Plantar Fasciitis Treatment Dover DE
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Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1993
Hospital: Bay Health Med Ctr -Kent, Dover, De
Group Practice: Tooze & Easter
Medical School: Ohio Univ, Coll Of Osteo Med, Athens Oh 45701
Graduation Year: 1984
Medical School: Med Coll Of Pa, Philadelphia Pa 19129
Graduation Year: 1992
New Treatment Advice for Plantar Fasciitis
If you suffer from heel pain as a result of plantar fasciitis, you are not alone. An estimated two million adults in the United States experience significant heel pain every year. And over time, at least one in 10 Americans will report this common foot pain problem.
The problem may be more aptly named by calling it "plantar heel pain" because studies show there is no active inflammatory component. The tissue quit trying to self-repair long ago. Sharp pain without swelling, heat, or other signs of inflammation is the only symptom. But that pain can be very disabling affecting quality of life.
The standard treatment for plantar fasciitis includes actively stretching the gastrocnemius and soleus (calf) muscles and passively stretching the plantar fascia (connective tissue along the bottom of the foot). Other conservative measures often used include medications and steroid injections. In severe cases that don't respond to nonoperative treatment, surgery may be an option.
In this study, physical therapists from Brazil compare the use of stretching alone with a program of manual therapy combined with stretching. In this instance, manual therapy refers to the release of trigger points in the calf. This technique is done by the therapist's hands directly over the calf muscles and applying pressure and then light stroking to the soft tissue structures.
Trigger points are irritable areas in the muscle. The area becomes tight and stiff keeping the muscle from moving (and stretching) normally. It's that stiffness that these researchers thought might respond better to manual therapy along with stretching.
Stretching alone doesn't always stop the pain or alleviate the problem. In theory, until the trigger point has been released, the heel pain will continue (or come back as soon as the stretching stops).
The groups were randomly assigned to the two treatment groups. Group one performed stretching exercises prescribed by the physical therapist. Group two were actively treated with manual therapy by the therapist and then did the same stretching program as group one.
Everyone came to the physical therapy clinic four times each week for a month. At the beginning and end of treatment (i.e., four weeks later), patient levels of pain, function, and pressure pain thresholds (PPTs) were measured.
As the name suggests, pressure pain threshold is the amount of pressure applied to the heel needed to create a painful response. A special device called a mechanical pressure algometer was used to take this measurement.
Results showed greater improvement in all measures for the manual therapy plus stretching group. Patients in both groups got better but the manual therapy group had statistically significant improvements over the stretching only group.
The conclusion is that stretching is good but stretching with a little hands-on work is yields much better results. The exact mechanism by which this works isn't known. It could be that ...
Shock-Wave Treatment for Plantar Fasciitis
Doctors at eight centers studied the use of a high-energy electrohydraulic shock-wave (EHSW) device to treat plantar fasciitis. The study was done in two phases. The first phase involved 20 patients and tested the treatment for safety. The second phase had 344 patients and looked at both safety and effectiveness of this treatment method.
All patients had heel pain lasting at least six months. Everyone had been treated with physical therapy, orthotic devices, and drugs, but they didn't get better. In the second phase there were two groups of patients. One group received shock-wave treatment to the bottom of the foot. The second group had a placebo treatment (shock waves that weren't absorbed).
Results were measured before treatment, three months after treatment ended, and one year after treatment ended. Pain levels and X-rays of heel spurs were used to measure results. Success was defined as 50 percent improvement in pain on first walking in the morning. Success also meant the patient didn't use any pain relievers for any reason.
The authors reported that age isn't linked with success of treatment. Patients who had symptoms for less time had better results. Patients in the treatment group had a better response than the placebo group. No one was made worse by the treatment.
The authors say there is plenty of proof that shock-wave treatment helps reduce heel pain caused by plantar fasciitis. EHSW should be used after conservative treatment, but before surgery....
Simple Stretch Works for Chronic Plantar Fasciitis
Physical therapists (PTs) often help patients find ways to stretch as a treatment for chronic soft tissue problems. In this study, a group of PTs from the Center for Foot and Ankle Research at the University of Rochester (New York) report on a fascia-stretching program for chronic plantar fasciitis.
An earlier study by this same group presented the results of 82 patients with chronic plantar fasciitis. Two different treatment methods were used. The first group did a stretch for the Achilles-tendon (calf muscle). The second group did a specific stretch for the plantar fascia.
Results after eight weeks showed greater improvement with the plantar fascia stretch. In phase two of this study, the Achilles stretching group was given the same plantar fascia stretch the other group had in the first study. They did the stretch three times a day, starting first thing in the morning before taking their first steps. The plantar fascia stretching program was done for at least eight weeks.
Now two years later, in this report, the researchers tell about the long-term results for this same group of patients. Pain, function, and satisfaction were measured using a survey mailed to each patient.
At the end of two years, everyone had improved. The Achilles tendon group from the original study improved the most after they were given the plantar fascia stretch. About one-fourth of the patients still reported some limitations in recreational activities. A small number of patients ...