What is plantar faciitis?
Dr. William Nelson, medical director at Explore Health, located in Scottsdale, AZ and Flagstaff, AZ is an expert in successfully evaluating and treating plantar fasciitis. He says, it's important for patients to understand their condition and their treatment options."
Although plantar fasciitis, means inflammation of the plantar fascia, recent studies reveal this condition is more accurately described as a degeneration of the plantar facia. plantar fasciitis degenerative report
Doctors once thought bony growths called heel spurs brought on the pain. Now they believe that heel spurs are the result -- not the cause -- of plantar fasciitis.
Approximately one out of ten adults will deal with plantar fasciitis in their life and there are an estimated 3 million annual visits to primary care physicians for the evaluation and treatment of plantar fasciitis.
For some, successful treatment may simply require avoiding certain activities or wearing a boot to restrict movement combined with daily alternating application of heat and ice. For others with more severe plantar pain, they'll need a plantar fasciitis treatment expert.
What are the symptoms of Plantar Fasciitis?
Plantar fasciitis causes pain in your heel or arch of your foot. It’s usually worse when you take your first steps in the morning or after you’ve been sitting for a long time. It tends to feel better with moderate activity but the pain will usually increase after extended periods of standing, walking or activities where you put stress on the inflammed tissues in the bottom of your foot.
What are plantar fasciitis causes and risk factors?
Your fascia is the connective tissue on the bottom of your foot that supports the muscles and arch of your foot. When overly stretched or injured, your fascia can develop tiny tears in the tissue. The body attempts to strength the compromised tissue by thickening the fascia and/or depositing calcium into the tissue. Calcification and thickening of the tissue actually makes the fascia less flexible, weaker and more painful.
You’re at greater risk of plantar fasciitis if you:
- Are female
- Are 40 to 60 years old
- Are overweight
- Have flat feet or high arches
- Have tight Achilles tendons, or “heel cords”
- Have an unusual walk or foot position
- Often wear high-heeled shoes
- Run on hard surfaces
- Spend many hours standing each day
- Wear worn-out shoes with thin soles
- Are currently taking oral steroids or have had steroid injections
- Have been prescribed fluoroquinolone antibacterial drugs fda study linking drugs with tendon damage
- Have recently increased exercising involving walking, running or jumping
- diabetes or poor blood sugar control diabetes and soft tissue damage relationship
- Vit D deficiency Vit D deficiency and soft tissue injury
What is the fastest way to heal plantar fasciitis?
Unfortunately, painful and plantar fasciitis that limits a patients ability to walk, run, etc, usually does not heal quickly. In fact, the more severe the symptoms and the longer it has been remained untreated, the longer it takes to heal. Many people look for a quick fix in order to get back to their favorite activity, sport, etc.
Mild discomfort of plantar fascia may respond to conservative treatment within days to weeks, while more severe and prolonged pain may require months to respond to conservative treatment.
Ninety percent of patients can resolve their heel pain and plantar fasciitis with conservative treatment, conservative plantar fasciitis treatment.
What is conservative treatment of plantar fasciitis?
In a conventional medical setting, conservative treatment includes the following: conservative conventional treatment
- Physical therapy. Exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. Physical therapy exercises from University of Washington
- Night splints. Your physical therapist or health care provider might recommend that you wear a splint that holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching while you sleep. Amazon.com night splints for plantar fasciitis
- Orthotics. Your health care provider might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to distribute the pressure on your feet more evenly. Amazon.com orthotics for plantar fasciitis
- Walking boot. Your health care provider might recommend one of these for a brief period either to keep you from moving your foot or to keep you from placing your full weight on your foot. amazon.com walking boot for plantar fasciitis
Conservative treatment in a complementary medical setting may include:
Ultrasound, radiofrequency, and laser treatment of plantar fascia inflammation. Explore Health utilizes these modalities to increase circulation, blood flow, remove metabolic waste and to promote healing of compromised soft tissue. These treatments also help break up calcifications of the soft tissue that restricts movement, decreases tissue integrity, and leads to further degeneration.
Naturopathic care to identify and treat underlying causes of systemic inflammation and structural stress from low back and hip problems and the nerves supplying the foot.
What plantar fasciitis treatments are covered by insurance?
If conservative treatments were not successful for eliminating the plantar fasciitis pain, the following options are available from conventional medical doctors or podiatrists.
- Injections. Steroid injections are commonly performed as the next step for plantar fasciitis treatment in an insurance based medical office (primary care or podiatrist). Unfortunately, cortisone injections are usually ineffective or the benefits are not long lasting. In addition, cotisone injections have been shown to weaken your plantar fascia and increase the risk of catastrophic plantar fascia tissue rupture. Cortisone injections increase risk of plantar fasciitis rupture.
- Extracorporeal shock wave therapy. Pressure waves are directed at the area of heel pain to stimulate healing. No long term studies have shown this treatment to be effective but it may prove to be beneficial. Extracorporeal shock wave therapy
- Ultrasonic tissue repair. This minimally invasive technology uses ultrasound imaging to guide a needlelike probe into the damaged plantar fascia tissue. This treatment has shown promise but has not been proven to be effecive. US tissue repair study
- Surgery. Surgery to correct plantar fasciitis is only performed on 5-10% of cases in an insurance based practice when all more conservative treatment modalities have failed. The success rate, recovery time and insurance reimbursements all favor other approaches to treatment.
What are the latest advances in plantar fasciitis treatment?
Dr. William Nelson, at Explore Health, in Scottsdale, AZ and Prescott, AZ has successfully treated hundreds of patients that have exhausted their efforts to become pain free using conservative treatments or more aggressive treatments offered by insurance based medical clinics.
After reviewing previous or newly ordered X-Ray, MRI, or CT studies, Dr. Nelson will perform a physical exam that includes a functional assessment of your plantar fasciitis and an in-office ultrasound evaluation of all the soft tissue and the nerves that may be causing your plantar fasciitis pain.
Once this information has been obtained, Dr. Nelson will help you decide what is the best approach to help heal your heel pain.
Your individualized treatment plan may include identifying and treating the underlying causes of inflammation and dysfunction including:
- undiagnosed chronic bacterial infection, mold, metal toxicity
- chronic infection in the jaw or undiagnosed problematic root canals
- inflammation and toxicity due to poor gut function and liver detoxification
- blockage of blood flow and lymphatic drainage due to previous surgical scars and/or scars from trauma
- Identifying associated soft tissue injuries and peripheral nerve impingement that are causing the plantar fasciitis and make healing impossible.
Our most successful treatments for plantar fasciitis are accomplished with Regenerative injections. These include:
Platelet Rich Plasma (PRP) - PRP injections is a safe biological means to stimulate physiologic soft tissue repair and regeneration. PRP is unique because it utilizes the amazing healing constituents contained in the patients blood. A small clinical trial shows that PRP is very successful at treating plantar fasciitis. PRP plantar fasciitis study The collection procedure is quick and easy and involves:
- A small sample of your blood is drawn and collected into a special device.
- The special device is then centrifuged at a high speed, two separate times, to isolate and concentrate the purest PRP.
- Once the PRP has been collected, it is injected into the injured plantar fascia tissue using Ultrasound guided injection technique to insure accurate and safe delivery to start the regenerative process.
Mesenchymal Stem-cell derived Exosome Injections
Exosomes are the latest advancement in state-of-the-art biological regenerative medicine. They contain high concentrations of growth factors, transcription factors messenger RNA, and matrix proteins that govern cell structure, function, signaling, regeneration, and growth. Exosomes tissue regeneration study
When Exosomes are accurately delivered to damaged target cells, they iniate the production of numerous copies of the new, healthy ligaments, tendons, and cartilage tissues. In addition to the proliferative effect on promoting new tissue growth, exosomal proteins also help decrease inflammation and degeneration of the compromised tissue.
In the past, we had to surgically remove the patient's stem cells from their bone marrow in their hip or by extracting their fat derived stem cells via liposuction. Our office now uses only exosome products which provides superior therapeutic benefits without the pain, expense and risks of invasive stem-cell extraction procedures.
Just as with the PRP injections, the benefits of the exosomes are only as good as the accuracy of the injections. In addition to 20 years or anatomy informed, palpation guided injections, Dr. Nelson has now performed hundreds of ultrasound guided injections to optimize his results to repair plantar fascia damaged tissue.
Can your office help me with my plantar fasciitis? Am I a good candidate for non-surgical treatment with PRP, or stem-cell derived regenerative injections for plantar fasciitis?
Patients with plantar fasciitis wondering if we can help can schedule a free 15-minute phone consultation with Dr. William Nelson, Scottdale's plantar fasciitis specialist., to determine if we can help resolve your plantar fasciitis problem. Please contact our Scottsdale or Flagstaff, AZ office at 602-692-4626 to schedule your free consultation. We look forward to helping you.
Dr. William Nelson, has been performing regenerative orthopedics since 1996 and continually is improving his craft by combining the time-honored materials and techniques of the original prolotherapist with the latest advances in regenerative injection therapeutic techniques