Foot and ankle joint

Plantar fasciitis – „calcaneal spur”

Plantar fascia

Plantar fasciitis is a disease whose symptoms are sudden and very irritating pain in the area of the heel. Colloquially referred to as a calcaneal spur, yet the spur is the radiological symptom which is presented in the X-ray in the form of an appendix, that is a heel bone spine. The very plantar fasciitis is not visible in such picture because it refers to soft tissue. The plantar fascia is an anatomic structure which stretches from heel bone tuber to fingers, thus assuring a proper shape of the foot as well as free walk and movement.

Who does the problem refer to?

Both women and men have to deal with this problem, yet overweight people and persons with limited ankle movements are highly susceptible to this disease. It may result from using high heels by women for a long time or doing sport, and applies to runners or dancers.

Methods of treatment

There are two forms of this disease – plantar fasciitis and its degeneration. A key element in further treatment is a relevant diagnostics. In mildest forms a suitable footwear is sufficient, as well as insoles which cushion heel bone loads and stretching exercises. In advanced forms we need to resort to pharmacotherapy – non-steroid anti-inflammatory drugs or steroid drugs in the form of injection supported by rehabilitation.

Degenerative changes

When cells of the plantar fascia die and are replaced with mucoid degeneration processes, and the tendon healing and regeneration potential is very limited, we have to use mother cell preparations. As a rule, we use patient’s bone marrow which is harvested and prepared and then injected under supervision of ultrasound scan to the most damaged areas in the plantar fascia structures. All drugs are certainly an addition to the actual treatment, that is rehabilitation. The plantar fascia is very rarely a disease itself as it is frequently accompanied by calf muscle contracture or e.g. foot structure disorders. Then we have to provide comprehensive treatment of other complaints as well. A proper diagnosis is a key.

In the worst-case scenarios and in the case of the most advanced forms when the non-surgical treatment fails, our clinic tends to apply surgical treatments and endoscopic treatment of plantar fascia. Thanks to this, it is possible to regain fitness for a long time.

Anatomy, causes, symptoms and methods of treatment discussed by:
MD Paweł Bąkowski, Rehasport Clinic orthopedist