The Doctor Is In

By Damon Raskin, M.D.  |  Special to the Palisadian-Post

Q: At the start of February, I was diagnosed with plantar fasciitis by my general practitioner, and they gave me a sheet with some exercises and put me on naproxen. I work in a hospital as a nursing assistant so spend a lot of the day on my feet and I have had some insoles made to go in my shoes to try and help me. The most annoying thing for me is that I want to start a regular running regime to help with weight loss and I was told by my GP that losing some weight will also help with the plantar fasciitis. I’m at a loss what else to do, is there anything more that I could be doing to return my feet to normal or am I basically doomed to just wait and hope it’ll one day pass?

Well, although your current medical situation at first seems challenging, let’s not get all “doom and gloom” now! What I always say is, “Let’s put our best foot forward.”

Plantar fasciitis is a fancy term for inflammation of the thick tissue that connects your heel to your toes. If your first steps in the morning cause a stabbing pain in your heel, you probably have it.

It is very common, especially in runners. It is also common in those who have flat feet, high arches, are overweight or who are on their feet a lot. It is also more common in women.

The good news is that with the right treatment, the condition usually does go away in several months, but there are ways to get better faster.

Your doctor did give you good advice, as anti-inflammatory medicines (like Naproxen), certain exercises and some shoe inserts are all good ways of easing the discomfort. And, you are right that weight loss can often be a big help.

But what happens if these do not work or are too slow to help the healing? It may be time to see a specialist like a podiatrist for other strategies.

Sometimes a steroid injection when placed into the most painful part of the connective tissue will ease the pain and reduce inflammation more rapidly. Physical therapy may also be quite helpful, as the therapists should be well trained to do massage, stretching and strengthening exercises and ultrasound to promote long-term healing.

If you still do not respond, there are more invasive techniques as well for this painful condition. The first is shock wave therapy, which uses sound waves to stimulate blood flow in the foot. This helps the tissue heal and can also stun the nerves to stop pain.

In addition, there is also a Tenex procedure, which requires a small incision and scar tissue is removed under ultrasound guidance. It takes only a few minutes and most patients are back to their regular routine in 10 days.

Finally, the last resort is surgery wherein the operation takes the plantar fascia off the heel bone, and then you often wear a splint or boot and stay off your foot for a short period of time.

You can still lose weight without high impact activities, which will prevent recurrence of this condition. Swimming or cycling, for example, can be beneficial, especially if you stretch out your calves after exercise.

Avoiding running and jumping, as well as choosing shoes with good support, are other preventive measures you can take. Replace your athletic shoes often, avoid high heels and do not go barefoot on hard surfaces.

Talk with your supervisor about your condition, and maybe you can get an assignment with patients all close together in one part of the hospital to reduce your excessive walking. A proper healthy diet will help promote weight loss, which will in turn help your feet.

All in all, these are some helpful hints to start the healing process. Have a good attitude each morning and just don’t put your foot in your mouth.

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