Plantar fasciitis is a severe inflammation of the insertion of the plantar fascia.

Patients who suffer from this know the pain and limitations it imposes in their lives. It is one of the easiest diagnoses for a doctor to make but is difficult to treat and very often recurs.

The plantar fascia is a thick band of fibrous tissue that runs along the bottom of your foot. The plantar fascia is a thick band of fibrous tissue that runs along the bottom of your foot. An MRI shows it as a tight black band insertion into the heel.

With repetitive stress, the insertion can become inflamed. In moderate to severe cases the fibers can tear and the underlying bone can become edematous. An MRI taken at this stage shows the inflammation as white/brighter signal on MRI, and the normal black healthy fibrous band becomes thickened and abnormally gray from scarring and inflammatory tissue.

A bony spur is the result of years of chronic inflammation as the body tries to heal the tissue by calcifying it and immobilizing the damaged area. The spur, however, is not the cause of the pain and disability. The inflammation is.

Over time the inflammation can weaken the surrounding fascia and make the problem worse. This inflammatory tissue can cause scar tissue to form. This tissue can be hypersensitive due to the abnormal nerve tissue formed within scar tissue, as well as the chemicals contained within inflammatory cells which increase the perception of pain by your pain receptor nerve fibers.

Traditional steroid injections can decrease inflammation temporarily but do not provide any stimulus for new, healthy tissue to form within the plantar fascia insertion. It is also very difficult to blindly inject a steroid into the plantar fascia and disseminate the medicine to all of the inflamed area. The steroid also does not help modulate the pain and does nothing to physically break up the scar tissue and adhesions. Chronic anti-inflammatory therapy also can weaken tissue over time. Because steroids do not promote healing, the plantar fascia remains weak and, in some cases, partially torn. Recurrences are therefore common.

Our Shockwave device uses acoustic pulse waves directed at the inflamed tissue. The result is to break up the chronic hypersensitive, friable scar tissue which surrounds the plantar fascia insertion. The body can then resorb that dysfunctional tissue. The pulsed energy also stimulates and invigorates the formation of healthy collagen to regenerate the plantar fascia insertion into a healthy, organized structure able to absorb the wear and tear of daily life.

The Shockwave treatment effect is to cause microtrauma to stimulate this healing process. The scar tissue breaks up, the inflammation is mechanically dissolved allowing the body to resorb it. The collagen fibers are stimulated to heal and regenerate the tissue. During treatment, you will feel a dull, deep ache and the settings of the Shockwave machine will be adjusted to your tolerance.

We prefer to use the medical laser in combination to attenuate or decrease the inflammatory component of the plantar fasciitis itself as well as the microtrauma from the Shockwave treatment by targeting and inhibiting the cells responsible for an exaggerated inflammatory response. The laser also adds energy into the tissue at the 810-nanometer wavelength which acts to increase the intracellular production of ATP. ATP is the energy currency of tissue. This accelerates healing.

The laser we use has multiple wavelengths. Different settings are used during your treatment program to help increase oxygen delivery to the healing tissue, as well as stimulate the growth of new microscopic blood vessels called capillaries into the tissue. These capillaries will help keep the area of the plantar fascia healthy and strong by delivering fresh blood and removing toxins from this area. The medical laser application is painless, and typically patients only feel a very soothing, relaxing heat in the area as the laser infuses healing energy into the tissue.

The treatment takes about five to six weeks.

You will likely experience a significant improvement during this time. The healing will continue, however, for several months after your last treatment as your body heals this area and regenerates the plantar fascia into the strong, durable tensile band it was designed to be.

Our treatment program can be used as a first-line treatment but often patients have been through traditional physical therapy or have had one or more steroid injections prior to seeking this newer technology and have had either no relief or only temporary relief.

Patients seeking an evaluation for plantar fasciitis can schedule a “new patient visit” which will include the first medical laser application. If the patient feels this service would be of benefit, they can schedule the “Shockwave + laser” package under our services. The new patient visit is $75.00 and would include osteopathic or chiropractic spinal manipulation if you desire. The spinal manipulation is not required for our plantar fasciitis program but is included in the price for our new patient visit, so it will be at your discretion.

If you have already been diagnosed by your primary care provider and have researched these treatments, you can call us, and we can coordinate starting your Shockwave Therapy package on your first new patient visit for your convenience and to speed you along your way to recovery.

To make an appointment, call or text 814-227-5855.

Spine and Extremities Center is located at 457 South 5th Avenue, Clarion, Pennsylvania 16214.