Chronic Plantar Fasciitis – Symptoms & Plantar Fasciitis Treatment
Patients with chronic plantar fasciitis (P.F) will have been suffering with symptoms for more than 2-4 weeks. The symptoms become consistent and the patients are able to see the patterns. Usually, the pain arises every single morning without fail. It is sometimes described as groundhog day – patients know that as soon as their foot hits the ground in the morning they will feel heel pain, which eases after a few minutes of walking.
These patients also know that later in the day if they sit down for a long enough period of time they will be sore as soon as they stand up and start walking. Some patients with chronic Plantar Fasciitis will also experience throbbing and shooting pains at rest – while driving or sitting down.
Plantar fasciitis – Common Causes
More often than not, patients with chronic P.F will have tight calf muscles. The tight calf muscles pull on the heel and this allows the acute plantar fasciitis to develop into chronic disease.
People who stand up at work or walk for long periods generally develop this as there is no rest for the heel. Flat and flexible shoes that are unsupportive can cause this condition too. They allow too much stress on the foot and the continued strain on the heel produces more and more inflammation. People who stand up at work or walk for long periods can prevent the condition from developing by wearing more supportive shoes.
Shoes with a slight heel and a more rigid sole provide more support. If a patient is suffering with acute P.F and they continue to wear the wrong shoes they are almost certainly going to develop the chronic form of the condition.
Chronic Plantar Fasciitis
X-rays don’t help
X rays will usually show a heel spur and calcification of the Plantar Fascia or Achilles tendon. They rarely show inflammation of the plantar fascia. To this end, the x-ray does not help the Podiatrist to help the patient (heel spurs rarely cause pain).
Patients with chronic P.F are better off having an ultrasound scan rather than an x-ray. This will help to detect micro-tears in the plantar fascia in addition to inflammation. The inflammation confirms chronic P.F, although a podiatrist who is experienced in treating the condition will usually be able to diagnose the condition during the consultation.
Forced changes to lifestyle
Frustration sets in as patients with the condition have no choice but to give up their morning walks, stop running, avoid tennis or reduce their preferred form of activity. Even the pet dog starts to suffer as he misses out on his daily walks!
All of the above situations are extremely common in patients who attend the clinic for chronic P.F treatment. This problem is compounded by the fact that inactivity leads to weight gain – and weight gain leads to tighter calf muscles and more stress on the feet. It’s a vicious circle and requires intervention.
Chronic Plantar Fasciitis
We have to unload the fascia – fact. Patients with Chronic Plantar Fasciitis MUST engage in treatment that is designed to take stress away from the plantar fascia.
Strapping, orthotics, a change in shoes, or an immobilisation boot if the condition warrants it – one of these forms of intervention is almost always required for patients suffering with chronic P.F.
Patients MUST stretch their calf muscles too (correct technique is crucial or else can be detrimental) if they are found to be tight.
If you are suffering with chronic P.F and you would like to learn more you may wish to click on the following Plantar Fasciitis Treatment and book or request an appointment at Sydney Heel Pain.
Written by Karl Lockett
SOME FREQUENTLY ASKED QUESTIONS
What aggravates plantar fasciitis?
Plantar fasciitis pain can be debilitating, often affecting the daily life of the patient. The best way to avoid experiencing a flare up, is to closely follow the instructions of your podiatrist, making sure that you are regularly carrying out any remedial treatments they have recommended.
Some of the common triggers that can lead to a flare up or aggravation of P.F can include:
- Starting a new physical activity, especially those that require you to walk barefoot such as martial arts or dance
- Sudden changes in the intensity of activity
- Tight calf muscles, specifically the gastrocnemius and soleus muscles
- Weight gain, even if it’s healthy weight gain
- New shoes, or old shoes!
Is it okay to walk with plantar fasciitis?
Every patient is different. For some people, the symptoms of plantar fasciitis are improved simply by walking around for a few minutes, as blood flow to the planar fascia increases and it begins to stretch out. For other patients, their condition causes them so much foot pain that it hinders their daily activities. It is important that you do not modify the way you walk in an attempt to ease your discomfort; even slight changes that shift your balance can lead to other foot, ankle, knee or hip injuries.
Your podiatrist will be able to make a thorough assessment of your condition, and from there they can offer solutions to treat plantar fasciitis and get you back to doing the things you love.
What happens if you ignore plantar fasciitis?
As we touched on above, ignoring the signs and symptoms of plantar fasciitis is not a good idea. Many patients brush off the pain in the hope that it will go away, however this is seldom the case. Daily load on the plantar fascia exacerbates the inflammation, and in just a short time frame of 2-4 weeks, the condition becomes chronic. In some patients, heel spurs may also form as the fascia pulls at the attachment point on the bone. Whilst these spurs are not typically the cause of pain, pain from chronic P.F may be severe due to the inflammation around the bone spur.
If you are experiencing the symptoms of P.F, you may contact our clinic by phone or email to arrange a consultation with a qualified podiatrist who is highly experienced and expertly skilled in the treatment of plantar fasciitis and bone spur related heel pain.
How long does it take for plantar fasciitis to go away?
The recovery time for P.F varies between individuals. There are a lot of factors that determine how quickly someone finds relief and heals. At Sydney Heel Pain Clinic, we are experts in the treatment of foot and heel pain conditions, and we have a special interest in treating P.F. We have tried and tested pretty much every treatment that exists for the condition, and having treated thousands of patients successfully over the years, we know what works.
Provided that you follow your podiatrists instructions and recommendations closely, adhering to the treatment plan, you can expect to see an improvement in just a few short weeks. Complete healing generally takes 6 to 8 weeks but can take longer depending on the severity of the condition, how long it has been present, the patient’s lifestyle factors and their adherence to the prescribed treatment plan.
Our podiatrists offer a variety of treatments to suit patients in every circumstance, from prescribed stretches, to immobilisation boots, custom-made orthotic devices, extracorporeal shockwave therapy, strapping, and footwear recommendations, plus more.
Invasive procedures such as plantar fascia release are very rarely necessary.
Can plantar fasciitis affect only one foot?
Yes, it is common to only affect one foot. Human beings are not symmetrical; most people will have a bigger foot, a longer leg, or even a shorter stride on one side, which means that the load on the feet is not equal. Hence most foot pain conditions will start on one side. Of course, if the pain is allowed to progress, the other foot may then also become painful due to compensation/added pressure on the “good” foot over time.
If you find that you are suddenly having painful symptoms in both feet at the same time (especially if your arches are more sore than your heels), this may be due to an underlying autoimmune condition, internal inflammatory changes, hormonal changes or digestive disease.