Thursday, September 24, 2009

Plantar fasciitis or not?

I recently had a patient that I was evaluating and treating for a completely unrelated problem, a two year history of plantar fasciitis. I spent most of my time assessing her current complaint but continued to question her about how her diagnosis of plantar fasciitis was made and what had been done over the past two years. The amount of treatment and assessment was rather extensive without there being any change in her symptoms. Typically, the primary complain of this condition is difficulty walking when getting up out of bed or after prolonged sitting. The patient described hobbling around for 10-20 minutes until the pain subsided and this occurs on an everyday basis.

I simply explained that it may not even be plantar fasciitis but perhaps an internal derangement in the ankle/foot complex. The patient had excellent concurrent signs. Every day when they wake up, they have “searing pain” for 15-20 minutes. They were given one corrective exercise that is common for derangement in the ankle/foot complex and was to perform this exercise 10 times every hour. Upon return, the patient quite happily responded that today was the first time that they had gotten out of bed and walked without any pain in their foot in two years.

The patient has continued with the one corrective exercise and is able to function without pain or limitations. The moral of the story is that diagnosis labels can often be misleading. We basically need to prove that derangements do not occur before accepting some of these clinical diagnoses.

So, plantar fasciitis or not? I think not.

1 comment:

  1. Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position. At Medicovi you can find solution of the problem.