Plantar Fasciitis Facts

Guide to Plantar Fasciitis by Orthopaedic & Spine Center

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If you wake up in the morning and experience a sharp, burning pain in the heel of your foot, you may be suffering from Plantar Fasciitis, a very common disorder of the fibrous tissue that runs along the bottom of the foot. This tissue is what connects the toes to the heel bone and it also is the architecture for the foot arch.

Preventing Plantar Fasciitis is relatively easy, but healing this disorder can be painful, tough, take a year and may require surgery. Prevention consists of stretching the foot, Achilles Tendon and ankles and calf muscles regularly to maintain flexibility.

One of the easiest stretches to these muscles is to stand with your toes on the edge of a curb or step, with your heels hanging off the edge. Then, slowly lower your heels until you feel a good, gentle stretch. If you perform this exercise regularly, you will notice that you will eventually be able to stretch with a much greater degree of flexibility AND help to prevent Plantar Fasciitis from occurring.

Foot care and pain management

What Causes Plantar Fasciitis

For anyone suffering from Plantar Fasciitis, they know the sharp, disabling pain that occurs when they first walk upon awakening or after sitting for a long time. Ouch! Most people immediately think that a bone spur must have formed on their heel to cause such intense stabbing pain. However, the connective tissue that runs from the heel to the toe can make us yelp in pain without having any other issue other than being inflamed.

Why do we get this disorder? There are many reasons, but the most common are:
• Lack of flexibility in the Achilles tendon, foot, ankle and calf
• Quick weight gain or chronic obesity
• Having high arches or flat feet
• Running on irregular surfaces, downhill or for great distances
• Wearing ill-fitting, non-supportive shoes

Plantar Fasciitis Facts

• Can occur in men and women, but more commonly in men who are active and between the ages of 40-70.
• Does not necessarily involve a bone spur of the heel, but both can occur simultaneously
• One of the most common reasons for a person to seek medical care from an Orthopaedic specialist
• Lack of flexibility, Weight gain or obesity, having flat feet or high arches or running competitively can put you at greater risk of developing this disorder
• Most Plantar Fasciitis is treated non-surgically, with stretching, NSAIDS, Physical Therapy and steroid injections.

Plantar Fasciitis Symptoms

You may suspect that you have Plantar Fasciitis if you experience heel pain, but what are the most common indications that you may have this disorder? You might experience the following symptoms:
• Pain, from mild to severe, which may be burning, sharp, stabbing or dull in the heel
• Pain is usually worse in the morning when you get out of bed, after intense periods of activity, if you sit or stand for a period of time, or when climbing ladders or stairs
• Your foot may swell or become red
• You may feel like your foot is tight or stiff, especially in the bottom of your arch
• The bottom of your foot may also feel tender to the touch

How Is Plantar Fasciitis Treated?

Most people will PF can easily be treated without surgery or any injections. Rest, icing the area, taking Ibuprofen or Naproxen Sodium to reduce inflammation and ease pain and beginning a comprehensive stretching program which addresses flexibility issues of the Achilles tendon, calf muscles and foot and ankle muscles will usually help most people recover. Your doctor may also recommend that you buy a good pair of supportive shoes.

Recovery may be slow. For those persons who do not respond to the aforementioned treatments, orthopaedic physicians may also recommend wearing a heel cup or using shoe inserts. Splints that hold the Plantar Fascia in a flexed position may also be recommended for use at night. Using a plastic removable boot cast for several weeks may also help. Tougher cases may require the injections of steroids into the heel or having custom orthotics made to be worn everyday in the shoe.

Rarely, a person may not recover and surgery will need to be considered to release the tight connective Plantar Fascia. Although this surgery is simple and performed as an outpatient procedure, all surgery has risks that need to be discussed with your doctor. In some persons, pain will continue even after surgery. That person will then need to be referred to a Pain Management Specialist or consultation.

For a consultation with OSC – Orthopaedic & Spine Center – Call (757) 596-1900
Email: info@osc-ortho.com

What is Kyphoplasty by OSC’s Dr Mark McFarland D.O.

Dr Mark McFarland, DO of Orthopaedic & Spine Center

Call (757) 596-1900 for a consultation with Dr McFarland

Kyphoplasty is a unique, minimally-invasive way to treat compression fractures of the thoracic and lumbar spine.  Most fractures of the aged spine are related to osteoporosis and can lead to a “bent forward” posture called kyphosis.  The kyphoplasty procedure can help restore the height of the collapsed vertebrae and relieve a patient of pain by repairing the bone with a strong internal scaffold of bone cement.

spinal exam by Dr Mark McFarland DO

Dr McFarland performs a spinal examination

The procedure can be done under conscious sedation or general anesthesic and usually takes around 15-25 minutes to complete.  A small needle is passed through the skin and into both sides of the broken vertebrae.  Next, small tubes are placed over the needles and small balloons are placed into the bone.  The balloons are elevated under pressure to help restore the bone, correct the patient’s posture and reduce the kyphosis.  Next, bone cement is placed into the bone to stabilize the fracture, just like an internal cast.

After the kyphoplasty procedure, the bone is very strong and usually the pain will be significantly reduced immediately.  Mild residual pain may last up to another 2 weeks after the procedure.

Orthopaedic & Spine Center

Call (757) 596-1900 for a consultation with Dr McFarland

Spondylolisthesis – A Fancy Name for a Common Spine Problem

Did you know that back pain and leg pain will cause about 20% of our population to see a physician each year? Although most back pain is minor and will usually resolve on its own,  there are many different diagnoses that can cause lingering lower back pain.  About 10% of the patients that see an orthopaedic spine specialist for their back pain are diagnosed with a condition where the bones in the spine have slipped or changed position slightly.  In medical terminology, this is called spondylolisthesis.

There are several different reasons that the bones may slide or change position.  The most common is degenerative disease of the discs that cause the bones of the spine to sit more loosely on each other and allows shifting to occur.  Children may also have a failure to form a complete connection in the spine.  This lack of connection allows the bones to slip on each other.

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Anterior Hip Replacement – What is it all about?

As a Fellowship Trained Joint Replacement Surgeon, I am often asked about the latest developments in arthritis surgery.  With the advent of minimally invasive techniques in orthopedic surgery there has been a renewed interest in performing hip replacement through the front (anterior) of the hip as opposed to the more traditional posterior, or backside approach.  The logic behind anterior hip replacement is to try to minimize muscle damage by separating muscles to gain access to the front of the hip as opposed to releasing and repairing the muscles to gain access to the hip joint form behind.  In short, there is no perfect way to deliver implants to the hip joint.  If there were, we would all be performing that approach only for hip replacement surgery. Having given you this background, these are the most frequently asked questions encountered in my office:

Is anterior hip replacement a new technique?

No. The anterior hip approach was first described by Smith-Petersen in 1917.  It was used by the French surgeon, Robert Judet, in 1947 to perform an isolated femoral head replacement.  This later evolved into other French surgeons performing complete hip joint replacements through an anterior exposure in the 1960’s.

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Interventional Pain Management Providing Innovative Pain Relief

More than 75 million Americans suffer from chronic, debilitating pain, according to the National Pain Foundation. In 2003, Research America released the results of a survey of 1,000 people in the United States that showed that 57% of all adults have had chronic or recurrent pain in the last year and that 75% of people currently in pain had to make adjustments to their lifestyle due to their pain. Chronic pain also accounts for more than 80% of all physician visits and leads to time off work and billions of dollars in lost productivity. With the prevalence and the exorbitant cost involved, it would seem only natural that health care workers would be clambering to find better ways to treat this epidemic problem. Unfortunately, this is not the case, and thus pain remains poorly understood and grossly under-treated. The complex mechanisms of pain transmission coupled with its inherent subjective nature creates an intimidating battle and requires physicians who are both comfortable with its diagnosis and more importantly who have an appreciation for the art of treating those in pain.

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