Plantar Fasciitis (Heel Pain)
The plantar fascia runs along the length of the sole of the foot and along with various ligaments and muscles of the foot functions to assist in maintaining the inner arch like the string of a bow. Plantar fasciitis is inflammation of the origin of the fascia and the calcaneus (heel bone). It is usually the result of repetitive strain, tear and repair of the fascia from traction forces that have worn it out. Heel spurs have been associated with heel pain, originally thought to be its cause, however heel spurs are a result of the problem and occur at the origin of the flexor digitorum brevis muscle which lies beneath the plantar fascia. Heel spurs are not the cause of the pain but are associated with the plantar fasciitis.
Initial management involves a multitude of non-operative approaches. This works for 90% of patients within 12 months. This includes analgesics, anti-inflammatories, massage, ice, exercises, appropriate shoe wear such as heel pads and night splints. Dr Rao does recommend the use of injection therapy, particularly platelet rich plasma. These injections are performed under an anaesthetic (see separate section). Other treatment includes ultrasound or shockwave therapy.
For those people who fail non-operative measures, surgery does involve releasing the plantar fascia. Dr Rao prefers to use a limited incision open technique, however as Dr Rao will explain to you, his use of platelet rich plasma injections for plantar fasciitis has resulted in the operation of plantar fasciitis being needed far, far less than what it used to be.
Risks and Complications
There is a less than 5% complication rate, with complications such as infection, nerve injury, blood clots and anaesthetic problems. The success rate with the surgery is around 90%.
In terms of hospital stay:
- 1-2 nights in hospital;
- Rest, elevation for 2 weeks;
- Time off work:
- for seated jobs, 2 weeks
- for standing jobs 5-6 weeks
- Foot swelling for about 6 weeks
- Return to sports by 3 months
Meet Dr Rao
Dr Rao is a Newcastle Orthopaedic surgeon who specialises in all aspects of foot and ankle surgery. He graduated from medicine at the University of Sydney and trained as an orthopaedic surgeon in Newcastle and also in Queensland.
He also undertook further training by way of fellowship with world famous Dr Terry Saxby in Brisbane in 2008. He has also conducted further training by attending numerous courses overseas, in Thailand, the USA and right across Australia.