What is Planter fasciitis

Planter fasciitis commonly known as heel pain usually occurs in person who has long standing jobs and among the sports players.

The plantar fascia is a strong, fibrous attachment that runs from your heel to the ball of your foot and your toes. It’s stretchy like a thick rubber band. The plantar fascia connects the bones in your foot together and forms the arch on the bottom of your foot.

Plantar fasciitis happens when your plantar fascia is overused or stretched too far. Anything that damages your plantar fascia can make it swell. This inflammation makes it painful to walk or use your foot. Most people experience plantar fasciitis in one foot at a time, but it’s possible for it to affect both your feet at once.

Symptoms of Planter Fasciitis

Sharp or stabbing pain when you use your affected foot or put pressure on heel.
Usually pain in heel more when start walking after prolong rest and when you wake up in morning.
After some walking pain gradually reduce in intensity.

Diagnosis & Investigation

Detailed clinical history and examination can get through the diagnosis of heel pain.
Further investigation include x-ray, USG & MRI

Risk factors for Planter fasciitis

Prolong walking or standing job with bare foot
Playing sports which involve quick stop and start
Running and dancing without proper shoes with arch support
Obesity
Flat feet
Weight lifting
Bone spur along the planter aspect of calcaneal bone

Treatment of Planter Fasciitis

Conservative treatment

Rest, Ice application, Compression, Elevation (RICE Protocol) is applicable to all patients which is a basic treatment of any sports injuries with acute onset of pain.
Hot and cold therapy. In this therapy patient needs to keep his foot inside the lukewarm water for 20 seconds and ice-cold water for 20 seconds and continue this therapy for at least 10 minutes in each session.
Over the counter medication like NSAID can be taken for some days to reduce pain and inflammation after consultation with your health care provider.
A splint at night to help your planter fascia stay stretched while you sleep.
Wearing supportive shoes with arch support inside and use soft slippers at home.
Soft silicon arch support you can add in your shoes

Interventional Pain Management

At Impulse Pain Clinic, we are managing planter fasciitis pain with some advanced machine (Class 4 LASER & ESWL) which has powerful capacity of healing damaged tissue and some interventional pain management treatment in form of Biologics (PRP & BMAC treatment)

CLASS 4 HIGH INTENSITY LASER:

Class 4 High intensity LASER is highly advance machine which was imported from UK (BTL company). It is biological effect with generation of new cells in damage planter fascia and gives pain relief by tissue healing. It may required two to three weeks of treatment only for fully cured.

EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Extracorporeal shock wave can be given along with class 4 laser for promotion of tissue healing in planter fascia. This shock wave improve the vascularity in damaged tissue and help for fast recovery within two to three weeks.

PLATELET RICH PLASMA (PRP Treatment)

What is PRP Treatment ?

PRP treatment is now consider is gold standard treatment for planter fasciitis pain.

It is consider as a “Biological Treatment“

PRP is a component of our blood. It contains the higher concentration of platelets which is helpful for tissue healing. It contain various growth factors which is required for regeneration of planter fascia and faster the biological healing process.

Procedure Details

PRP therapy required only 20 ml of the patients own blood and that is processed in USFDA approved special kit in refrigerated centrifuge machine. Processing time is only 20 minutes.

We find damaged part of planter fascia under USG examination and inject PRP in same area under USG guidance for better results. Most of patient can get good pain relief within three weeks of treatment.

BONE MARROW ASPIRATE CONCENTRATE (BMAC)

BMAC is internationally acceptable biological treatment. BMAC is a concentrated solution of cells and proteins extracted from bone marrow. It contains stem cells, anti-inflammatory cytokines and growth factors which trigger tissue healing. As a part of treatment, we harvest bone marrow from hollow bone of back or thigh through 12 G cannula and process it with "Tricell" kit to make concentration of cells and growth factor about 4 to 6 times. Treatment done with help of USG machine and we inject BMAC into the substance of fascia.

Benefits of Therapy

It's safe treatment as we use patient's own blood
Very less side effects
Effective and much better than steroid injection
Totally biological treatment
Not a temporary effect, it gives long lasting pain relief