Suggest Treatment For Chronic Heel Pain
The MRI scan and X-ray is suggestive of plantar fasciitis.
Till now, she has done the following towards her treatment -
1. Anti inflammatory medicines with rest and cold fomentation
2. Cortisone injection
3. Applying apple cider vinegar
4. Physiotherapy
However, none of the above have helped.
Can you please take a look.
Conservative vs Surgery
Detailed Answer:
Hi XXXXXXX
Thanks for the query.
I have reviewed your attached reports such is in keeping with the diagnosis of plantar fascitis and mild arthritis.
Plantar fascitis is a very common cause of heel pain.
Your mother has bony spurs and cysts which support the diagnosis of Plantar fascitis.
It is important to perform calf muscle stretching and plantar fascia stretching exercises. Wearing a foot drop splint at night is very helpful to prevent pain next day. Wearing MCR slippers is very useful. Hot soaks in salt water helps to reduce swelling.
Injection of Plasma Rich Precipitate (PRP) at the insertion of the fascia is also useful. Creating microtears in the fascia is also indicated in minimally invasive surgical option.
If all this fails, surgery can be done to remove the bony spurs and fascia release.
The decision can be taken after discussing these options with her treating Doctor.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
you mentioned three options -
1. Injection of Plasma Rich Precipitate (PRP)
2. Creating microtears
3. Surgery
Q1. what is the kind of procedure and tentative approximate time in each procedure. Q2. what has worked best for other patients in your experience
Open surgery
Detailed Answer:
PRP injection takes few minutes to perform as it is an injection of the patient's blood precipitate into the fascia. Recovery time takes upto 6 months to show results.
Percutaneous creation of mictotears in the fascia using a needle also takes few minutes to half an hour and recovery time depends on the physiotherapy that follows. Usually about 2 to 3 months you should find relief.
Open surgery can take half an hour to an hour to perform under Anaesthesia. Recovery time should be within a few weeks after stitches are removed.
Best of the three could be open surgery because there is no further chance of plantar fascia tightness because the fascia is nearly completely released.