Patients coming into our clinic limping with heel pain mostly commonly have plantar fasciitis. In most of these cases, the heel pain will reduce effectively with our plantar fasciitis treatment plan. However, there will be some cases where the pain does not resolve. This may be due to a condition mimicking or related to plantar fasciitis, such as plantar nerve neuritis.
The term neuritis in general is an inflammation of the peripheral nerves, affecting a single nerve or a group of nerves. Plantar nerve neuritis is an inflammation of the nerve in the foot, and is found to be very common that can cause pain and loss of function. The innervations in the foot are branches from posterior tibialis nerves, namely the medial and lateral plantar nerve that covers the sole of the foot and supplies multiple intrinsic muscles of the foot.
Plantar nerve neuritis can be debilitating affecting daily activities. Pain can be gradually increasing overtime. The irritation or entrapment of the nerves can results in constant pain that radiate to the lower part of the heel and ankle. This symptom worsens with forceful or continuous activity, where adding pressure to the foot either by walking or sitting, just standing is often difficult. If it is left untreated, the continuous irritation will make the nerve inflamed resulting to symptoms such as numbness, tingling or buzzing sensation, pins and needles, burning and cramping.
The most common cause of plantar nerve neuritis is a repetitive irritation or impingement of the nerves from abnormal movement (the musculoskeletal) around the ankle area. Although, the nerves can also easily be damaged when any other part of the foot suffers an injury or trauma. In some cases, where there is a microtear in the plantar fascia, the inflamed and thickened fascia can impinged the nerve running underneath the plantar fascia.
The podiatrist will devise a treatment plan that has two goals –
Depending on our podiatrist’s assessment of the condition and cause, reducing pain and symptoms can be accomplished through a combination of pulsed electromagnetic field therapy (SIS) and shockwave therapy. Reducing the repetitive movement around the ankle area can be accomplished through a customised orthotic device tailored to the patients’ full musculoskeletal assessment.
Consulting a podiatrist is important for an individual with heel pain as heel pain may be more than plantar fasciitis. With cutting edge technologies, it is possible to get our patients back on their feet faster than the body’s natural healing process.