What is Plantar Fasciitis?
Plantar fasciitis is a common and debilitating condition that effects millions of Americans. The patient usually presents with foot/heel pain that intensifies upon rising in the morning and after prolonged standing or walking. The plantar fascia is a thick connective tissue structure that originates at the bottom of your foot and attaches to the heel. When that connective tissue gets inflamed it is referred to as plantar fasciitis, which is an extremely painful and life effecting condition. The causes of this condition are numerous, some of the most common are : over pronation or “flat footed”, “high” foot arches, ankle weakness or instability , and occupations that require you to stand or walk for many hours a day
How does a doctor diagnose plantar fasciitis?
Before a specific treatment is recommended a proper medical work up should be performed. A thorough health history and physical exam must be performed. The physician must rule out other conditions that can mimic plantar fasciitis, such as lumbar radiculopathy, peripheral neuropathy, stress fracture of the foot , and Tarsal Tunnel syndrome to name a few. MRI evaluation, diagnostic ultra sound and neuro diagnostic testing (EMG/NCV) may be ordered to help the doctor make a definitive diagnosis.
What are the treatment options for relief from plantar fasciitis and heel pain?
Traditionally, patients suffering from acute or chronic plantar fasciitis were prescribed oral anti-inflammatory medications (NSAID’s), the foot was immobilized, and patient was fitted for an orthotic insert and advised to rest. In more challenging cases a regiment of physical therapy was ordered. If the patient failed conservative options, surgical intervention was recommended, usually a plantar release procedure. If a patient has failed conservative treatment and does not desire surgical intervention, regenerative medicine may be the perfect option.
Platelet Rich Plasma (PRP) Therapy
Platelet Rich Plasma (PRP) Therapy is a type of regenerative medicine procedure that has been proven to help rebuild and restore diseased plantar fascia tissue, thus reducing pain and retuning patient back to pre-injury status. The procedure is quite simple: a small amount of the patient’s blood is drawn and processed, to separate the healing power of platelets from blood plasma. Platelets are rich in growth factor and other bioactive proteins that are essential for healing.
The doctor then takes that concentrated healing components of the patient’s own blood and re-introduces it or “grafts” it into the specific injured site to regenerate tissue and speed the healing process. The grafting is done with precise accuracy under Ultrasound imaging.
When a patient is injured in an acute sports trauma or as the result of the aging process the body will automatically send growth factors and stem cells to the injured site to repair damaged tissue. PRP enhance that process. Research shows a PRP procedure can deliver 500% more growth factor and bio active proteins to the injured area then would occur there naturally.
If the plantar fascia has a tear that has been evidenced on MRI or diagnostic ultrasound, the physician may recommend a stem cell graft to the injured site prior to the PRP injection.
After the procedure, the foot is immobilized for several days and the patient then can slowly resume activities and began a rehabilitative process. It is essential for patients to understand that the Regenerative Medicine process discussed above is a reparative and restorative process that takes 2-3 months to complete. However, in most cases patients do report improvements within several week of the procedure. We encourage our patients to undergo 4-8 weeks of physical therapy and rehabilitation after the stem cell procedure to regain full strength, function and return to an active lifestyle.
If you feel your are a candidate for a Regenerative Medicine procedure or have questions and you live in the tri-state area, we recommend you make an appointment to discuss it with one of doctors. For more information visit us at www.deveperfrehab.wpengine.com or call our Patient Relations Coordinator at 908-756-2424.
About the author
Joseph Mejia D.O., F.A.A.P.M.&R, Is a graduate of University of Michigan and West Virginia School of Osteopathic Medicine. He is Board Certified in Physical Medicine & Rehabilitation and Sports Medicine. Dr. Mejia received his Fellowship Training in Interventional Pain Management from University of Medicine and Dentistry. He has advanced training in Regenerative Medicine and is the Medical Director and Partner of Performance Rehabilitation and Integrated Medicine.