Spine & Extremities Center in Clarion is combining Osteopathic Manipulative Therapy with Shockwave and Class IV Medical Laser to treat plantar fasciitis.
Plantar fasciitis is primarily due to inflammation of the insertion of the plantar fascia; however, other structures are often also involved with this disorder. It is important to treat these other areas to help achieve a more complete healing response in an attempt to limit or prevent recurrences.
The plantar fascia is a thick band of fibrous tissue that runs along the bottom of your foot. With repetitive stress the insertion can become inflamed. In moderate to severe cases the fibers can tear and the underlying bone can become edematous. A bony spur may or may not be present, and is the result of years of chronic inflammation as the body tries to heal the tissue by calcifying it and immobilizing the damaged area.
Along the medial (inner) aspect of the foot are an important artery and nerve that supply the area of the plantar fascia. These important structures lie along a muscle on the edge of the foot that flexes your great toe, called the abductor hallucis. Part of our treatment involves assessing and treating this area and muscle with OMT and our modalities to make sure this muscle and soft tissue are healthy and that the nerve and blood supply to the plantar fascia are optimized. We use manipulation to mobilize and increase range of motion in the mid/hind foot joints to reduce abnormal strain patterns.
Chronic planar fasciitis causes 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 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 area and disseminate the medicine to all of the inflamed tissue. 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. This is known as Extracorporeal Pulse Activation Therapy (EPAT). The result is to break up the chronic hypersensitive, friable scar tissue which surround 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 therapeutic 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. During the first visit one of our doctors will assess and treat the ankle and foot for dysfunctions associated with plantar fasciitis and treat with manipulation as needed.
We 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, 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 stimulating 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 8 weeks and include six sessions. You will likely experience a significant improvement during this time. The healing will continue for several months after you begin your 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 with Dr. Barrett if they want the assessment covered by insurance, or Dr. Peters if they prefer self-pay.
The six session Shockwave and laser therapy components of the program are self-pay only and cost $595.
Forms of accepted payment include cash, check, credit card, and Care Credit. View Care Credit here: https://www.carecredit.com/apply/.
To book an appointment, call or text 814-227-5855 or download their app here:
Apple App Store: https://apps.apple.com/us/app/spine-extremities-center/id1590117359?ign-itsct=apps_box_link&ign-itscg=30200
Google Play Store: https://play.google.com/store/apps/details?id=com.fitnessmobileapps.spineandextremetiescenter&hl=en
Spine & Extremities Center is locate at 457 South 5th Ave, Clarion, PA 16214.
More information can be found on their website at www.spineandextremitiescenter.com.
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