Previously The Foot Specialist, Mr Steven Dowdeswell at our Telford based Clinic has provided a quick guide to the different forms of heel and arch pain and some generic information on reducing the daily grind of this annoyance.
Here Steven takes a more focal look at Plantar fasciitis specifically and where bespoke orthotics (www.pmorthotics.com) fit into the treatment regime.
Plantar Facsiitis can be a severely dehabilitating condition. A simple and short term attack of heel and arch pain can litterally bring a patient to a standstill if left unattended. Each Month we see over 25 cases of specific plantar fasciitis, the sad fact is that we are often the last source of help sought, the patient in 10% of cases will actually be near tears and kept awake at night as a consequence of the pain.
It is no coincidence that the very worst pain is reserved for those poor individuals who have occupations that require a lot of standing and walking, Nurse, Police officers, Builders, and Warehouse operatives are often at the top of this list as well as those suffering a little general bad luck!
Symptoms of plantar fasciitis include burning, aching, searing, tingling and sharp discomfort to the heel of the foot and arch. The ligament becomes inflammed where it attaches at the heel. Longer standing cases have an obvious thickening of this ligament (simmilar to a thick elastic band) when observed with our Diagnostic Ultrasound. This ligament can be thicker by 3 times that of a normal non injured area.
Suffering Foot Pain Is Not Normal, Ever.
Treatment is as varied as the individual and individual cause of plantar fasciitis
When we have ruled out systemic arthritis, diabetes and other medical causes of heel pain, then we can begin to look at a staged treatment process. The foot Specialists offer inclusive packages to assist favourable outcomes, with a set budget to take the concern of cost out of the equation. We truly have one simple aim. To make your every step more comfortable.
Initially an assesment will focus upn causitive factors.
Footwear advice and guidance.
Biomechancs are corrected with orthotics. This is crucial to avoid the inevitable boomerang of returning and worsening plantar fasciitis 12 months after initially being "cured".
Orthotics are bespokely made from accurate scans of your feet. The Custom orthotic needs to stop abnormal foot position and movement, aswell as physically reducing pressure upon the painful area. A job that is more difficult the longer that the pain has been present. We may start with a very soft custom device, particulalrly if you are standing all day at work etc. A move towards lower profile and more corrective custom orthotics is then made over a period of months.
I am often asked if custom orthotics are better than over the counter. The answer is simply yes. The research literature and medical opinion on this point is clear, however the provider must be respectable, well qualified and experienced with the definate ability to quickly adjust and alter the device or manufacture a different style and type quickly and easily, if not then disappointment often results.
Steroid Injections are often profided as a first line treatment, Mr Dowdeswell personally leaves this option for the very worst cases and also the last conservative option prior to surgical opinion.
In all reality steroids are simply inflammation reducing injections. It sounds simple, but the area has to be inflammed and the injection must be placed in the correct area. We numb the area prior to the injection into the plantar foot, preventing almost all pain that is often experienced. In some cases, the are is so injured that the steroid can only ever reduce some of the pain in a small area, in other instances the injection will not work. The reason is that some cases of plantar heel pain are not the result of inflammation, it really is that simple.
Stretching Of the plantar fascia and also the calf muscle is essential, 8 lots of 60 second per day is a minimum prescribed.
Night Splint This device prevents the calf and arch ligaments tightening overnight, reducing the stretching of injured tissue when we stand in the morning.
Anti-inflammtory Tablets Can be issued for a short period.
Ice and Cold are always required. Simple, cheap and effective.
Therapeutic Ultrasound may assist with healing although the evidence is weak and in our experience the time and effort rarely rewarded.
Aircast Boot The worst cases may require temporary ofloading with a removable cast.
As can be seen the treatment options above are varied and have to be tailored individually for each specific patient. The knowledge of how to respond to each individual case and the experience to guide the treatment at each hurdle is essential in choosing your Foot and Ankle Specialist.
The Shropshire Foot Specialists and Mr Steven Dowdeswell of Precision Made Orthotics is available for a talk and consult on 01952 427858.
Finally, again......Please seek expert assistance soon rather than later
Our Service is delivered in a friendly manner and always by Steven Dowdeswell. We commit to helping you and your condition and stand by our advice at all times. Please Call 0800 978 8104
Established at the headquarters of a Bespoke Insole and Orthotics Laboratory (Precision Orthotics) The Foot Specialists are true experts in the conservative treatment of foot, ankle and gait related problems.
The founder, Specialist Podiatrist Mr Steven Dowdeswell, is called upon to consult with podiatrists, doctors and physiotherapists across the UK on a daily basis, regarding orthotic manufacture and foot pain solutions.
As a result we are extremely experienced is this specific area.
From Our Tips to Your Toes, Experience That Counts.
Member since: 28th September 2012
Mr Steven Dowdeswell Bsc (Hons) Podiatric Medicine
Is a Telford, Shrewsbury and West Midlands based Consulting Podiatrist and Chiropodist.
My Office has the latest Orthotic Scanning equipment along...