- Does your job requires long hours of standing or running?
- Do you often wear unpadded shoes or walk on uneven ground?
- Are you over-weight or deficient in Vitamin C?
If answer to one or more of the above questions is a Yes- you are at risk of developing plantar fasciitis.
Pain and discomfort in any part of the body is agonizing; but if the disease process involve your extremities (especially hands or feet), it becomes even harder to ignore the symptoms. Plantar fasciitis is known to compromise the personal and professional life of millions of individuals each year. According to a latest study conducted by Scher (1), the lifetime risk of developing plantar fasciitis is 10% in the general population.
Classic symptoms of plantar fasciitis are produced mainly due to ongoing inflammation and formation of bony spurs. Most patients experience severe pain in the heels that aggravates with any activity or movement.
What are some common causes of plantar fasciitis?
- Bruising/ acute trauma: Any incident that exposes your feet/ heel to sudden pressure or trauma can lead to plantar fasciitis if injury is not managed adequately. Risk of developing plantar fasciitis increases in the scenarios of ongoing inflammation (marked by redness, swelling, loss of function, tenderness etc.)
- Osteoma: This is a condition where bones are inflamed due to an infectious agent; one of the manifestations of this disease is inflammation of heels and pain.
- Incorrect posture: Inadequate posture that does not evenly distribute the pressure of your body on both feet; or use of ill-fitting footwear which are not suitable for your feet shape can result in heel pain.
- Arthritis: Arthritis can be inflammatory or autoimmune and may present as stiff joints, remarkable tissue swelling and inflammation. This can cause immense pain in the heel region over time, if left untreated.
Why choose a chiropractor for the management of plantar fasciitis?
A lot of people choose allopathic interventions for the management of acute cases of plantar fasciitis. It is unfortunate that most healthcare providers classify plantar fasciitis as mild or severe and adopt either of the treatment options listed below.
- Painkillers: Most cases of mild pain are managed by NSAIDS (non-steroidal anti-inflammatory drugs). These drugs are anti-inflammatory pain-killers that masks the symptoms of fever, pain, swelling and redness. Unfortunately, these agents are not suitable for long-term use (because of high risk of gastro-intestinal side effects). In addition, these agents have no therapeutic value per se and thus the risk of recurrence is very high.
- Steroids: Corticosteroids are used for the acute management of ongoing inflammation. Steroids are very effective in the management of acute cases but moderate use is associated with a very high rate of complications such as weakening of bones and cartilage, high propensity to develop infections and chances of developing diabetes.
- Surgery: In certain cases when the degeneration or damage to the plantar fascia is severe (and associated with degeneration of surrounding tissues as well), surgical intervention is employed by healthcare providers. Once again this solution is associated with a number of potential issues that may ultimately compromise the overall functional stability and independence.
Chiropractors on the other hand utilize a multimodal approach that begins with the identification of the problem before devising a treatment plan.
Chiropractic therapy is a preferred approach because:
- Chiropractors take detailed history and conducted in-depth physical examination to ascertain the extent of damage or degeneration (that is followed by radiological or ultrasonological investigations).
- Chiropractors address the primary issue or core cause instead of just managing symptoms. This is important because untreated or poorly managed heel pain/ plantar fasciitis can eventually involve the ankle, knees, hip and other joints of the body due to compromised motion and inadequate gait.
- Often time plantar fasciitis is the first symptom of a chronic ongoing pathological process. Identification and resolution of the core cause by chiropractors halts the degeneration/ inflammation and prevent the damage to other musculoskeletal elements.
Interventions taken by Chiropractors to manage heel pain:
- Chiropractic manipulation: According to a latest study published in the Journal of Chiropractic Medicine (1), investigators reported a case study of a 10-year footballer with a 3-week history of plantar fasciitis and moderately severe foot pain. The team of chiropractors utilized multimodal approach that include soft tissue mobilization by Graston technique along with low amplitude, high velocity manipulation to address the issue over a period of 6 weeks in 6 sessions. After completion of the interventional period, patient reported compete resolution of pain and discomfort.
- Stretching and strengthening exercises: Weak muscles are incapable of withstanding extreme pressure and tension that feet are exposed to. Needless to say that stretching and strengthening exercises are fairly helpful in enhancing the functional stability of pedal architecture.
- Passive stretching of calf muscles by a chiropractor is classified as the best acute intervention to reduce the tension and maintain free range of motion in case of chronic pain and inflammation. Chiropractic exercises helps the muscles to stretch and relax and relieve any cramping and pain over time.
- Weight loss and diet modification is also recommended since one of the primary causes of plantar fasciitis is physical stress on the pedal ligaments.
- Lifestyle modification and occupational therapy: It has been observed that the risk of plantar fasciitis is higher in ballet dancers, long-distance runners, aerobic dancer, teachers and factory workers who are required to stand on their feet for long hours. All these individuals can definitely get guidance and support from chiropractors to learn the useful techniques and strategies to reduce the stress and strain on the musculoskeletal elements. In addition, chiropractors also offer occupational therapy, tips on lifestyle modification and use of suitable gear to minimize the risk of recurrences.
- Immediate relief via simple interventions: It has been observed that simple modalities like use of hot/ cold compresses, massage therapy and adding extra padding in the shoes can relieve acute discomfort.
According to a case study published in the peer reviewed Journal of Chiropractic Medicine (4), investigators suggested that refractory cases of plantar fasciitis can be managed by dry needling of trigger points based on myofascial meridians.
There are several other chiropractic interventions that are helpful in managing the symptoms. It is highly recommended to seek the advice of a registered chiropractor to adequately address your health concerns.
References:
- Scher, D., Belmont, P. J., & Owens, B. (2010). The epidemiology of plantar fasciitis. Lower Extremity Review.
- Daniels, C. J., & Morrell, A. P. (2012). Chiropractic management of pediatric plantar fasciitis: a case report. Journal of chiropractic medicine, 11(1), 58-63.
- Rama, S. (2012). The efficacy of chiropractic care in the treatment of plantar fasciitis utilising foot and ankle manipulation, gastrocsoleus stretching and cross friction massage of the plantar fascia (Doctoral dissertation).
- Behnam, A., Mahyar, S., Ezzati, K., & Rad, S. M. (2014). The Use of Dry Needling and Myofascial Meridians in a Case of Plantar Fasciitis. Journal of chiropractic medicine, 13(1), 43-48.
