Editing What Is Heel Discomfort
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<br>Overview<br><br><br>Plantar Fasciitis is a chronic pain in the heel that can just appear from nowhere but it is actually a long standing mechanical condition caused by prolonged stress on your foot. In most cases Plantar Fasciitis is a common, but very treatable, mechanical condition of the foot and responds positively to orthotics. A heel pain caused by prolonged stress on a ligament like structure in the arch that is very important in weigh-bearing activities. The tissue becomes damaged and needs to be helped to repair in order for the pain to go or subside to a manageable level. Orthotics for your feet can achieve this necessary healing for pain relief. It can be very painful, and even debilitating for sufferers.<br><br><br>Causes<br><br><br>The cause of plantar fasciitis is poorly understood and is thought to likely have several contributing factors. The plantar fascia is a thick fibrous band of connective tissue that originates from the medial tubercle and anterior aspect of the heel bone. From there, the fascia extends along the sole of the foot before inserting at the base of the toes, and supports the arch of the foot. Originally, plantar fasciitis was believed to be an inflammatory condition of the plantar fascia. However, within the last decade, studies have observed microscopic anatomical changes indicating that plantar fasciitis is actually due to a non-inflammatory structural breakdown of the plantar fascia rather than an inflammatory process. Due to this shift in thought about the underlying mechanisms in plantar fasciitis, many in the academic community have stated the condition should be renamed plantar fasciosis. The structural breakdown of the plantar fascia is believed to be the result of repetitive microtrauma (small tears). Microscopic examination of the plantar fascia often shows myxomatous degeneration, connective tissue calcium deposits, and disorganized collagen fibers. Disruptions in the plantar fascia’s normal mechanical movement during standing and walking (known as the Windlass mechanism) are thought to contribute to the development of plantar fasciitis by placing excess strain on the calcaneal tuberosity.<br><br><br>Symptoms<br><br><br>Most patients with plantar fasciitis describe a sharp or stabbing pain on the bottom of the heel that is most severe when they first get up in the morning or after a period of resting. Some may feel like the heel is bruised while others may describe tightness or even a pulling sensation on the heel or arch.<br><br><br>Diagnosis<br><br><br>X-rays are a commonly used diagnostic imaging technique to rule out the possibility of a bone spur as a cause of your heel pain. A bone spur, if it is present in this location, is probably not the cause of your pain, but it is evidence that your plantar fascia has been exerting excessive force on your heel bone. X-ray images can also help determine if you have arthritis or whether other, more rare problems, stress fractures, bone tumors-are contributing to your heel pain.<br><br><br>Non Surgical Treatment<br><br><br>Your GP or podiatrist may advise you to change your footwear. You should avoid wearing flat-soled shoes, because they will not provide your heel with support and could make your heel pain worse. Ideally, you should wear shoes that cushion your heels and provide a good level of support to the arches of your feet. For women wearing high heels, and for men wearing heeled boots or brogues, can provide short- to medium-term pain relief, as they help reduce pressure on the heels. However, these types of shoes may not be suitable in the long term, because they can lead to further episodes of heel pain. Your GP or podiatrist can advise on footwear. Orthoses are insoles that fit inside your shoe to support your foot and help your heel recover. You can buy orthoses off-the-shelf from sports shops and larger pharmacies. Alternatively, your podiatrist should be able to recommend a supplier. If your pain does not respond to treatment and keeps recurring, or if you have an abnormal foot shape or structure, custom-made orthoses are available. These are specifically made to fit the shape of your feet. However, there is currently no evidence to suggest that custom-made orthoses are more effective than those bought off-the-shelf. An alternative to using orthoses is to have your heel strapped with sports strapping (zinc oxide) tape, which helps relieve pressure on your heel. Your GP or podiatrist can teach you [http://www.daozhouwang.com/home.php?mod=space&uid=1164877&do=profile&from=space How do you get taller?] to apply the tape yourself. In some cases, night splints can also be useful. Most people sleep with their toes pointing down, which means tissue inside the heel is squeezed together. Night splints, which look like boots, are designed to keep your toes and feet pointing up while you are asleep. This will stretch both your Achilles tendon and your plantar fascia, which should help speed up your recovery time. Night splints are usually only available from specialist shops and online retailers. Again, your podiatrist should be able to recommend a supplier. If treatment hasn't helped relieve your painful symptoms, your GP may recommend corticosteroid injections. Corticosteroids are a type of medication that have a powerful anti-inflammatory effect. They have to be used sparingly because overuse can cause serious side effects, such as weight gain and high blood pressure (hypertension). As a result, it is usually recommended that no more than three corticosteroid injections are given within a year in any part of the body. Before having a corticosteroid injection, a local anaesthetic may be used to numb your foot so you don't feel any pain.<br><br><br><br>Surgical Treatment<br><br><br>In very rare cases plantar fascia surgery is suggested, as a last resort. In this case the surgeon makes an incision into the ligament, partially cutting the plantar fascia to release it. If a heel spur is present, the surgeon will remove it. Plantar Fasciitis surgery should always be considered the last resort when all the conventional treatment methods have failed to succeed. Endoscopic plantar fasciotomy (EPF) is a form of surgery whereby two incisions are made around the heel and the ligament is being detached from the heel bone allowing the new ligament to develop in the same place. In some cases the surgeon may decide to remove the heel spur itself, if present. Just like any type of surgery, Plantar Fascia surgery comes with certain risks and side effects. For example, the arch of the foot may drop and become weak. Wearing an arch support after surgery is therefore recommended. Heel spur surgeries may also do some damage to veins and arteries of your foot that allow blood supply in the area. This will increase the time of recovery.<br><br><br>Prevention<br><br><br>Maintain a healthy weight. This minimizes the stress on your plantar fascia. Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don't go barefoot, especially on hard surfaces. Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 500 miles of use. Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging. Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation. Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.
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