PLANTAR FASCIITIS

About Plantar Fasciitis

Plantar Fasciitis is the inflammation of the plantar fascia – the rubber band-like ligament that stretches from your heel to your toes. It is attached to the metatarsal bones of the five toes in the front and is fan-shaped on the inside of the heel. It supports the arch of your foot and bears the weight of your body.

What Causes Plantar Fasciitis?

Inflammation and tearing of the plantar fascia can result from too much pressure and stretching.

Those at greater risk of plantar fasciitis include:

Athletes
People with a high arch or flat feet
People who are overweight
People who stand for prolonged periods

Symptoms Of Plantar Fasciitis

HEEL PAIN
The heel pain is typically a stabbing pain at the bottom of the feet near the heel. The pain may feel worse in the morning or when standing up after sitting for a long time

TENDERNESS
The heel will also feel tender or swollen.

PROLONGED PAIN
Pain may continue for months.

PAIN IN THE ARCH OF THE FOOT
Aside from the heel, pain may also be felt at the arch of the foot or ball of the foot.

When Should I Seek Medical Help?

You should seek medical help when:

Sharp pain when stepping out of bed in the morning
Pain from any movement of the foot
Long period of standing aggravates the pain
Pain is dull at the beginning of activities but worsens through the day

A Message About Plantar fasciitis

Plantar fasciitis pain can range from mild to severe and debilitating. It may cause limping or inability to walk. While generally, it is unilaterally one-sided, it may inflict both feet concurrently. The severity of pain does not correspond to the severity of the condition. It may start as inflammation of the plantar fascia tendon or it may be a severe injury involving tears of the cords of the tendon.

While initial self-remedy such as using a tennis or golf ball to roll the injured sole may be helpful, prolong persisted application of this will result in worsening of the condition. Similarly walking barefooted on stones/pebbles or using a stick to prod at the tender area may give temporary relief, but long-term use will result in aggravation of the condition.

About 30% of patients will fail physiotherapy and orthosis support. These patients will benefit from Myospan PRP treatment. Our proprietary Coreflex injection will target the injured plantar fascia by injecting platelet-rich plasma into the inflamed area it stops the swelling and improves scarring and healing. There is no downtime. Post-procedure, active rehabilitation encourages the healing of the plantar fascia, resulting in full resolution of the condition.

Diagnosing Plantar Fasciitis

Although many people have heel spurs, it is important to note that heel spurs are not the cause of Plantar Fasciitis pain. There is no need to remove or excise the “bone spur”. Here at Singapore Paincare, our team of experienced primary care and specialist pain care doctors will conduct a thorough diagnosis. This includes a physical exam, questions about your symptoms and an evaluation of your medical history. An X-ray or MRI scan may be needed to evaluate the condition.

What Treatments Are Available for Plantar Fasciitis?

In many instances, non-surgical treatment methods can provide excellent outcomes. At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve functions and prevent pain from recurring.

Non-Surgical Treatments for Plantar Fasciitis

ORTHOTICS
Our doctors may recommend pads to be worn in shoes to improve the foot problem. Orthotics can be custom-made or standard-sized.

PHYSIOTHERAPY (
Physiotherapists will formulate a variety of exercises to improve elasticity, strength and support of the feet and ankles. Muscle exercise can also reduce pain and prevent damage from worsening.

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
Over-the-counter or prescription pain medications can treat most foot inflammations.

SPECIALISED INJECTIONS – MYOSPAN INJECTIONS
Anti-inflammatory injections such as cortisone can be injected into the inflamed plantar fascia, reducing swelling and stopping pain.

If cortisone injections are inadequate, Myospan PRP (Platelet Rich Plasma) injections are also utilised by our doctors to have more directed healing of the injured tendon.

EXTRACORPOREAL SHOCK WAVE THERAPY
This procedure involves using high-energy sound waves to treat the affected area.

Surgical Treatments for Plantar Fasciitis

Surgical options for Plantar Fasciitis will only be considered after non-surgical treatments have been attempted for at least 6 months. As surgery always comes with associated risks, complications and downtime – it may not be suitable for everyone.

ENDOSCOPIC PLANTAR FASCIOTOMY (EPF)
The procedure is done with general anaesthesia and it involves making an incision to detach the fascia from the heel bone. We generally do not recommend plantar fasciotomy.

How Can I Prevent Plantar Fasciitis?

You can lessen the risk of having Plantar Fasciitis by:

Doing regular stretches involving your feet, calves and Achilles tendon
Taping your arches
Getting plenty of rest
Doing low-impact exercises like swimming
Wearing proper footwear when exercising and doing sports