04 October 2010
A chronic pain condition of the foot can be debilitating, as it inhibits the ability to stand, walk and move about. If foot pain is so severe the patient loses the ability to walk, it can have a major impact on their life.
Foot pain can be due to injury or to a number of other factors. For those patients with a history of being on their feet on hard surfaces, plantar fasciitis often can arise. This condition is characterized by heel pain that is often at its worst in the morning, may get better by the end of the day, and can be alleviated somewhat with rest.
Pain is often made worse in the heel by walking for prolonged periods of time or wearing shoes that do not offer the correct and proper arch support for your foot type. This condition is often seen in those who habitually run, but may also be seen in pregnant women, those with extremely low or high arches, those who stand on their feet for extended periods of time and those who are overweight. Once the conditions of plantar fasciitis are indicated, it is important to seek treatment as soon as possible, as it is possible for this condition to develop into back, hip or knee problems as you change your gait to compensate for the heel pain. Bone spurs may develop as well, (Raj, 2008) and are due to chronic strain on the plantar fascia.
Conservative treatment for plantar fasciitis begins with physical therapy, the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin, and, in rare cases, the use of corticosteroid injections. While sometimes helpful, it has often been seen that repeat injections of corticosteroids have actually weakened the area, which may cause further injury to the plantar fascia. Your physician may also recommend a specialized splint for while you are sleeping to correctly and slowly stretch the plantar fascia and facilitate healing. It is rare for plantar fasciitis to be corrected by surgery, and is often only indicated after all conservative measures have failed.
To prevent plantar fasciitis, it is recommended to always be cognizant of your footwear. Shoes should always be of a proper fit, and should adhere to your sport and foot type. Additionally, it is advised to avoid walking barefoot or while wearing flimsy shoes such as flip-flops, or high heels. Once plantar fasciitis pain has presented, it is important to rest, ice the area, and choose non-or-low impact exercises until heel pain has disappeared.
Achilles’ tendonitis is a condition caused by injury to the Achilles’ tendon, and is caused by injury. Multiple sources indicate that approximately 11% of all running injuries are later diagnosed as Achilles’ tendonitis. Achilles’ tendonitis is brought about by the repetitive motion required of runners and joggers. The Achilles’ tendon is located at the back of the ankle, and is the larger tendon. The biggest complication of Achilles’ tendon injuries is that they are slow to heal due to the low blood supply to the area.
Treatment of Achilles’ tendonitis should start conservatively with physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin, application of heat or cold therapy as indicated and rest. Should these treatments prove ineffective, corticosteroid injections may be indicated. There has also been some success shown with ultrasound treatments.
Injury to the Achilles can be avoided with the proper measures. Proper stretching of the tendon before exercise is always recommended, as well as stopping the activity once pain has started. Use of proper footwear may help you avoid injury; make sure you are wearing the correct shoe for both the activity and your foot type (high arch, low arch, etc.). Should you feel minor pain in the Achilles’ tendon, it is important to rehabilitate your injury and not continue to push yourself. Repetitive activity on an already painful Achilles’ tendon may cause the tendon to rupture, requiring further medical intervention.
Raj, (2008) Raj’s Practical Management of Pain.415. (Benzon, Rathmell, Wu, Turk, Argoff Eds.)Philadelphia: Mosby Elsevier
MayoClinic.com
