the causes, symptoms, and various treatment options for plantar fasciitis, helping you understand and manage this condition more effectively.

Causes of Plantar Fasciitis: Plantar fasciitis typically develops due to repetitive stress on the plantar fascia. Many patients believe that it is a result of a heel spur causing their pain. This is not the case and we find many patients having large heel spurs without any discomfort. The pain is a result of inflammation to the plantar fascia. Several factors can contribute to the development of this condition, including:

Overuse or excessive physical activity, such as running, dancing, or standing for extended periods.
Flat feet or high arches, which can alter foot mechanics and put additional strain on the plantar fascia.
Obesity or sudden weight gain, leading to increased pressure on the feet.
Tight calf muscles or Achilles tendon, limiting ankle flexibility and impacting foot function.
Poor footwear with inadequate support or cushioning.

Recognizing the Symptoms: The most common symptom of plantar fasciitis is a sharp, stabbing pain in the heel, particularly when taking the first steps in the morning or after a prolonged period of inactivity. The pain may subside as you walk around, but it often returns after prolonged activity or at the end of the day. Other symptoms may include:

Aching or burning sensation in the heel.
Increased pain after exercising or standing for long periods.
Difficulty in climbing stairs or standing on tiptoes.

Diagnosing Plantar Fasciitis: If you experience persistent heel pain, it's crucial to consult a healthcare professional for a proper diagnosis. Your doctor will likely perform a physical examination and may order imaging tests like X-rays,ultrasounds or MRIs to rule out other potential causes of your pain.
Treatment Options: The good news is that plantar fasciitis can often be managed effectively with conservative treatments. Here are some common options:

Rest: Give your feet sufficient time to heal by avoiding activities that exacerbate the pain.
Ice: Applying ice to the affected area can help reduce inflammation and alleviate pain.
Stretching exercises: Regularly stretching the calf muscles and plantar fascia can improve flexibility and relieve tension.
Supportive footwear: Invest in shoes with adequate arch support and cushioning to reduce strain on the plantar fascia.
Orthotics: Custom orthotic inserts can provide additional support and alignment for your feet.
Physical therapy: Working with a physical therapist can help strengthen and stretch the affected areas.
Medications: Over-the-counter pain relievers or anti-inflammatory drugs may be recommended in some cases.

When to Seek Professional Help: If your symptoms persist despite trying conservative treatments, or if the pain becomes severe and affects your daily life, it's essential to seek further medical attention. At Kyrou Podiatry Associates we may suggest more advanced treatments, such as corticosteroid injections or surgical procedures such as
Tenex: Tenex is a medical procedure used to treat chronic tendonitis and related conditions. The full name of the procedure is "Tenex Health TX System" or simply "Tenex." It is a minimally invasive, non-surgical technique that aims to remove damaged tissue from tendons or soft tissues without the need for traditional open surgery.

Here's how the Tenex procedure works:
1. Targeting the Affected Tissue: First, the doctor uses ultrasound imaging to identify the damaged or diseased tissue precisely. This usually occurs in cases of chronic tendonitis, where repetitive stress has led to the formation of scar tissue or degenerated tissue in the tendon.
2. Ultrasonic Energy Application: Once the target tissue is identified, a small incision is made in the skin near the affected tendon. Through this incision, the doctor inserts the Tenex device, which emits ultrasonic energy. The ultrasonic energy is used to break down and liquefy the damaged tissue without harming the surrounding healthy tissue.
3. Tissue Removal: After breaking down the damaged tissue, the liquefied tissue is gently suctioned out of the body using the same Tenex device. This process helps to alleviate pressure on the tendon and promotes the body's natural healing response.
4. Minimal Recovery Time: The Tenex procedure is typically performed on an outpatient basis, and most patients can go home the same day. Recovery time is generally quicker compared to traditional open surgery, and patients can often resume normal activities within a few weeks, depending on the specific case.
Tenex is considered a viable option for patients who have not found relief from conservative treatments like physical therapy, rest, and anti-inflammatory medications. It provides an alternative to more invasive surgical procedures while still effectively addressing the underlying cause of chronic tendonitis.

It's important to note that, like any medical procedure, Tenex may not be suitable for everyone. If you are experiencing chronic tendon pain or have been diagnosed with tendonitis, it is essential to consult with a qualified healthcare professional to determine the most appropriate treatment plan for your specific condition. They can help you explore all available options and decide if the Tenex procedure is a suitable choice for you.
Endoscopic Plantar Fasciotomy :
Endoscopic Plantar Fasciotomy (EPF) is a surgical procedure used to treat chronic plantar fasciitis, a condition characterized by inflammation and pain in the plantar fascia, a thick band of tissue that runs along the bottom of the foot from the heel to the toes. EPF is considered a minimally invasive alternative to traditional open surgery for plantar fasciitis, and it aims to release tension in the plantar fascia and alleviate pain.

Here's how the Endoscopic Plantar Fasciotomy procedure is typically performed:
1. Anesthesia: Before the surgery, the patient is given either local or regional anesthesia to numb the foot and make the procedure more comfortable.
2. Small Incision: The surgeon makes a small incision (usually around 1 cm) near the heel of the affected foot.
3. Endoscope Insertion: An endoscope, which is a thin, flexible tube with a camera on the tip, is inserted through the incision. The camera allows the surgeon to visualize the inside of the foot without the need for a larger incision.
4. Release of the Plantar Fascia: Using specialized surgical instruments inserted through additional small incisions, the surgeon carefully cuts or releases a portion of the plantar fascia to reduce tension and relieve pressure on the inflamed tissue.
5. Incision Closure: Once the procedure is completed, the small incisions are closed with stitches or surgical adhesive.
Benefits of EPF:
- Minimally Invasive: EPF is a minimally invasive procedure, meaning it involves smaller incisions, resulting in less tissue damage, reduced scarring, and potentially faster recovery times compared to traditional open surgery.
- Outpatient Procedure: In many cases, Endoscopic Plantar Fasciotomy is performed on an outpatient basis, allowing patients to go home on the same day of the surgery.
- Faster Recovery: Since the procedure is less invasive, patients may experience less pain and a quicker return to normal activities compared to open surgery.
It's important to note that while EPF can be an effective treatment option for some individuals with chronic plantar fasciitis, not everyone is a suitable candidate for this procedure. The decision to undergo EPF or any other surgical intervention should be made in consultation with a qualified healthcare professional who can thoroughly assess the individual's condition, medical history, and overall health.

As with any medical procedure, there are potential risks and complications associated with EPF. These may include infection, nerve damage, or incomplete relief of symptoms. Patients should discuss these risks with their surgeon and be aware of the possible outcomes before proceeding with the surgery.

Conclusion: Plantar fasciitis can be a painful and debilitating condition, but with proper care and attention, it is manageable and often resolves over time.

Here at Kyrou Podiatry Associates we have had many years of experience treating plantar fasciitis and are up to date with the latest technology to properly treat plantar fasciitis.