Question:Is there anything new in the world of plantar fasciitis? I've had this problem for 10 years now with no improvement. I've tried heel pads, orthotics, aspirin, night splints, and steroid injections. Nothing has helped. Ouch.
Answer:Plantar fasciitis can be difficult to treat successfully. Often, it requires time and many trials of different treatment combinations. Some patients get lucky and within six to eight weeks, they are better. For others, it can take six to 12 months to find the right mix.
Even if you have tried a variety of methods, you may still get pain relief by trying them together in different ways. The American Orthopaedic Foot and Ankle Society (AOFAS) recommends heel padding, medications, and stretching first.
If you fail to get pain relief, or if your pain is reduced but not eliminated, then custom orthotics and physical therapy can be added next.
Two new methods are under investigation. Early reports are favorable. The first is shock wave therapy. Sound waves directed at the insertion point of the plantar fascia may help the healing process.
Scientists aren't sure yet exactly how this works. They think the force of the energy waves sets up a microdisruption of the plantar fascia tissue. The body responds with the release of growth factors and stem cells. The result is a healing response.
Another new treatment is radiofrequency waves. Exposing the area to radiofrequency stimulation aids in the formation of new blood vessels. Increased blood flow to the area generates tissue healing.
Clinical trials are underway using BOTOX injections for plantar fasciitis. The toxin causes paralysis of the injected muscles. In short-term studies done so far, there have been no side effects. More studies are needed before shock waves, radiofrequency, or BOTOX become standard methods of treatment.Steven K. Neufeld, MD, and Rebecca Cerrato, MD. Plantar Fasciitis: Evaluation and Treatment. In Journal of the American Academy of Orthopaedic Surgeons. June 2008. Vol. 16. No. 6. Pp. 338-346.
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