The elastic covering on the sole of the foot--the plantar fascia--runs the length of the foot and holds up the arch. When this shock-absorbing pad becomes inflamed, this is called plantar fasciitis, causing a dull ache along the length of the arch. The ache is due to over-stretching or partially tearing the arch pad. This happens most often to people with rigid, high arches. They feel the pain when they put weight on their foot or when pushing off for the next stride. Pain is particularly intense upon arising or after sitting for a long while. Plantar fasciitis is particularly common among middle-aged people who have been sedentary and who suddenly increase their level of physical activity. Runners are most susceptible, but almost any sport that keeps the athlete standing can lead to arch pain. Inappropriately fitting shoes or a weight gain of 10 to 20 pounds can also contribute to the condition.
Tarsal Tunnel Syndrome develops when there is compression on the tibial nerve as it passes through the tarsal tunnel on the inner side of the ankle bone (medial malleolus). It can cause pain on bottom of foot as well as pins and needles. Numbness in the heel can often extend down to the big toe and adjacent three toes. In addition, it may also produce hot and cold sensations along the bottom of the foot. Tarsal Tunnel Syndrome is caused by anything which occupies space in the tarsal tunnel including cysts, ganglions, bone spurs, swelling from ankle injuries or tumours. Treatment aims to reduce the foot arch pain and usually consists of rest, strengthening and stretching exercises, compression bandages and steroid injections. If the pain in bottom of foot persists, surgery may be required.
Go to a podiatrist at the first sign of symptoms. Besides pain on the bottom of the foot, additional symptoms may include burning sensation in arch, difficulty standing on tiptoes, inflammation, more pain after sleeping or resting, redness, heat, localized pain in the ball of the foot, sharp or shooting pain in the toes, pain that increases when toes are flexed, tingling or numbness in the toes, aching, pain that increases when walking barefoot, pain that increases when walking on hard surfaces, pain the increases when standing (putting weight on your feet) or moving around and decreases when immobile, skin Lesions, it?s important to get a proper diagnosis and treatment plan. Let?s go over the possible causes of the pain.
In people with flat feet, the instep of the foot comes in contact with the ground when standing. To diagnose the problem, the health care provider will ask you to stand on your toes. If an arch forms,the flat foot is called flexible. You will not need any more tests or treatment. If the arch does not form with toe-standing (called rigid flat feet), or if there is pain, other tests may be needed, including a CT scan to look at the bones in the foot. MRI scan to look at the tendons in the foot. X-ray of the foot.
Non Surgical Treatment
Rest is the most important thing you can do. Stay off your feet, or use a cane. Gently apply ice to the arch for at least 30 minutes, and repeat every 3 or 4 hours. Apply mild compression to the foot. Use a Fabriform PSC Foot and Ankle Strap to help support the arch, reduce swelling, and relieve pain and fatigue. This strap is easy to apply and adjust for a custom fit. Low profile allows it to fit in any shoe. Allows you to apply just the right amount of arch support/compression for your foot. Before stepping down after sleeping or resting, stretch the arch of your foot by pulling up on the ball of the foot and toes, as far as you comfortably can; hold the foot in this position for ten seconds. Repeat at least ten times. Consideration should also be given to the use of night splints. These are very effective for stretching the plantar fascia to relieve first weight bearing pain.
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage. Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage. The most common complications of release surgery include incomplete relief of pain and nerve damage. Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted.
Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.