Plantar fasciitis and bone spur - Orthoinfo - AAOS (2023)

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Plantar fasciitis (fashionable eye) is one of the most common causes of pain at the bottom of the heel. The year of the Judes is treated for this condition to some 2 million patients.

Plantar fasciitis occurs when plantar fascia, a strong tissue tape that supports, irritates and inflames the arch.

Anatomy

The plantar fascia is a long and thin tape, located directly under the skin at the bottom of the foot. The heel connects in front of the foot and holds the arch.

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The plantar fascia is a band that is under the skin at the bottom of the foot.

Weil

The plantar fascia is intended to absorb the upper loads and loads that we put on our feet when walking, running, running, running, running, but sometimes damaging or tearing a lot of pressure. The heel pain and the stiffness of plantar fasciitis they lead.

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A lot of pressure on the plantar fascia can damage the fabric or breakage and cause pain pain.

Risk factor's

In most cases, plantar fasciitis develops without a specific and identifiable reason. However, there are many factors that can make them more susceptible to the disease:

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  • New or greater activity
  • Repeated activities with high impact (race/dance/sport)
  • Longer reputation on hard surfaces (especially among nurses, factor and teachers workers)
  • Anatomy (boring feet or a high arch)
  • Climbing calf muscles
  • obesity
  • Age (plantar fascis occurs mainly in people between 40 and 60 years))))

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Symptoms

The most common symptoms of plantar fasciitis are:

  • Pain in the lower foot near the heel.
  • Pain with the first steps after being taken out of bed in the morning or after a long rest period after a long trip.
  • Greater pain after (not during) training or activity.

Medical exam

After describing your symptoms and discussing your concerns, your doctor examines your foot. You will search this signal:

  • A high sheet orFlat flight
  • An area of maximum sensitivity at the bottom of the foot, right in front of the heel bone
  • Limited dorsial lexion or movement above in your ankle
  • The lack of symptoms of other diseases, such as insertionAchilles -TendinitaGiftsCalcon voltage fracture (Fersen), the nervous inclusion of star plant
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Testicles

Your doctor can request image tests to ensure that the pain of your heel is caused by plantar fasciitis and not by another problem.

X -Arra

X -rays provide clear bone images. They are useful to exclude other causes of heel pain, such as: b.fractures orArthritis.

Heel spores can be seen in an X -rays. A heel spur can be the result of a long -term tension of the plantar fascia is (the place in the heel bone where the plantar fascia is located). The bone sporesThe heel are not the cause of plantar fasciitis, painting pain can be treated without eliminating spur.

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Heel spores do not cause pain in fasciitis planting.

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Other image tests

Other image tests, such as magnetic resonance (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are ordered.

A magnetic resonance image can be used if heel pain is not relieved by initial treatment methods or if your doctor fears that another problem causes the pain of your heel.

treatment

Non -surgical treatment

More than 90% of patients with plantar fasciitis will improve within 10 months after the start of simple treatment methods.

Rest.Reduce or even the activities that make pain worse is the first step to reduce pain. It is possible that you have to stop sports where your feet on hard surfaces (for example, supplier, dance or start) may recommend that you use start and crutchesFor a short time for your foot to rest.

Change your activity.Low impact exercises, such as cycling or swimming, are less stress in the joints and feet than walking or running.

Variety.Plantar fasciitis is adjusted by tight muscles on the feet and calves. Stretching its calves and plantar fascia is the most effective way to relieve pain associated with this state.

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Stretching

  • Stretching
    Tilt with a knee and a heel on the floor in front of one wall. COLLECT THE OTHER LEG WITH THE KNEWseconds and relax. Receive this exercise 20 times for each foot. During the route, a strong costume must be remarkable in the calf.
  • Parry
    This route is made in the sitting position. Cruce the affected foot on the other knee of the leg. Take your painful fingers and pull you. If it is difficult to reach the foot, wrap a towel around your standing thumb to pull theFingers of your feet to you. Put the other hand on the plantar fascia. Fascia must be seen as a tight strip at the bottom of the foot when it stretches. He still stretches for 10 seconds. Repeat 20 times for each foot, this exercise isDo better in the morning before stopping or walking.

Eis.It is effective winding the foot with a bottle of cold water or ice for 20 minutes. This can occur 3 to 4 times a day.

Non -Alesterosid Non -Eyeinflamatory Medication (NSAIDs).Medications such as ibuprofen or naproxen reduce pain and inflammation. The use of the medication for more than a month should be verified with your family doctor.

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Physiotherapy.Your doctor can suggest that you work with a physiotherapist in a training program that focuses on stretching the calf muscles and planting fascia. To reduce planting fascia.

Shoes and orthosis support.Shoes with thick plants and additional cushioning can reduce the pain of standing and walking. If treads and your heel hits the floor, a considerable amount of tensions in the fascia is placed, which causes microtrauma (small tears in the fabric) .unShoe or padded use reduces this voltage and the microtrauma that occurs with each step. Silicone pillows are cheap and work increase and fill the heel. Prepared or personalized ortones (shoe cells) are also useful.

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Soft heel pillows can offer additional support.

Avoid shoes that do not support and spend. Keep replace your old sports shoes before wearing up and no longer supports your feet.

Rails Noturnos.Most people sleep with their feet. This relaxes the plantar fascia and is one of the reasons for the morning pain of painting. A night train stretches the plantation of the fascia while sleeping. To reduce pain in heel tothrough plantar fasciitis.

Other treatments

Your medical care provider may recommend the following procedures if it remains symptomatic after several months of conservative treatments.

List.Using a line, for a short time, it can be extremely useful for treatBe a better option than initial property.

Cortisone injections.Cortisone, a kind of steroids, is a strong anti -inflammatory medicine. It can be injected into the plantar fascia to reduce inflammation and pain.

Your doctor can restrict or prevent this treatment as steroid injections weaken the plantar fascia and can cause a break (crack), which can cause chronic foot and pain.

Plasma injections rich in thrombocytes (PRP).PRP is obtained from your own blood and can be injected into the plantar fascia to promote healing. PRP injections do not run the risk of leading to a plantar fascia. De injections of PRP necessary.

Shock wave therapy because by extracor (ESWT).During this procedure, the impulses of the shock wave rich in energy stimulate the healing process in damaged plantar fascism, showed no consistent results and, therefore, are generally not performed.

ESWT is not invasive: it does not require a surgical incision. Sometimes, ESWT is experienced from the minimum risk before the operation is taken into account.

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Ultrasound tissue repair.This is a minimally invasive treatment for patients with persistent plantar (continuous).

Surgical treatment

As more than 90% of patients with plantar fasciitis recover with non -surgical treatment, surgery generally reserves for people who did not improve after 12 months of non -surgical treatment.

Gastrocnemius recession.This is a surgical extension of the calf muscles (gastrocnemio)..

In the recession of the gastrocnemio, one of the two muscles of which the calf consists extends to increase the movement of the ankle. The process can be carried out with a traditional, open cut or a smaller average and an endoscope that contains a small cameraThe doctor will discuss the procedure that best meets their requirements.

The rates of complications for the recession of Gastrocnemius are low, but may include damage to the nerve and the weakness of the calf.

Partial liberation of plantar fascia.A partial planting fascia that is usually done at the same time as a gastrocnema recession includes a partial planting fascia that produces a cut on the floor or on the heel side. The band is in the bone) and makes a partial cut to relieveThe tension in the fabric. If there is a large bone spur, it can also be removed.

Although the operation can be carried out endoscopically, it is more difficult than with an open cut.

  • ComplicationsThe most common complications in release surgery include an incomplete relief of pain and nervous damage.
  • Restoration.After the operation, little time with protected weight is recommended to cure the incision.

Most patients have good results in the operation, but since surgery can cause chronic pain and dissatisfaction, this is recommended only after all non -surgical measures have been exhausted.

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Information on this topic is also available as available.OrtoinfoBasic concepts in PDF Basic concepts.

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