Effective Treatment Options for Plantar Fasciitis in Older Adults

Plantar fasciitis

What treatment options are available for elderly patients, and is it possible for them to fully recover? Should pain relief injections be administered?

g, 60~69 year old female. Ask Date: 2013/12/27

Dr. Chen Xingyuan reply Orthopedics

Dear Readers,
The occurrence of plantar fasciitis is related to age, physical condition, and usage patterns, making it difficult to completely cure.
Since age and physical condition cannot be changed, we can only focus on careful usage to reduce the chances and intensity of its occurrence.

In terms of treatment, please pay attention to the following:
1.
Reduce the amount of foot usage; avoid unnecessary walking, standing, or weight-bearing activities.
2.
Change your footwear; try to wear soft insoles and avoid walking barefoot.
If necessary, consider using silicone heel pads for additional support.
3.
Perform stretching exercises for the calf muscles; dorsiflex the ankle to stretch the plantar fascia and Achilles tendon to a tight state, hold for 10 seconds, then relax.
Repeat this 20 times, and you can do it 2-3 times a day.
4.
Medication treatment may include anti-inflammatory pain relievers, steroid injections, and even extracorporeal shock wave therapy.
Reducing foot usage is the most important aspect of treatment; injections and medications can only provide short-term relief and cannot cure the condition.
Wishing you health and safety!
Sincerely,
Dr.
Chen

Reply Date: 2013/12/27

More Info

Plantar fasciitis is a common condition, especially among older adults, characterized by pain in the heel and bottom of the foot due to inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot. As we age, the risk of developing plantar fasciitis increases due to factors such as decreased elasticity of the plantar fascia, changes in foot structure, and the cumulative effects of wear and tear. Fortunately, there are several effective treatment options available for managing this condition, and many individuals can achieve significant relief or even complete recovery.

Non-Surgical Treatment Options
1. Rest and Activity Modification: One of the first steps in treating plantar fasciitis is to reduce activities that exacerbate the pain. This may involve taking breaks from high-impact activities like running or standing for long periods.

2. Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Ice packs can be applied for 15-20 minutes several times a day, especially after activities that aggravate the condition.

3. Stretching and Strengthening Exercises: Gentle stretching of the calf muscles and plantar fascia can improve flexibility and reduce tension. Exercises such as calf stretches, toe stretches, and rolling the foot over a frozen water bottle can be beneficial. Strengthening exercises for the foot and ankle can also help support the arch and reduce strain on the plantar fascia.

4. Orthotic Devices: Custom or over-the-counter orthotic inserts can provide additional arch support and cushioning, helping to distribute pressure more evenly across the foot. Proper footwear is also crucial; shoes with good arch support and cushioning can significantly alleviate symptoms.

5. Physical Therapy: A physical therapist can design a personalized exercise program that includes stretching, strengthening, and manual therapy techniques to improve foot mechanics and reduce pain.

6. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. However, it's essential to consult with a healthcare provider before starting any medication, especially for older adults who may have other health conditions or take other medications.

Injections and Advanced Treatments
1. Corticosteroid Injections: For persistent pain that does not respond to conservative treatments, corticosteroid injections may be considered. These injections can provide significant relief by reducing inflammation in the plantar fascia. However, they should be used judiciously, as repeated injections can weaken the tissue.

2. Platelet-Rich Plasma (PRP) Therapy: This is a newer treatment option that involves injecting a concentration of platelets derived from the patient's blood into the affected area. PRP has shown promise in promoting healing and reducing pain in some patients with plantar fasciitis.

3. Shockwave Therapy: Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that uses sound waves to promote healing in the plantar fascia. This treatment may be beneficial for those who have not found relief from other conservative measures.

Surgical Options
Surgery is typically considered a last resort for plantar fasciitis, usually after at least six months of conservative treatment has failed. Surgical options may involve releasing the plantar fascia or removing bone spurs if present.

Conclusion
In summary, while plantar fasciitis can be a challenging condition, especially for older adults, there are numerous effective treatment options available. Most individuals can expect improvement with conservative measures, and many can achieve complete recovery. It is essential to consult with a healthcare provider to develop a tailored treatment plan that considers individual health status, activity level, and specific symptoms. Regarding the use of pain injections, such as corticosteroids, this should be discussed with a healthcare professional to weigh the potential benefits against any risks, especially in older adults who may have other underlying health issues.

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