Platelet Rich Plasma injections has come to the forefront as a successful treatment for several conditions. Among them include tendonitis, inflammatory joint conditions, and plantar fasciitis.

Plantar fasciitis is a very common and painful foot disorder. The true etiology of plantar fasciitis is unknown and has been attributed to many factors. The plantar fascia is a fibrous, thick band of tissue on the bottom of the foot originating behind the toes and extending across the bottom of the heel and joins the attachment of the Achilles tendon.

The classic symptom of plantar fasciitis is pain when first stepping down with the foot. The discomfort eases after walking for a short time, but returns after getting up from a sitting position. The pain may also occur again after standing or walking for prolonged periods of time.

Treatment modalities include cortisone injections, oral anti-inflammatory medication, stretching exercises, physical therapy, arch supports or custom orthotics, shock wave therapy, and surgical intervention.

A new treatment that has evolved is platelet rich plasma (PRP) injection. The purpose of this treatment is aimed at taking the platelet component of blood that contains growth factors and healing factors, to initiate repair and healing.

The process involves drawing a sample of your own blood and separating the platelet component. The concentrated platelets are then injected into and around the area of discomfort or injury. This seems to help promote healing and strengthen the body’s natural healing process. Because your own blood is used, there is no risk of transmissible infection. Most people return to their jobs and activities right after the procedure.

Up to three injections may be given over a six week period, usually at three week intervals. However, considerable relief may be attained after one or two injections. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses.

Because there is not yet enough clinical data available, the majority of insurance companies do not reimburse for this procedure. The usual cost per injection is approximately $200 to $300.

Platelet rich plasma injections certainly should be a consideration of treatment in intractable, inflammatory pain prior to surgical intervention.

To learn more about this procedure or to find out if you are a good candidate, contact us at (716) 839-3930 or e-mail us at questions@podiatryaffiliates.com.

Plantar fasciitis, a very common problem seen in podiatry offices, does not always respond to typical treatment modalities. The most common cause of not responding to standard therapy is small, traumatic tears of the fascia, rather than the usual inflammation we see due to inflexibility.

Typically, treatments include 3-6 months of standard therapy. This may incorporate proper stretching techniques for the plantar fascia and calf muscles, night splints to passively stretch the fascia while you sleep, heel raises, avoiding going barefoot, using a higher heel shoe or a clog-type shoe. In addition, icing, using a roller massage of the fascia (including a commercially available roller device or a frozen water bottle) is often used.

Other treatment options may involve custom orthotics with a heel cup, cortisone injections of the fascia or the bursa that can accompany the fasciitis or a new therapy called “platelet rich plasma injection “(discussed in a previous article);

If tears of the fascia are suspected, soft tissue imaging is often required for confirmation. We use diagnostic ultrasound and/or MRI to evaluate for these small tears. The therapy then changes from icing and stretching to rest and positional change with orthotics. Cam Walkers (boot-type devices to remove strain from the fascia) or below knee casting are often utilized. In addition, the use of oral steroids for brief periods may be helpful.

To complicate matters further, the diagnosis may be plantar fasciosis not fasciitis. This chronic, degenerative process requires different therapies.

In summary, plantar fasciitis is not always easily diagnosed. If typical, conservative treatment does not seem to resolve your symptoms, ask about further testing.

For further information or to see an experienced doctor of podiatrist medicine, please contact Podiatry Affiliates today at (716) 839-3930 or visit our web site at www.podiatryaffiliates.com.