Fasciitis of the foot. Inflammation of the fascia treatment. What is plantar fasciitis and how to treat it. Ointments, folk remedies, exercises. Video “How to treat plantar fasciitis?”

Plantar fasciitis or heel spur is a disease that involves inflammation of the foot, or rather its plantar fascia (PF), which is a powerful tissue bundle (in medical parlance - aponeurosis). The PF supports the foot arch, acting as a shock absorber.

Causes of the disease

The main cause of the disease is a minor injury to the PF.

The risk of illness increases when a person:

• stays on your feet for a very long time (due to standing work, for example), walks or runs;
• leads a lifestyle that involves a constant sitting position, which is why the foot cannot adapt to stress;
• suffered or suffers from flat feet;
• has hollow feet;
• constantly wears shoes without the use of arch support (for example, flip-flops, sneakers);
• is overweight, which means it puts additional stress on the foot;
• is an athlete increasing training intensity:
• does not follow the exercise technique, which can lead to excessive stretching.

Symptoms of plantar fasciitis– pain in the heel area (occurring immediately after a person gets out of bed or after spending a long time in a sitting position), which may increase. The worst pain may occur after standing for a long time or after climbing stairs.

Fasciitis of the sole can progress to chronic form, in this case, conventional treatment methods will not be able to help, surgical intervention will be required.

Diagnosis of plantar fasciitis

To begin, the doctor studies the patient's medical history, obtaining information about when the pain began, the area where it is localized, and when it becomes most severe. After this, he collects information about what lifestyle the patient leads, and whether he has anatomical confirmations in the form of thin tendons or flat feet.

Ultimately, ultrasound and radiography, MRI and CT are prescribed to confirm the previously made diagnosis.

Considering all of the above, The risk group includes 40-70 year olds, leading active image life people, most often women. There is also Great chance Runners, factory workers, waiters and many other representatives of standing professions get sick.

Treatment Methods for Heel Fasciitis

The treatment period can take a whole year, and the plantar aponeurosis and Achilles tendon will need to be stretched. To do this, the patient will have to constantly perform special exercises. As an addition, a splint is placed on the foot (at night) to ensure its immobility in neutral dorsiflexion.

Actions like these will help avoid layoffs. plantar aponeurosis. Mandatory heel cushioning is performed using heel pads. The need to use arch supports designed for the entire water supply of the foot for such tasks is not confirmed by doctors.

Actions to relieve pain in the heels and feet:

• resting the legs;
• using comfortable shoes;
• anesthesia;
• Do some exercises to help relieve the symptoms of plantar fasciitis.

Treatment of plantar fasciitis at home - exercises

Legs need rest as often and as much as possible. It is necessary to avoid excessive stress, do not walk or run unnecessarily, and do not stretch the foot too much. It's better to walk calmly.

You can do gymnastics at home, but you should consult your doctor before doing so.

Exercise No. 1

The patient stands against the wall and places his right and left hands on it, while slightly spreading his legs. Bend the knee of your left leg without bending your back. Next, tilt towards the wall. A person must feel his calf muscles(their tension). You need to remain in this position for a few seconds and then relax.

After repeating 10 times, switch to the right leg, and do the exercise 10 more times, after which use both legs, performing alternating bends, but now the back should be slightly bent. You need to practice the procedure at least 2 times a day.

Exercise No. 2

The patient stands on the bottom step of a flight of stairs, with his legs slightly apart (heels hanging down). While holding onto the railing, your heels should be lowered without straightening your knees.

And again, when carrying out such manipulations, a person should feel the tension in the calf muscles and hold this position for about a minute, then relax.

Perform the exercise 2 times a day, repeating 6 times in a row.

Exercise No. 3

A person needs to sit on the floor and stretch his legs forward, his knees should also remain straight. Next, you need to stretch the toes of one of your feet towards your nose and hold on for half a minute. Repeat 3 times, repeating the procedure for the other leg. It is enough to perform the exercise itself once a day.

Exercise No. 4

Now you need to sit on a chair, keeping your knees at an angle of 90 degrees, while both the heels and the feet as a whole should remain on the floor. Hold this for a few seconds and then you can relax. It should be repeated at least 10 times, the number of repetitions per day is 6.

To treat fasciitis of the soles, they also use:

• steroid injections;
• extracorporeal (shock wave) and/or radiation therapy;
• application of special splints;
• surgical intervention.

Doctors prefer to use radiation therapy more often than other methods because of its high efficiency and at the same time low cost.

Cortisone injections are given only when pain does not disappear after using painkillers ( "Paracetamol", "Ibuprofen", which also perform an anti-inflammatory function) or a cold compress. However, this does not solve the problem itself, it only eliminates unpleasant symptoms.

The essence of extracorporeal therapy is the use of special medical equipment, thanks to which a high-energy sound wave effect is carried out on the affected area, thus stimulating the healing of the PF. Several sessions may be required to completely cure the disease. Using this method, you need to be prepared for some side effects in the form of skin redness and swelling.

During radiation therapy x-ray irradiation(in small doses) to the spurs and plantar fascia, providing a long-lasting effect aimed at relieving inflammation.

During the operation, the doctor gets rid of the spur and/or partially cuts the PF fibers. Thanks to the intervention of a surgeon, it is possible to cope with 50 percent of all cases of the disease.

A foot massage can have a beneficial effect on the heel. For this, a low threshold is used, which is found in any apartment. The patient may experience pain at the beginning, but very soon he will feel relief.

Preventive measures in the fight against plantar fasciitis

To avoid heel problems, you should:

• regularly change sports shoes (sneakers, for example);
• wear shoes with good cushioning in the heel area or arch support;
• lose excess weight, if any;
• stretch the fascia and Achilles tendon;
• Do not jog on hard surfaces.

Our expert - orthopedic doctor, Researcher Endocrinological scientific center Ministry of Health of the Russian Federation Sergey Gorokhov.

​ The first steps are very difficult

The main symptom of plantar fasciitis is pain in the heel area. It is felt most strongly after waking up: getting out of bed, a person can hardly step on his foot. Doctors call this phenomenon morning pain of the first step. If you overcome it and, despite the discomfort, start walking, it will decrease or even disappear. However, the pain may recur periodically throughout the day, for example when a person stands up after sitting for a while.

The cause of pain is inflammation of the plantar fascia. This is what is called the hard layer fibrous tissue, which runs along the lower surface of the foot. In fact, it is a ligament, and one of the longest and strongest in our body. It, like a cable, connects the heel bone to the metatarsal bones and at the same time supports the longitudinal arch of the foot.

Where it all begins

There are several factors that can lead to plantar fasciitis. The most important is the development of flat feet. When the arch of the foot flattens, the plantar fascia becomes overstretched and develops microtears. The damage is especially pronounced in the place where the fascia attaches to the heel bone, so inflammation occurs here.

Another risk factor is whether a person has excess weight, which increases the load on the plantar fascia. Fasciitis can also be triggered by a change in habitual physical activity, such as too intense exercise or heavy work.

Gymnastics plus orthoses

If nothing is done, heel pain can last on average from 6 to 18 months. Then it may retreat, but soon returns again. Therefore, plantar fasciitis necessarily requires treatment - it is necessary to reduce inflammation and eliminate the cause of the disease. Several methods may be included in therapy at the discretion of the physician.

Stretching. This is gymnastics to stretch the muscles of the foot. The calf muscles also need to be worked out, because tension in them aggravates the course of plantar fasciitis. This effective method reduce heel pain, but only if you exercise regularly.

Taking medications. Nonsteroidal anti-inflammatory drugs relieve pain, but cannot be used for long periods of time because large quantity side effects.

Wearing individual orthopedic insoles (orthoses). They are made from an impression specifically for each patient. It is important that the insoles are full-contact, that is, they adhere to the foot over its entire area. Only in this case will they restore the normal height of the longitudinal arch of the foot, due to which the tension of the plantar fascia will decrease, which means the pain will go away. Its severity decreases already in the first weeks of constant wearing of insoles. Today this method is considered the most reliable and gives a long-term effect.

On a note

Night tires. These are special orthopedic devices similar to a plastic boot. It should be worn at night to prevent stretching of the plantar fascia. Splints can reduce the pain of taking that first morning step. But they are quite bulky and not very convenient to use.

Shock wave therapy (SWT). Nowadays this is a fashionable technique that is used for various diseases. Plantar fasciitis- not an exception. However, studies have shown that shockwave therapy does not always completely relieve pain and this effect does not last long. In addition, the procedure itself is painful, and the cost of the course of treatment is quite high.

Injections of corticosteroids into the site of inflammation. The drugs reduce pain, but have many side effects. In addition, with such an introduction there is a risk of fascia rupture, especially in people with overweight. Therefore, the technique is used only if other methods have not helped.

Operation. This is also an extreme measure, which is resorted to if conservative treatment has been carried out for six months, and the pain has not decreased. Part of the plantar fascia is excised and its tension is reduced. This reduces pain, but may lead to accelerated development flat feet, which means the emergence of new problems. If possible, it is better not to go through with surgery. Do not neglect the recommendations for gymnastics and wearing special insoles - this does not require much effort.

Not everyone knows, but ignoring even minor pain in the foot is very dangerous. You should start worrying already when you feel discomfort when getting out of bed in the morning.

Diagnosis of problems

Most cases of foot pain are caused by plantar fasciitis. This inflammatory disease can lead to lameness, and in advanced cases, patients without outside help They can't even stand on their feet.

You can independently suspect the development of this disease if you notice morning pain on the soles of your feet in the heel area. Usually the unpleasant sensations subside, and often disappear completely by the end of the day. But they can resume after a long rest of the legs. Do not underestimate a disease such as plantar fasciitis. Symptoms, the treatment of which it is advisable to begin immediately, become more noticeable every day. As a result, getting up in the morning becomes real torture, and the pain does not subside throughout the day.

At the first problem, it is advisable to go to the doctor. The surgeon will examine the sore leg and order an x-ray to identify heel spurs and rule out other possible problems. He will also listen to all your complaints and clarify when exactly the pain occurs. Based on the description you provide, visual examination and x-ray data, the final diagnosis will be established.

Causes of the disease

In most cases, plantar fasciitis develops for a reason. People with flat feet, high arches, and excess weight are most susceptible to this disease. Also, problems with the fascia can begin due to sudden intense stress, regular wearing of high heels and other shoes that are uncomfortable for the feet.

Fasciitis of the sole occurs due to the fact that when walking and other loads on the foot there is an incorrect distribution of weight. Normally, a person should rest on the outer edge of the foot and then move to its inner side. But when overweight, flat feet and others related reasons this mechanism is disrupted. The result is overstretching of the fascia, followed by micro-tears. They are the ones that cause pain.

Development of the inflammatory process

Because of excessive load on the plantar fascia, which connects the heel bone to the forefoot and supports its longitudinal arch, and all the problems arise. Most often, the ligaments are injured at the place where they are attached to the heel. As a result, micro-tears appear that can heal on their own. But constant injury to these areas leads to inflammation in their place, accompanied by pain. In most cases, plantar fasciitis is also accompanied by an overgrowth of the heel bones. The x-ray shows a spur-shaped growth.

It is worth noting that women most often suffer from the disease, and mainly people over 40 years of age are susceptible to it. The risk group includes all patients with excess weight, problems with the spine, joint diseases, injuries of the heel bones, gout, circulatory disorders, flat feet and other similar problems.

Disease prevention

It is advisable for every person to know how to avoid a disease such as plantar fasciitis. Treatment of the initial stages of the disease and preventive methods very similar. Thus, the development of the inflammatory process can be prevented with the help of simple gymnastics and stretching exercises. But no less attention should be paid to the choice of shoes and insoles. It is advisable to use orthopedic options that provide good support for the foot.

Don’t forget about exercises to evenly stretch the plantar fascia. Every day it is advisable to roll your feet over any interior threshold with pressure. A regular bottle is also suitable for these purposes. Another exercise that can prevent plantar fasciitis is stretching. To do this, pull your feet towards you every day for 10 seconds, repeat this 20 times for each leg. Stretching the calf muscle is also an effective method.

Treatment of the initial stages of fasciitis

Our sneakers must have:

• light and springy foam sole, covered with a layer of rubber only on the sole - so that it does not wear out too quickly;
• Confident heel and toe support. That is, sneakers with a heel formed by a series of rubber springs or a sole molded in the shape of a horseshoe. looks unusual, which can attract our attention. But this type of shoe is designed for sports that require frequent jumping in different directions. They play basketball and tennis in it, do sprinting and shuttle running, etc. But they are not suitable for us at all because of the difficult balance of the heel with every movement. Therefore, the heel of the sole of our sneakers should be solid;
• the heel in our sneakers should be 5-7 mm higher than the toe. This rise is equally necessary for both men and women - to avoid the effect of throwing the body back;
• the middle part of the sole should follow the natural shape of the foot (the footprint of the shoe should follow the contour of a normal foot, not a flat one, that is, inner part soles should not be imprinted on the floor);
• the sole in the middle part should be equipped with rigid external instep supports. Typically, they are molded from hard plastic (much harder than any other part of the sole) and painted in various colors. That is, they also perform a decorative function. The instep supports we need will be wide, slightly concave inward, located along the sole, and not across it;
• the sole on the toe cannot be too thin. That is, its thickness should not be less than 1 cm. Shoes with thin soles look more elegant, but we should remember that we won’t be able to stand up on our toes on our own. Therefore, with each step, between our stiff fingers and the floor there must be a pad - a shock absorber - capable of bending under the pressure of the pads;
• the toes of the sneakers should be wide and high enough so that the toes are free in them, and if desired, we can even move them slightly;
• The upper part of the shoe on the sides in the middle should narrow slightly - in accordance with the natural narrowing of the foot in this place. Shoes called “shoes” (a special type of youth shoes, sneakers with flat soles that are deliberately widened at the sides) require a lot of effort from the feet to keep them on the leg. Since the “shoes” are almost not secured with lacing, the feeling of wearing them is in many ways reminiscent of walking in sandals - the shoes slap the heel with every step and tend to come off. Sandals without heel fixation are not suitable for every fashionista, and with fasciitis, a similar effect is contraindicated.

We are forbidden to massage the fascia in this state of affairs. However, we definitely need to begin to slowly relieve the spasm and fatigue of her fiber, otherwise this treatment may last for months, almost wasted. The question arises: how can we stretch the fiber without resorting to active warm-up, which it may not be able to withstand?

As already mentioned, the main enemy of muscles is not at all heavy weight or rhythmic, intense, long work. In fact, they can work, constantly contracting and relaxing, for hours, and this will not bring them any problems. If we remember to supply them with new portions of sugar with their food on time, nothing tragic will happen - they will just get pretty tired. But if we force the muscles of the body to freeze for a long time in a tense position, we will always have plenty of complications even without weights in our hands. Hence the conclusion: our fascia in normal mode does not work as it should.

Perhaps this is due to our excess weight. Perhaps the fact is that over the years our metatarsal bones straighten, the arch of the foot sags towards the floor and stretches the fascia more than it should. Perhaps it's our habit of carrying weights in only one hand. It is even possible that we have been falling on this particular leg for a long time due to some problems with posture or the bones of the sacrum/pelvis. In any case, when she walks for a long time tensed up more than usual and remained in this state longer than required. And now, as the pathology progresses, its fiber itself is already undergoing degeneration. That is, it cannot recover after exercise due to impaired blood supply and simply collapses.

We have already removed the load from it, let our new sneakers and the insoles inserted into them do the work for the muscle. It remains to try to speed up the process of resorption of blood clots in its fibers due to more varied movements of these fibers without weight. And, of course, not without the help of physiotherapeutic procedures.

To return the fascia to the feeling of normal compression-tension work, we will use gymnastics for the feet:

1. Let's take off the slippers and socks from our feet, sit on the floor without a carpet, bend our knees and pull them towards us so that our bare feet can stand freely on the floor. Place a handful of coins, pebbles of any shape, or glass balls for decoration right under your toes. In a word, any objects a little less or a little more than 1 cm in diameter - objects that it will be easy for us to grab with our toes from the floor. Small dishes should be placed next to and to the side of the foot. And now we need, without lifting our heels from the floor for a second, to grasp one or two pebbles with our toes, turn our foot towards the bowl and put them in it. Practicing for more than 20 minutes will be unnecessary, even if we have not moved all the objects. And after working with one foot, you need to immediately move to the other.
2. Let's sit on the floor in the same position: pulling our legs up to our chin so that our feet stand freely on the floor. By the way, in order not to overload your lower back, you can do this against a wall, leaning your shoulders on it - it will become much easier to maintain your balance. No matter how we choose, we should grab our toes with our fingers and slightly pull them, not upward, towards ourselves, but forward, as if we want to slightly stretch them in length. Count to three, let go. Repeat 5-7 times.
3. Let's sit in the same position on the floor, confidently place our bare feet on it and “ride” them forward, away from ourselves as much as the contraction of the Achilles tendon allows us. Let's stop at the point where the feet are already trying to lift off the floor, and place a waffle towel or any thick cotton fabric under the fingers. Let's grab this fabric with our toes and begin to pull it along the floor along with our feet back towards us. You cannot play any part of the foot off the floor. 2-3 such passes from the farthest point to the nearest one will be enough. You should not move the towel away from you - you need to move it back only with your hands.
4. Sitting on the floor, stretch your legs forward and spread them slightly to the sides so that there is room for movement. Of course, the feet should not stand on the floor, but “look” at the ceiling - as usual, when we sit with our legs stretched out along the surface. Our task now is to swing our feet back and forth and left and right freely, without the action of weight or the application of other forces. Rotations can be preferred to pendulum movements to the sides. We need to move our feet only as widely and actively as it is possible for us to do. with minimal effort. You cannot “press” the sore muscle all the way in any direction. If we notice. that the amplitude of free movement of the diseased foot is gradually leveled out in comparison with the healthy one, we can congratulate ourselves on the obvious successes in treatment.

Of course, all these warm-ups and other measures are recommended to be combined with therapy for swelling and inflammation. Swelling will be especially noticeable at the end next day spent at work. Even in orthopedic insoles, and even if we sat most of the time, as befits people with sore feet. Well. It’s not difficult to deal with the swelling itself: it can be easily reduced by applying a container of ice prepared in advance. A 0.5 liter plastic bottle or, even better, ice cubes placed in a plastic bag will do. You can also get reusable drink coolers - plastic balloons filled with water. These balls are frozen like regular ice in molds and used as needed to cool drinks that do not need to be diluted with ice.

Ice prepared in advance should be poured into a bag, tied tightly and applied to the foot, closer to the heel than to the toes, for 10-15 minutes. An option is to lay it on the floor and place your foot on top. Then you shouldn’t press the bag or bottle too hard with your foot, but lightly is quite acceptable. You can do with our cooler the same way we did with a rubber mat, grass and pebbles - knead it with your fingers, roll the sole on it.

Only you need to do all this exclusively while sitting or even lying down. If with tight foot syndrome we can still afford to be treated when the weight of the whole body presses on the fascia, then with fasciitis we are instructed to strictly avoid such combinations.

If there is not so much swelling as inflammation (the foot is hot, “shoots” when moving, a hard swelling is felt near the heel when palpated), it is not always reasonable to treat it with heat. In case of inflammation and spasm of the shoulder, we would apply mustard plaster without hesitation and we were right. But the fascia in many patients reacts to local heating by increasing the tendency to edema instead of the expected relief. If we could eliminate the very cause of blood stagnation, this would not happen. But since we are forced to influence it entirely by indirect methods, it can enhance the coagulation (clotting) of crumbs in tissues. And since the blood flow in this area is already impaired, we risk worsening the problem.

So in case of fasciitis, it is better to relieve inflammation with pure injections medical supplies. Antibiotics are of no use here (after all, there is no infection), but corticosteroid hormones would be quite appropriate - they will increase muscle activity naturally, relieve pain and indirectly reduce inflammation. However, if hormonal drugs cause us legitimate doubts (they can disrupt the functioning of the adrenal glands and pituitary gland), it is permissible to resort to other options. For example, fix your ankle with a plaster cast or walk for a while in a foot splint. However, you can try some traditional medicine. Just before using them, you should remember that all these components should be applied to the arch of the foot for a long time and cold.

So we can choose from:

• plantain leaves: crushed fresh leaves Before the juice appears, put the entire pulp in gauze, bandage it to the arch of the foot closer to the heel. Dry plantain needs to be brewed: 1 tbsp. spoon of herb in 1 glass of water, let it boil, cook covered over low heat for 10 minutes. Then let it cool and strain, soak gauze folded several times in the broth, apply it to the base of the heel and fix it until it dries;
• Comfrey leaf: apply and fix until it withers, if the leaf is fresh. You can mash it to release the juice. If dry, proceed as described above with plantain;
• celandine herb: take only in dry form, since celandine is poisonous. But it is very good as an anti-inflammatory agent. 1 tbsp. A spoonful of dry celandine herb should be poured with 1 cup of boiling water, heated in a water bath for 10 minutes, cooled and drained. Make a tampon from cotton wool and gauze, soak it in the broth, put it in the recess of the arch and fix it for 30 minutes. You should not use a decoction of celandine for more than 7 days in a row;
• finally, there is one more remedy that significantly improves the condition of all joints of the body, accelerates their regeneration, and promotes the restoration of cartilage and tendon tissue. This remedy is shark oil. The product is sold in the dietary supplement department of the pharmacy. It is recommended to apply shark oil to the skin of the foot and rub it in as intensely as the condition of the fascia allows. If it does not allow this, you should thickly smear the arch with fat, bandage it on top, and then put on a thick sock.

And by the way, one more nuance. If we have problems with any muscles in the body, during the period of their recovery after injury, we need to consume a sufficient amount of protein in our diet. All body cells are not built from carbohydrates or even from fat - they are built from amino acids, into which all types of meat and fish break down in our stomach. Therefore, if we are vegetarians or simply do not like meat, with any muscle damage we will have to temporarily sacrifice our food preferences to necessity. For the average person without sports training and big muscle mass you need to eat 150 g of meat or fish per day.

If plantar fasciitis occurs, treatment at home should begin immediately. The sooner you take it necessary measures, the greater the chances of quickly getting rid of the problem and achieving improved well-being. Therapy for the disease is aimed at relieving pain and reducing the inflammatory process, rapid healing of micro-tears and cracks, increasing the flexibility and strength of the foot.

Priority actions

Whenever initial signs Diseases should pay attention to lifestyle and physical activity. If possible, they should be adjusted so as to relieve unpleasant symptoms and prevent complications from occurring in the future.

If you have plantar fasciitis, you need to get enough physical activity. If you wear thin-soled shoes every day, you should avoid walking on asphalt or concrete. It is forbidden to run, as this promotes activation of the inflammatory process. During an exacerbation of the disease, it is necessary to stop playing sports or limit exercises that provoke pain.

Ice has a good analgesic and anti-inflammatory effect. It can be applied to the heel area at the end of the working day. This will allow you to quickly and effectively relieve the condition.

Very severe pain will help remove drugs from NSAID groups. They are characterized by a complex effect and have anti-inflammatory, analgesic, and decongestant effects. For this purpose, you can use medications based on Diclofenac or Ibuprofen.

However, drugs cannot be used uncontrolled. They have a large number of side effects, in particular, they negatively affect the mucous membrane of the gastrointestinal tract and can provoke the development of ulcers and bleeding.

Choice plays an important role in successfully getting rid of unpleasant sensations. the right shoes. It should successfully absorb the shock of walking and support the arch of the foot. During the period of exacerbation of the disease, it is necessary to stop using slippers, high-heeled shoes or sandals. You should give preference to a pair with a soft and thick sole. The ideal option is sneakers.

Proximal fasciitis requires improved footwear. Special inserts in the heel area or orthopedic insoles will help solve this problem. This way you can reduce the load on the area of ​​inflammation.

Walking barefoot can increase pain, so you need to put on shoes as soon as possible after getting out of bed. It is advisable to do calf stretching exercises in the morning. It won’t take much time, only 3-4 minutes, but it will help to effectively strengthen the ligaments and muscles, which will have a positive effect on the course of the disease.

Excess weight has negative impact on the human ligamentous apparatus, exposing it to increased loads. Therefore, one of the first recommendations in the treatment of plantar fasciitis is weight loss. It is not necessary to lose half the weight; even a slight decrease in indicators will have a positive effect on the patient’s well-being.

When treating a disease at home, you should remember some limitations. For example, a ban on long-term thermal procedures. In this case, cold will help reduce pain and relieve inflammation, and elevated temperature will negatively affect the patient's condition. It is advisable to observe this rule even during water procedures and in mandatory complete hygiene measures cold shower.

The use of baths in the treatment of disease

How to treat plantar fasciitis with folk remedies? Alternative medicine involves an integrated approach. Therefore one of important conditions successful therapy is the use of baths. Thanks to water procedures, the skin of the affected leg will steam well and soften. To enhance positive result It is necessary to add medicinal components to the liquid.

An additional advantage of this treatment method is that subsequent application of a compress will provide a more pronounced therapeutic effect.

The simplest recipe for preparing a bath is to add soda and salt. For 1 l hot water you will need 1 tbsp. l. each means. If desired, you can add a few drops of iodine, which has an antiseptic effect. The duration of water procedures is about 15-20 minutes. It is not recommended to use liquid that is too hot, as it can not only cause a burn, but also worsen the patient’s well-being.

The healing composition, which includes turpentine, vinegar and vodka, has a good effect. All components must be mixed in equal proportions and heated slightly in a water bath. The procedure achieves an analgesic, anti-inflammatory and relaxing effect.

Treatment with folk remedies includes the use of an “ice bath.” Very cold water is suitable for this. Adding crushed ice will lower the temperature of the liquid even further. The procedure should be done carefully, only the heel should be immersed in the water, and the total duration should not exceed 5–10 minutes. IN otherwise exists high risk frostbite of the feet.

The use of compresses in the treatment of plantar fasciitis

Folk remedies in the treatment of the disease necessarily include medications for local application. good therapeutic effect has the use of compresses. Thanks to the correct application of the application, optimal conditions are created for deep penetration of the drug deep into the epidermis. For compresses you can use the following recipes:

1. Horseradish and laundry soap. Grind both components in equal proportions, mix well and place on the area of ​​inflammation. Attach to the leg, cover with a plastic bag or wax paper and wrap. It is advisable to do this procedure at night so that the medicine acts on the pathological focus for as long as possible. The product has an antibacterial, anti-inflammatory and analgesic effect. Apply the application daily before bed until you feel better.
2. Sunflower tincture. U flowering plant cut off the head and remove the white porous pulp. Grind the mixture, put it in a glass container and fill it with vodka. The liquid should cover the sunflower by 0.5–1 cm. Leave the product in a dark place for 10–14 days. Before use, strain the tincture and add sunflower, olive, flaxseed or any other vegetable oil in a 1:1 ratio. Use the product for rubbing and applying compresses.
3. Infusion of cinquefoil. To prepare it, you need to grind the root of the plant. 2 tbsp. l. pour 50 ml of water and leave for 2 hours. After this time, strain the product and mash the remaining pulp to a puree-like consistency. Place the mixture on the heel and apply a compress. The duration of use of the medicine is at least 10–12 hours. Therefore, the procedure should be done before bedtime so that the patient does not have to walk with the application.
4. Beets and apple cider vinegar. To apply a compress, you need to grate the vegetable and mix it with apple cider vinegar in equal proportions. The product has a pronounced softening, anti-inflammatory and analgesic effect. Its only drawback is that it can paint the sole red, which is only relevant in the hot season.
5. Elderberry tincture. It has pronounced anti-inflammatory and antiseptic properties. To prepare it, you need to pour the berries medical alcohol and leave for 5-7 days. It is advisable to do this in a glass container. Ready product use for rubbing and applying compresses - moisten a piece of cotton cloth or gauze in liquid, apply to the sore spot and wrap it on top.

Using ointments and rubs

Treatment for plantar fasciitis with folk remedies involves using medications to rub into the inflamed area several times a day.

The easiest way to prepare an ointment is to grind fresh unsalted lard in a meat grinder and use it as a rub. To enhance the anti-inflammatory and analgesic effect of fat, it should be attached to the heel area and left overnight. To avoid unnecessary worries, you don’t have to twist the lard and add a whole slice. It will also have a positive effect.

When treating fasciitis with folk remedies, you should definitely use an effective propolis-based recipe. To prepare the ointment, mix 25 g of herb and 200 g butter, melt the mixture in a water bath and rub the sore heel. The product can be left overnight, and to avoid soiling the bed linen, put a sock on top.

Golden mustache has a powerful anti-inflammatory effect. Ointments, infusions, rubs and other forms based on it are used in the treatment of many diseases. The stem and leaves of the plant are used for medicine. To strengthen healing effect, the cut parts should be placed in the freezer for several hours. After this, pass through a meat grinder and add animal fat (pork, bear, badger). For 1 part golden mustache you will need 2 parts lard. The product is used as an ointment, but is not used for applying compresses. The medicine should be kept in the refrigerator so that it retains its consistency.

Fasciitis therapy with folk remedies will help cope with the inflammatory process without using pharmacological drugs. However, you should be patient, because although this treatment is absolutely safe, it does not act as quickly as medications.

Plantar fasciitis is a pathological process of inflammatory origin, localized in the heel area and characterized by severe pain that intensifies with load on the affected leg. The disease occurs in older people and younger people. The prevalence of the disease is low, which is explained by the anatomical protection of the fascia from inflammation. The pathological process must be treated as early as possible, without exacerbating the severity of the disease. Treatment can be carried out at home.

Fascia is a sheath formed by dense connective tissue that covers muscle tissue, tendons, organs and branches - vascular and nervous. Strong connecting formations form reliable cases for these anatomical formations, protecting them from mechanical, physical, and biological damage; perform the function of holding, fixing; provide processes of nutrition, innervation, and performance of functions.

On the foot, the fascia has the most important than in other parts of the body - in the heel area, the soles are subject to maximum physical stress during walking and running. Due to increased loads in the area of ​​the feet, the fascia is thickened and is called -. Its maximum thickness is in the middle part of the foot; towards the periphery, there is a tendency for the fascial sheath to become thinner. The fascia is attached to the metatarsal bones I and V, and from the other end to the bones of the midfoot. The aponeurosis has small openings through which the relationship between the subcutaneous tissue, blood vessels and the contents of the fascia occurs.

Causes of fasciitis

Fascia is an element of a protective mechanism created by nature. If you neglect some rules, it is impossible to avoid the occurrence of fasciitis. Causes of fasciitis:

• Excessive physical activity, mediating high mechanical load on the aponeurosis. Pressure on the fascia leads to tension and thinning. Thinning causes constant irritation of the periosteum, with which the fascia is intimately fused.
• Excessive pressure and progressive thinning of the fascia leads to the formation of microcracks and tears in the tissues of the aponeurosis. Aseptic develops inflammatory process, the disease must be treated immediately. The word “aseptic” implies the absence of pathogenic agents. Inflammation causes swelling and pain.
• Prolonged aseptic inflammation in tissues leads to an increase in degenerative processes, a slow destruction of the connective tissue of the fascia occurs, then the process spreads to the bone.
• In addition to mechanical reasons, genetic mechanisms may also be involved. The risk of the disease increases in individuals whose families have a history of connective tissue disease.
• There may be cases when the fascia is irritated from the outside, when as a result general pathology is growing bone heel bone and a heel spur is formed, irritating the fascia.

The disease must be treated starting with the elimination of these causes.

Predisposing factors

In addition to the direct causes of plantar fasciitis, there are factors that, under certain conditions, can provoke the development of the pathological process. These include:

Treatment of pathology without assessing these factors may be meaningless.

Pathogenesis

The plantar fascia attaches to the tubercle of the heel bone on one side, as well as to the metatarsal bones of the toes. The main load and weight of the human body during walking, standing, and running falls on this fascia. Predominantly the pressure falls on the area of ​​the fascia of the calcaneus.

Under the influence of these factors, tissue tension occurs and microtraumas form. Inflammation occurs. As a compensatory reaction, defense mechanisms mediated by our immune system are activated. Since there is inflammation in the body, cells are delivered to this area that produce biologically active substances aimed at eliminating inflammation and the causes that caused it. The immune system is programmed to assume that inflammation is caused by microorganisms, so it begins to actively produce inflammatory mediators and immunoglobulins, which these microorganisms must destroy. But fasciitis is an aseptic inflammation; there are no microorganisms in this area. Therefore, all these substances accumulate in the problem area, irritate the nerve endings and mediate the formation of swelling and pain.

Plantar fasciitis mainly affects people over 40 years of age; women are more often affected, which can be explained by wearing high-heeled shoes.

Symptoms of the disease

The main symptom that causes inconvenience and trouble for patients is pain. Its localization may be different. Most often this is the area of ​​the inner edge of the foot. Pain bothers patients while walking, especially for a long time. Possible morning pain. Frequent localization pain symptom– area of ​​the arch of the foot; anterior, lateral and posterior surface of the ankles; heel area. The peculiarity of the disease is increased sensitivity thumb feet to pressure and the action of other irritants, in this area the patient is also bothered by a feeling of pain.

With plantar aponeurosis, pathological productive elements of inflammation are formed in the connective tissue of the fascia - nodules that tend to merge and form a cord that can thicken, thicken, and fuse with the skin. A persistent flexion contracture is formed - the inability to straighten the muscles, ligaments, foot and toes. This condition significantly complicates the ability to walk and affects general condition patient, he loses the ability to lead a normal lifestyle. Most often, one foot is affected; the possibility of spread and involvement of both feet in the pathological process cannot be ruled out.

Diagnosis

The main symptom of the disease is pain in the foot and heel area that occurs during exercise. The pain syndrome is also intense in the morning or after long stay at rest, when there was no pressure on the leg. In most cases, diagnosis of plantar fasciitis is possible based on subjective data provided by the patient and objective examination data. The decisive factor in making a diagnosis is the radiographic method. It is possible to use ultrasound or echography methods for diagnosis.

Treatment of plantar fasciitis

Fasciitis is treated comprehensively. All therapeutic measures are divided into types:

• etiotropic methods of treatment - aimed at eliminating the causes leading to the development of the disease;
• pathogenetic therapy - acts on the components of the chain of disease pathogenesis;
• symptomatic treatment - aimed at completely eliminating or reducing the symptoms of the disease. We are talking about a pain symptom.

Etiotropic treatment includes the following measures:

• the reasons are determined - incorrect gait, inappropriate shoes, occupational hazards, and so on. These reasons are eliminated whenever possible;
• if the cause of the disease is anatomical or functional disorders stop – they try to eliminate overstrain in individual areas with the help of orthopedic insoles, arch supports and pronators;
• It is necessary to follow a daily routine and a walking routine: at the first signs of the onset and intensification of pain, give yourself a break until the pain subsides, minimize the time you walk on a hard surface.

Pathogenetic therapy includes drug treatment, physiotherapeutic treatment, gymnastics and massage.

Drug treatment includes medications that reduce inflammation. Effectively use medications in the form of ointments, gels, creams. Such drugs include Nimesulide ointment, Diclofenac derivatives - representatives of the group of non-steroidal anti-inflammatory drugs. Dosage form in the form of ointments it is easy to use at home. If symptoms and clinical signs are severe, systemic glucocorticosteroid drugs are prescribed to eliminate inflammation.

The most effective methods Physiotherapeutic procedures are considered treatments. Among them:

• ultrasound therapy– aimed at relieving inflammation and swelling;
• phonophoresis and electrophoresis are carried out with drugs that have pronounced anti-inflammatory effects. These include calcium gluconate and steroid drugs. Due to tissue heating, the permeability of blood vessels and tissues increases, large quantity the medicinal substance enters the area of ​​inflammation;
• Shock wave therapy is used when a significant size heel spur has formed on the heel, causing severe pain and discomfort.

At home, you can use baths with medicinal herbs and perform special gymnastics.

Symptomatic treatment is painkillers. They can also be used in the form of ointments or tablets orally.

If these treatment methods are ineffective, you can proceed with surgery. Surgical excision of the inflamed and deformed area of ​​the aponeurosis is performed.

The prognosis of the disease is favorable if treatment is started in a timely manner and all doctor’s instructions are followed. Then there is the possibility of restoring foot function.

The main thing in the treatment of fasciitis is to identify the causes leading to its development. Only complete and extensive diagnostics, installation accurate diagnosis, correctly selected combination therapy may lead to positive effects. Otherwise, no treatment will help you, but will only worsen the problem.

Heel pain that gets worse with normal walking and running is not easy unpleasant problem, such a symptom may signal the development of a disease called plantar fasciitis. What is this disease and is it possible to treat it at home?

Why does your heel hurt?

Fasciitis of the sole is popularly called a heel spur because of the peculiar bone growth that appears with this disease. Heel pain occurs due to severe inflammation and deformities of the plantar fascia, the part of the sole that connects the heel and phalanges of the toes.

The appearance of plantar fasciitis is provoked by the following factors:

1. the presence of flat feet, as well as a high arch of the foot;
2. overweight;
3. physical activity, standing for long periods of time;
4. osteochondrosis, joint diseases - arthritis, arthrosis.

The main symptom of this disease is sharp pain in the heel, which may appear after waking up. Swelling appears on the foot, and over time the pain can spread to the arch of the foot and ankle.

Diagnosing plantar fasciitis is not difficult. The doctor will have enough visual inspection and x-ray.

How to treat:

1. To treat plantar fasciitis, it is necessary, first of all, to reduce the load on the foot and limit mobility. You can put special orthopedic insoles into your shoes, which will help secure the heel well and keep the foot at the desired angle to the shin. At night, at home, you can wear special orthoses-boots that stretch the plantar fascia and allow it to heal.
2. The benefits are undeniable various massages in the treatment of fasciitis. Also, a person with such a disease should not forget about physical exercise, aimed at stretching the fascia and lower leg, which can be done at home.
3. In addition to the above methods, various physical procedures help well in the treatment of plantar fasciitis. Warming up, ultrasound, laser exposure - doctors recommend doing them regularly for maximum effect.
4. In case of severe pain that does not go away, you can use anti-inflammatory non-hormonal ointments. Indomethacin, Advil, Diclofenac quickly relieve pain.
5. In very severe and advanced cases, the doctor can conduct a course of injections with hormonal drugs, they must be placed in the fascia area. If this method does not help, surgery may be necessary. During such an operation, the doctor will remove the bone growth and altered tissue.

Time-tested recipes

Add drug therapy at home you can always use folk remedies. Compresses made from garlic with lard, horseradish with laundry soap, cinquefoil root, sunflower flowers.

You can also try making foot baths from whey and walnuts.

Lotions made from hot boiled potatoes, beet juice mixed with apple cider vinegar, and plantain seeds will also have an anti-inflammatory and analgesic effect.

Video

Plantar fasciitis is a disease that is caused by inflammatory and degenerative changes in the tissues of the plantar fascia and is accompanied by heel pain during exercise.

Causes

Plantar fascia (plantar aponeurosis) is a dense connective tissue that attaches to the heel bone and phalanges of the toes. Its main function is to form and support the longitudinal arch of the foot. If a person stands, half of his weight puts pressure on the plantar aponeurosis. High load provokes micro-tears in the area that is attached to the heel tubercle.

In many cases, while in vertical position(during sleep) injuries regress on their own. But under the influence unfavorable factors fascial ruptures recur. As a result, plantar fasciitis develops, the cause of which is constant microtraumatization of the aponeurosis, leading to aseptic tissue inflammation and pain.

Plantar fasciitis of the heel most often affects women over 40 years of age. The following unfavorable factors increase the likelihood of developing the disease:

• overweight;
• sports activities that involve prolonged stress on the heel or Achilles tendon;
• flat feet or too high arches;
• turning the foot inward while walking;
• wearing uncomfortable shoes;
• diseases of the musculoskeletal system;
• injuries;
• gout.

Chronic plantar fasciitis over time can lead to the formation of a heel spur, a bone growth (osteophyte) that occurs as a result of the deposition of calcium salts.

Symptoms

The main symptom of plantar fasciitis is pain in the heel area. Unpleasant sensations arise or intensify with exertion. In the morning they are most pronounced, then gradually subside. This is due to the rupture of the fascia that has grown together during night sleep. In addition, the pain intensifies after a long period of sitting, when a person takes his first steps.

The formation of a heel spur can increase the intensity of the symptoms of plantar fasciitis of the foot as the bony growths put pressure on the surrounding tissue. In many cases, the osteophyte does not manifest itself at all.

Diagnostics

Plantar fasciitis is diagnosed based on an analysis of complaints and examination. In addition, radiography is prescribed, which allows you to detect a heel spur.

During the examination, plantar fasciitis is differentiated from diseases such as:

• tarsal tunnel syndrome;
• rheumatoid arthritis;
• Reiter's syndrome and so on.

Treatment

Treatment for plantar fasciitis is determined by the severity of its symptoms. In mild cases, the main directions of therapy are to ensure unloading of the plantar aponeurosis and eliminate inflammation of the soft tissues.

Unloading the plantar fascia is achieved by reducing physical activity and periodically resting while walking. The main methods of therapy are gymnastics, taping and the use of special devices for the foot.

The purpose of exercises for fasciitis is to stretch, strengthen and increase the elasticity of the aponeurosis. They must be done every morning after warming up. Regular exercise helps lengthen the plantar fascia. As a result, pain is reduced and future injuries are prevented.

After physical therapy The foot is taped - applying an elastic band (tape) or patch to support the longitudinal arch and fix the aponeurosis. When applying the tape, it is necessary to increase its tension when it bends around the leg from below.

To increase the effectiveness of treatment of plantar fasciitis at home, braces or orthoses are used - devices that fix the foot at a right angle. They are worn all night and do not allow the aponeurosis to shorten. IN daytime Patients with fasciitis are advised to wear orthopedic shoes or insoles with arch support and a depression in the center of the heel.

To relieve tissue inflammation and reduce pain, the following are practiced:

• massage;
• applying ice;
• rubbing with warming and anti-inflammatory drugs;
• mud applications;
• warm foot baths;
• analgesics – ibuprofen, acetylsalicylic acid, naproxen.

How to treat plantar fasciitis in severe cases? For severe discomfort and significant bone growths, the following methods are used:

• injection of glucocorticoids into the foot tissue in combination with anesthetics;
• shock wave therapy to destroy heel spurs;
• laser or ultrasound effect on inflamed tissue.

If ineffective conservative treatment For plantar fasciitis, an operation is performed during which the osteophyte and altered parts of the fascia are removed.

Forecast

Plantar fasciitis has a favorable prognosis. In advanced cases, the course of the disease may worsen due to a fracture of the heel spur.

Prevention

Basic measures to prevent plantar fasciitis:

• wearing orthopedic shoes;
• adequate physical activity;
• maintaining normal weight;
• treatment of pathologies of the musculoskeletal system.

Heel or foot pain is a common symptom with which hundreds of thousands of people present to the doctor every year. medical institutions to identify the causes and eliminate pain. It would seem that, modern medicine and the technical equipment of medical institutions should no longer leave incurable diseases, but such diseases still exist. Such diseases include plantar fasciitis, which should be treated immediately. You can also treat at home.

Plantar fasciitis is called a heel spur, which is incorrect medical point vision. A heel spur is a bony growth that forms in the area of ​​the heel bone and fascia of the foot. The bone growth does not cause pain or discomfort; its presence in clinical course the disease does not affect treatment methods. Often, heel spurs are found in completely healthy individuals who have never had complaints about the health of their feet or heel spurs.

Let's talk about the anatomical structure and functions of the fascia. Plantar fascia is a connective tissue formation covering the bone formations of the foot, starting from metatarsal bones fourth and fifth toes, attached to the heel bone. The thickness and structure of the fascia is not the same throughout, and the load on the foot in different parts is different. A large load is applied to the midfoot, so the thickness of the fascia in this section is maximum. Towards the periphery the fascia becomes thinner.

The main functions of the fascia include:

• protective – the fascia tightly covers bone structures, forming a case that protects bones and protects them from mechanical, chemical and biological irritants;
• the so-called fascia connects all the bone formations of the feet, forming a single functional system;
• nutritional function – connective tissue formation contains nervous and vascular components, ensuring the supply nutrients in this area, also provides sensitivity to the feet;
• Availability lymphatic capillaries ensures the outflow of metabolic and decay products from the area of ​​the feet, does not allow them to accumulate, causing various kinds pathological processes.

Etiology of the disease

The feet withstand enormous loads, which causes spurs to form on the heels. On average, the fascia of the feet experiences a force of 50-100 kg. Over time, loads lead to structural inferiority and the formation of pathology. Reasons that can cause pathology:

Pathogenesis

The pathogenesis of the disease is quite clear. When exposed to a causative factor, fascial overstrain occurs. As a result increased load on the fascia, it becomes thinner and stretches. In this state, it still performs its function. Fascia, as a connective tissue structure, is easily stretched, so the disease does not develop immediately. When the fascia stretches to its maximum extent, it is susceptible to all irritants. Under the pressure of a force that the fascia could previously easily withstand, ruptures and microcracks occur.

Such microcracks lead to activation immune system, seeking to compensate for the emerging pathology and secreting a huge number of cells into the epicenter and biologically active substances. These cells are active chemical substances lead to the development of aseptic inflammation. Aseptic inflammation means a process of inflammatory changes that occur without the participation of pathogenic microorganisms.

As a result of the activity of inflammatory mediators, the permeability of blood vessels in this area increases, and plasma emerges from the vessels into the area of ​​​​increased concentration of active chemical compounds. This is how edema forms, leading to greater stretching of the fascia and irritation. pain receptors and nerve endings – a feeling of pain is formed.

Clinic of the disease and symptoms

The main symptom that causes trouble for patients is pain. The pain occurs more often in the morning, and may develop during the daytime, after prolonged physical activity. This is explained by the course of the pathogenesis of the disease. At night, when the leg is at rest, the productive phase of inflammation is activated, cells in the area of ​​aseptic inflammation begin to secrete substances aimed at healing the resulting microtraumas and restoring integrity. The tissues formed in this way are inferior and fragile. In the morning, when the patient takes his first steps, the ligaments are torn again, causing pain.

Diagnostics

Diagnosis of plantar fasciitis is quite easy. The doctor interviews the patient, finds out the symptoms, identifies the location of the pain and the time of its occurrence. The location of the pain is important and helps determine whether the pain is caused by plantar fasciitis or another cause of the pain.

The doctor assesses the health of everyone musculoskeletal system. To do this, tests are carried out to evaluate the symptoms:

• reflexes are checked;
• muscle strength;
• muscle tone;
• sensitivity in the feet;
• coordination of movements;
• sense of balance.

To completely confirm the diagnosis, instrumental diagnostic methods are used:

• X-ray;
• computed tomography;
• magnetic resonance imaging.

Treatment

Most patients, with properly selected treatment and timely application to professionals, recovers within a few months thanks to conservative therapy.

Conservative treatment involves the use of drugs:

1. The main group of drugs is glucocorticosteroids. Strong anti-inflammatory drugs, aimed at the pathogenetic mechanisms of disease formation, are mandatory for use.
2. Non-steroidal anti-inflammatory drugs in the form of ointments are used locally. These drugs include Nemesid and Ibuprofen derivatives. They relieve pain and relieve inflammation.

Physiotherapeutic treatment methods are widely used to treat plantar fasciitis - electrophoresis, phonophoresis, ultrasound therapy, UHF. The maximum effect of these plantar fasciitis treatment methods is achieved when used in conjunction with medications.

It is effective to use special orthopedic shoes and insoles equipped with pronators and instep supports, ensuring uniform distribution of the load on the surface of the foot.

If the effect of conservative therapy is insignificant, treatment methods are used:

• shock wave therapy – shock waves are sent to the heel area different intensity, stimulating the reparative forces of the body, accelerating recovery. Effective for chronic plantar fasciitis;
• in case of ineffectiveness of drug treatments and subsequent progression of the pathology, they are used surgical methods treatment. The affected connective tissue of the plantar aponeurosis is excised. These treatment methods are fraught with complications and lead to weakening of the arch of the foot, requiring constant health care, compliance with the daily routine and exercise.

Physiotherapy

At home, it is advisable to perform physical exercises aimed at stretching the plantar fascia and increasing its reserve forces.

Exercise 1

Place your palms on the wall and place your feet directly behind each other. The sore leg is at the back; if pain occurs in both heels, then the legs must be alternated. Without lifting your heels off the floor, squat down, bending your knees until you feel tension in the lower part of the shin of your sore leg. Stay in this position for 15-20 seconds. Perform 10-15 repetitions. The exercise warms up and increases the elasticity and strength of the lower leg muscles, relieving the load on the aponeurosis.

Exercise 2

The exercise is a warm-up exercise with elements aimed at training the plantar fascia.

On the floor, in front of the wall, place several books in a stack 5 cm high. Stand on the books so that your heels hang over the edge. Place your palms on the wall. From this position, lean forward toward the wall to feel the stretch in the lower part of your shin, hold for 15-20 seconds. Complete 15 reps.

Exercise 3

The same manipulations are performed in the same sequence as when performing exercise 2, but bending towards the wall is carried out while standing on one leg.

Exercise 4

Take a tennis ball, rolling pin, or cylindrical object and place it under your feet. Roll the object along the floor like rolling out dough, pressing it with your foot to the surface of the floor. If expressed pain syndrome, you can take a bottle with cold water- this will reduce pain.

Conservative treatment prescribed by a doctor will become effective if you begin to take care of yourself at home. During treatment, it is necessary to reduce walking time and the intensity of physical activity. Don't forget about cold compresses, massages, baths and exercises. Avoid uncomfortable shoes, especially heels.