Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.
What is plantar fasciitis?
The plantar fascia is a ligament that starts in the heel and extends towards the forefoot. It serves to support the arch of the foot. In some cases, this ligament can develop a chronic strain that causes pain with walking, typically worse when you get out of bed in the morning. In addition, the chronic strain causes the plantar fascia to swell with inflammation and tighten at the heel.
What causes plantar fasciitis?
There are multiple causes of plantar fasciitis. The most common causes are: spending prolonged periods of time standing on your feet, having weakness in the muscles of the calf and foot, having tightness in the calf muscles or having Achilles contracture, and being overweight.
What are some conservative treatments for plantar fasciitis?
Frequently, the patient is offered a course of physical therapy to strengthen the foot muscles and stretch the calf muscles. In addition, anti-inflammatory medications and/or a steroid injection may be offered to treat the pain and inflammation. Over the counter shoe inserts or custom orthotics may also be offered. A weight management program that incorporates regular exercises on a daily basis can also be beneficial.
Is there a “permanent fix” or surgical treatment for plantar fasciitis?
Surgery through an open incision has prolonged recovery due to the wound healing, and in some cases outcomes are poor given that the surgery does not fully treat all of the inflammation in the plantar fascia.
Now, there is a minimally invasive procedure that can offer full symptom relief in up to 90% of cases and does not require a surgical incision. It is called a partial plantar fascia release and fascia debridement using the Topaz microdebrider.
This procedure consists of using a cauterizing needle to get rid of the inflammation and partially release the plantar fascia. There is no incision with a scalpel so the recovery is much quicker. Typically, the patient will start walking within three days and wear a boot for two weeks. A course of physical therapy is recommended after the procedure to ensure the plantar fascia heals appropriately.
If you have patients suffering with plantar fasciitis and have not experienced relief from conservative treatment, the Topaz Microdebrider procedure may be a viable option for them.
Partial Plantar Fascia release and Fascia Debridement using the Topaz Microdebrider video
Ricardo E. Colberg, MD is a non-surgical orthopaedic & sports medicine physician at Andrews Sports Medicine & Orthopaedic Center in Birmingham, AL. Dr. Colberg is Medical Director for the Jacksonville State University Gamecocks, and Head Team Physician for the Birmingham Blaze semi-pro football team, Birmingham Hammers semi-pro soccer team, Minor High School, Lawson State Community College, and the Alabama Soccer Association's Olympic Development Program (ODP).
For more information, contact Andrews Sports Medicine & Orthopaedic Center at (205) 939-3699 or visit AndrewsSportsMedicine.com
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