Prolotherapy can heal foot pain

Prolotherapy can heal foot pain

Under normal circumstances, the plantar fascia acts like a shock-absorbing bowstring, supporting the arch in the foot. If tension on that bowstring becomes too great, it can create small tears in the fascia with collagen breakdown and scarring.

by Dr. Fred G. Arnold — 

If you have ever had pain in the heel and bottom of your foot, you likely are already aware of a condition called plantar fasciitis, which is one of the most common causes of this pain. Plantar refers to the bottom of the foot; fasciitis refers to a band of connective tissue on the bottom of the foot called the fascia. The condition is also known as plantar fasciosis or jogger’s heel.

Typically there is a stabbing pain in the bottom of the foot near the heel and stiffness in the bottom of the heel, with dull or sharp pain. The heel may also ache or burn. The pain is usually worse with the first few steps in the morning or triggered by long periods of standing or getting up from a chair. Climbing stairs and intense activity can aggravate the condition. The onset of the pain may develop slowly over time or come on suddenly after intense activity.

Under normal circumstances, the plantar fascia acts like a shock-absorbing bowstring, supporting the arch in the foot. If tension on that bowstring becomes too great, it can create small tears in the fascia with collagen breakdown and scarring. Because inflammation only plays a minor role in the condition, some believe the condition should be called plantar fasciosis, rather than plantar fasciitis. Plantar fasciosis refers to the tears in the connective tissue; whereas, plantar fasciitis refers to inflammation of the connective tissue.

Predisposing factors 

Predisposing factors may increase the risk of developing tears in the plantar fasciitis.

• Age — It is most common between the ages of 40 and 60.

• Exercise — Certain activities can place undue stress on the heel and connective tissue, such as long-distance running, ballet dancing and dance aerobics.

• Overweight — Excess pounds put more stress on the bottom of the foot and heel.

• Foot biomechanics — Being flat-footed, having a high arch or foot flare and excessive pronation will affect how one’s body weight is distributed to the bottom of the foot.

• Occupation — People who spend most of their work time walking or standing on hard surfaces can damage the fascia.

Examination 

To determine if you have plantar fasciitis, a physical examination should be performed. You may be asked to stand and walk, and the doctor will examine your foot, pressing where it hurts. The nature of your symptoms, such as the location of pain and what makes it better or worse is important to know. An ultrasound evaluation or X-ray of the foot may be ordered to rule out a stress fracture or some other active disease process.

It is important that the doctor examines the whole foot, as the pain may also be found in other areas of it, not just on the bottom. It is rare to find pain only on the bottom of the foot.

Conventional treatment

The conventional or traditional approach to treating this painful condition involves pain medication, such as acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) to reduce pain and inflammation. Heel and foot stretching exercises and a night splint to wear while sleeping to stretch the foot may be recommended. Patients are usually advised to rest the foot as much as possible for at least a week.

If these treatments do not work, the foot may be put in a boot cast for three to six weeks. Steroid shots or injections into the heel are given, with foot surgery recommended if the pain persists.

Prolotherapy 

Although patients may experience some degree of pain relief with the above conventional treatments, none of them addresses the cause of the problem — micro tears in the connective tissue with collagen breakdown. Anti-inflammatory drugs like Advil and Motrin prevent the body from trying to heal injured tissue, and steroid injections break down the weakened connective tissue and can worsen the condition.

Prolotherapy is a proven nonsurgical treatment that stimulates the body’s natural healing response to heal and strengthen the damaged connective tissue. Tissue growth and repair with prolotherapy injections can be documented with ultrasound and confirmed with magnetic resonance imaging (MRI). In a study by the American Journal of Roentgenology, prolotherapy (dextrose) injections “showed a good clinical response in patients with chronic plantar fasciitis …”

In addition to prolotherapy injections, it is important to address any predisposing factors to speed up the recovery and prevent a recurrence of the condition.

Conclusion 

Plantar fasciitis is a very common condition that affects many people who spend a lot of time on their feet and are active in work or sports. Many conventional treatments exist to address this painful condition; however, none of them addresses the cause of the pain. Micro tears are produced in the connective tissue by a variety of predisposing factors that are the causes of the pain and inflammation in the foot.

Prolotherapy is a proven and extremely effective way to treat plantar fasciitis and should be considered for this painful condition, especially if the doctor wants to inject the foot with a steroid, which can weaken the fascia and make the problem worse. Because prolotherapy works so well for this condition, surgery should only be considered as a last resort.

References

1. Fullerton, B.D., High-resolution ultrasound and magnetic resonance imaging to document tissue repair after prolotherapy: a report of three cases. Arch. Phys. Med. Rehabil. 2008;Feb;89(2):377-85.

2. Ryan, M.B., Wong, A.D., et.al. Sonographically guided intratendinous injections for the treatment of chronic plantar fasciitis of hyperosmolar dextrose/lidocaine: a pilot study. Br. J. Sports Med. 2009;43;303-306.

Fred G. Arnold, N.M.D., has more than 20 years of clinical experience and specializes in pain rehabilitation services. He is certified in prolotherapy by the American Association of Orthopedic Medicine, a Fellow in Anti-Aging & Regenerative Medicine, a Fellow of American Academy of Ozonotherapy and certified in chelation. He is one of the few physicians in the nation with both a naturopathic medical degree and chiropractic degree. prolotherapyphoenix.com or 602-292-2978. 

Reprinted from AzNetNews, Volume 34, Number 5, October/November 2015.