Plantar fasciitis

Overview of Planter fasciitis

Plantar fasciitis (heel pain) is now a common problem among people. In gender ratio, it occurs in women more than men.

This occurs when the plantar fascia gets inflamed due to over stress.[2]

The pain originates at or near the site of the plantar fascia attachment to the medial tuberosity of calcaneus.

Indian epidemiology then other

This refers to the initiating factors that trigger a disease process.

• Examples of causes include:
  
  • Pathogens: Viruses, bacteria, fungi, parasites (infectious diseases)
  • Genetic mutations: Inherited or spontaneous changes in genes (genetic diseases)
  • Environmental factors: Toxins, radiation, nutritional deficiencies
  • Lifestyle choices: Smoking, unhealthy diet, lack of exercise (contributing factors)

Causes of Planter fasciitis

Too much pressure and stretching damages, inflames or tears your plantar fascia.

Unfortunately, there’s no discernable cause for some cases. However, you’re more likely to get plantar fasciitis if:

• You have high-arched feet or flat feet.
• You wear shoes that don’t support your feet (especially for a long time on a hard surface).
• You’re higher-weight person. (70% of patients with plantar fasciitis are also higher-weight person.)
• You’re an athlete.
• You’re a runner or jumper.
• You work or exercise on a hard surface.
• You stand for prolonged periods of time.
• You exercise without stretching your calves.[4]

Risk factors are things that make you more likely to develop a disease in the first place.

Risk factor of Plantar fasciitis

Several factors that increase the risk of developing plantar fasciitis include

• Obesity,
• Pes planus (Flat foot or absence of foot arch when standing),
• Pes cavus (high arched foot),
• Limited dorsiflexion of the ankle,
• Prolonged standing,
• Walking on hard surface and faulty shoes.

In runners, excessive running and a change to a harder running surface may precipitate plantar fasciitis.[1]

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology, on the other hand, focuses on the functional changes that occur in the body due to the disease. It explains how the disease disrupts normal physiological processes and how this disruption leads to the signs and symptoms we see.

Imagine a car accident. Pathogenesis would be like understanding how the accident happened – what caused it, the sequence of events (e.g., one car ran a red light, then hit another car). Pathophysiology would be like understanding the damage caused by the accident – the bent fenders, deployed airbags, and any injuries to the passengers.

In simpler terms, pathogenesis is about the "why" of a disease, while pathophysiology is about the "how" of the disease’s effects.

Pathophysiology of Plantar fasciitis

The plantar fascia is a thick flat band of tissue (ligament) that originate from the heel bone to the base of toes.

It supports the arch of your foot. Actually, the plantar fasciitis as it is named is not an inflammatory condition of plantar fascia.

It is a non-inflammatory micro tear of the fascia result from over stress on its surface.

There is also calcification of fibrous tissues of plantar fascia. [2]

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Sign & Symptoms of Plantar fasciitis

Both a dull pain and a stabbing pain have been reported by patients with plantar fasciitis. The symptoms of plantar fasciitis include:

• Pain on the bottom of the heel, or nearby.
• Increased pain after exercise (not during).
• Pain in the arch of the foot.
• Pain that is worse in the morning or when you stand after sitting for a long time.
• A swollen heel.
• Pain that continues for months.
• A tight Achilles tendon.
• Your Achilles tendon connects your calf muscles to your heel.[4]

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Diagnosis of Plantar fasciitis

• The diagnosis   of plantar fasciitis can usually made on the basis of history and physical examination alone.
• Patients experience severe pain with  the first steps on arising in the morning or following inactivity during the day.
• The pain  usually lessens    with weight-bearing activity during  the day,  only to worsen with continued activity.
• Pain make  worse on  walking barefoot  or On examination, maximal tenderness elicit on palpation over the inferior heel corresponding to the site of attachment  of the plantar fascia.
• Plain radiography shows heel spurs, Ultrasonography shows thickening of the fascia and diffuse hypo echogenicity, indicating edema at the attachment of the plantar fascia to the calcaneus.
• MRI is a sensitive method for detecting plantar fasciitis, but it is usually not require for establishing the diagnosis.[1]

Differential Diagnosis of Plantar fasciitis

• Calcaneal stress fractures
• The spondylarthrosis, rheumatoid arthritis
• Neoplastic or infiltrative bone  processes
• Nerve compression, entrapment syndromes

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

• Plain radiography shows heel spurs, Ultrasonography shows thickening of the fascia and diffuse hypo echogenicity, indicating edema at the attachment of the plantar fascia to the calcaneus.
• MRI is a sensitive method for detecting plantar fasciitis, but it is usually not require for establishing the diagnosis.[1]

Treatment of Plantar fasciitis

Resolution of  symptoms occur within  12 months in more than  80% of  patients with plantar fasciitis.

• The patient is  advised to reduce or discontinue activities that can exacerbate plantar.
• Initial treatment consists of ice, heat, massage and stretching.
• Orthotics provide medial arch support and can be effective.
• Foot strapping or taping are  commonly performed and some patients may benefit by wearing  a night splint designed to keep the ankle  in a neutral position.
• A short course  of NSAIDs can be given to patients when the benefits outweigh the risks.
• Local glucocorticoid injections have also been shown to be efficacious but may carry an increased  risk for plantar fascia Plantar fasciotomy is reserved for those  patients who have failed to improve after  at  least  6–12 months of conservative treatment.[1]

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Homeopathic Treatment of Plantar fasciitis

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Plantar fasciitis

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.

Medicines:

Berberis Vulgaris

• Excellent among Homeopathic medicines for plantar fasciitis where heel pain worsens on standing
• Berberis Vulgaris is one of the most effective Homeopathic medicines for plantar fasciitis where standing worsens heel pain.
• Few persons needing Berberis Vulgaris may specifically complain of ulcerative pain in the heel.
• Pain in balls of feet on stepping is yet another indication to use Berberis Vulgaris. 

Bryonia Alba

• One of the best Homeopathic medicines especially for plantar fasciitis where heel pain worsens from stepping
• Moreover, Bryonia Alba is one of the most suitable Homeopathic medicines for plantar fasciitis where the heel pain worsens from stepping. Rest brings relief.
• Pins also needle-like sensation in soles may accompany the heel pain in some cases.[3]

Rhus Tox

• Rhus Tox one of the best rate Homeopathic medicines for plantar fasciitis.
• Rhus Tox prominently indicate for complaints arising from excessive stress, strain on or use of a body part.
• In cases where heel pain is worse specifically in the mornings as one takes the first few steps, Rhus Tox is the Homeopathic medicine for plantar fasciitis.
• The heel pain subsides eventually.
• Apart from the above unique symptom, Homeopathic medicine Rhus Tox is also considered for plantar fasciitis cases where running and exercise worsen the pain by putting excessive stress on the heels.[3] 

Pulsatilla Nigricans 

• One of the most wonderful Homeopathic medicines for plantar fasciitis where heel pain worsens from rising from seat.
• For heel pain that worsens when rising from a sitting position.
• Pulsatilla Nigricans consider one of the best Homeopathic medicines for plantar fasciitis.
• Boring pain in the heel that worsens in the evening is another unique symptom that signals use of Pulsatilla Nigricans as the ideal choice among Homeopathic medicines for plantar fasciitis.
• Pulsatilla Nigricans is also helpful for heel pain that comes on every time one starts walking.
• Such persons feel the need to stretch their feet.[3]

Valeriana Officinalis 

• Well indicated among Homeopathic medicines for plantar fasciitis where heel pain gets better by walking.
• Valeriana Officinalis is another of the well-recognized Homeopathic medicines for plantar fasciitis treatment.
• Valeriana Officinalis is well indicated for plantar fasciitis where the heel pain gets better by walking.
• Sitting worsens the heel pain.

Diet & Regimen of Plantar fasciitis

• Try to avoid prolonged standing posture on any hard surface.
• In case of women, they usually do cook and other household work standing for a long period.
• In this case it is advisable not to stand for a long period and take a break every few minutes.
• Otherwise, they can use silicon pads inside the shoes. Though in our tradition shoes not allowed inside the kitchen, but a silicon pad packed shoe can be kept only for using inside kitchen.
• To relieve pain, you can apply both ice and warm application alternately.
• Keep two tubs, one tub filled with cold water & the other one filled with warm water. Dip your foot first in warm water tub for 1 to 2 minutes, then remove out and put in cold water tub for 1-2 minutes. Do it 5 to 6 times daily before going to bed.[2]
• Some exercises to relieve pain:

Toe exercise– Sit in a chair, and extend your affected leg so that your heel is on the floor. With your hand pull your big toe up and back. Pull toward your ankle and away from the floor. Hold the position for at least 15 to 30 seconds. Repeat 2 to 4 times a session, several times a day.

Towel stretch– Place a rolled towel under the ball of your foot, holding the towel at both ends. Gently pull the towel toward you while keeping your knee straight. Hold this position for 15 to 30 seconds.[2]

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References use for Article Planter fasciitis

[1] Harrison-s_Principles_of_Internal_Medicine-_19th_Edition-_2_Volume_Set

[2] https://www.practo.com/healthfeed/homeopathy-treatment-for-heel-pain-plantar-fasciitis-12726/post

[3] https://www.drhomeo.com/homeopathic-treatment/homeopathic-medicines-for-plantar-fasciitis/

[4] https://my.clevelandclinic.org

Frequently Asked Questions

What is Plantar fasciitis?

Plantar fasciitis is a common cause of foot pain in adults, with peak incidence occurring in people between the ages of 40 and 60 years.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Plantar fasciitis?

• Berberis Vulgaris
• Bryonia Alba
• Rhus Tox
• Pulsatilla Nigricans
• Valeriana Officinalis

What causes Plantar fasciitis?

Too much pressure and stretching damages, inflames or tears your plantar fascia.

What are the symptoms of Plantar fasciitis?

• Pain on the bottom of the heel, or nearby.
• Increased pain after exercise (not during).
• Pain in the arch of the foot.
• Pain that is worse in the morning
• A swollen heel.
• Pain that continues for months.