Category Archives: plantar fasciitis

What causes plantar fasciitis?

Gretchen Reynolds writing in The New York Times reported that plantar fasciitis plantar-fasciitis-2is “characterized by stabbing pain in the heel or arch,” and “sidelines up to 10 percent of all runners, as well as countless soccer, baseball, football and basketball players,” among other athletes. However, its “underlying cause remains surprisingly enigmatic” which “underscores how little is understood, medically, about overuse sports injuries in general and why, as a result, they remain so insidiously difficult to treat.”

She articulates the theory that many of us in practice share.  Plantar fasciitis is less due to inflammation and more due to degeneration or weakening of the tissue.”

That’s why ultrasound-guided needle tenotomy with platelet-rich plasma (PRP) is the procedure of choice for this problem.

 

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Radiation Therapy Provides Relief For Plantar Fasciitis

Helen Albert writing in Medwire reported on a study of 62 patients, published in the International Journal of Radiation Oncology, which showed that “external beam radiation therapy, similar to that used in treating cancer, provided effective pain relief for patients with plantar fasciitis.” plantar-fasciitis

For the study, “researchers found that 80% of those who received standard-dose therapy experienced complete pain relief, 64% of whom maintained this relief for up to 48 weeks.”

Comment: I would be concerned that radiation would bring along its own potential risks.  There are better and safer options for this condition. It’s like using a bazooka to kill a mouse.

One option we’ve used is ultrasound-guided injections of platelet-rich plasma (PRP). Another is ultrasound-guided injection of Botox.  Both of these are far safer than radiation.  Another treatment that seems to work and is safe is shock wave therapy.

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What are some bad habits that lead to aches and pains in women?

Bad habits at any age can cause aches and pains in women.
Really young women often wear flip flops with no arch support.  This can lead to a nasty case of plantar fasciitis.
Young women who have infants often carry the infant on one hip using one hand.  This causes them to develop a form of tendonitis of the thumb called DeQuervain’s disease.  It’s very painful but can be fixed with a glucocorticoid injection, splinting, and rest.
Women who work in an office setting still often hold a phone in the crook of their neck and this can obviously cause problems with neck pain. The pain can radiate down between the shoulder blades.
High heels, particularly the fashionable stiletto heels can cause ankle sprains and eventual problems with arthritis/bursitis in the big toe (bunions).high-heels
Carrying big handbags are a recipe for disaster since they can cause strains of the shoulder and neck.
A really bad habit is eating too much.  This obviously leads to aches and pains in weight bearing joints. Obesity aggravates arthritis from a biomechanical perspective as well as an inflammatory one.  Fat cells make chemicals that aggravate inflammation.
Cigarette smoking is a risk factor for the development of rheumatoid arthritis.

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A new use for Botox?

First reported in Singapore, then confirmed by a number of studies elsewhere, the popular cosmetic drug, Botox, has another novel use.botox

For sufferers of chronic plantar fasciitis, it appears to not only relieve pain but actually reduces the thickness of the plantar fascia, as measured by diagnostic ultrasound.

I found out about this from a physician in our community who wanted me to try the treatment for his chronic plantar fasciitis.  Using our standard ultrasound-ultrasound-guided-plantar-fascia-injectionguided technique, I did so.  Not only have his symptoms resolved, the serial measurement of plantar fascial thickness has shown improvement as well.

Botox is also being studied as a symptomatic treatment for knee osteoarthritis.

It apparently has an effect on nocioceptive receptors (pain receptors.)

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