Plantar fasciitis is one of the most common causes of heel pain. Overall prevalence of diagnosed plantar fasciitis with pain in the U.S. was 0.85 percent in 2017. This problem happens to people aged 45-64 more than other age group, and women more than men.
The plantar fascia shown in the picture below is a band of tissue (fascia) that connects the heel bone to the base of the toes. It supports the arch of the foot and absorbs shock when walking.
Plantar fasciitis involves inflammation plantar fascia. Its symptom is stabbing pain that usually occurs with the first steps in the morning. As patients get up and move, the pain normally decreases, but it might return after long periods of standing or when they stand up after sitting.
It is more common in runners and in people who are overweight. Ignoring plantar fasciitis can result in chronic heel pain that makes regular activities difficult. The patients are likely to change their walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems.
In Chinese Medicine, it is the Kidney meridian that covers the bottom of the feet and heel. Its pathway is blue and shown in the picture below . According to Huangdi’s Internal Classic, the most important Chinese Medical literature, the details are as followed: The Kidney meridian starts from the inferior aspect of the small toe and runs obliquely towards the sole. Emerging from the lower aspect of the prominence of the navicular bone, a wedge-shaped bone, located in the medial side of the midfoot, and running behind the medial malleolus located on the inside the ankle, it enters the heel. Then it ascends along the medial side of the leg to the medial side of the popliteal fossa, a diamond-shaped region directly posterior to the knee, and goes further upwards along the postero-medial aspect of the thigh towards the vertebral column, where it enters the Kidney, its pertaining organ, and connects with the Bladder. Let’s stop here. The more details of the pathway will be introduced in another blog.
From Chinese Medical perspective, this problem is caused by the weak Kidney organ or Qi stagnation in the Kidney meridian or both, and the nourishment cannot reach to the heel and the damage cannot be repaired. The purpose of the treatment is to strengthen the Kidney and circulate Qi and Blood.
Matthew, 47 years old male, came to see to me due to the pain in his left heel (the bottom). The pain had been bothering him constantly for over a year. The pain was four on the scale of one to ten and could be worse if he used his feet more. He was a soccer player and had been coaching his boys. He had to do less due to the pain and to use the right foot more to compensate his left. His symptoms met the diagnostic criteria of the plantar fasciitis.
Acupuncture was administered and the heat was applied. He could only come once a week. Even after the first session, he felt 60% better. After the eighth session, he did not experience the pain in his left heel anymore but he could tell the left heel was different from his right one if pressing them very hard. As the progress was made, he was able and started to do more activities such as coaching or playing the soccer. This resulted in the pain in the inner, the lateral or top of the left foot or left ankle. The treatment plan was tailored according to the affected area(s). After the twentieth session, he played an eighty minutes long soccer game without any problem. After that, he only felt the stiffness in the bottom of the left foot. After the twenty first session, he could not tell any discomfort in his left foot but only a little stiff in the left ankle (the front part). After the twenty second session, he had no discomfort in his left foot and ankle. Totally he had twenty-three sessions.
The short term and long term efficacy of acupuncture on plantar fasciitis was confirmed through the clinical trials. A review, with the title of How Effective Is Acupuncture for Reducing Pain Due to Plantar Fasciitis, published at the journal of Singapore Medical Journal (2017:58(2):92-97), made a conclusion that acupuncture may be a safe and effective treatment modality for the short-term management of plantar fasciitis. Four studies included in this review had shown a significant reduction in pain during 4–8 weeks of therapy compared to standard therapy (stretching, ice therapy, NSAIDs or oral analgesics) or sham acupuncture (the needling in the acupuncture points not for Plantar Fasciitis).
The research of Acupuncture Treatment for Plantar Fasciitis: A Randomized Controlled Trial with Six Months Follow-Up was published at the journal of Evidence-Based Complementary and Alternative Medicine Volume 2011. The results showed that there were significant differences in reduction in pain scores, favoring the treatment group and that no serious adverse event was observed.
Another article with the title of Acupuncture Planta Fasciitis Confirmed published by HealthCIi in November 2017 reiterated that acupuncture has a proven and lengthy track record for producing significant positive patient outcome rates for patients with plantar fasciitis. Besides, access to acupuncture, moxibustion, and TCM herbal foot baths is an adequate solution for the vast majority of patients.
How can this problem be prevented? There are some recommendations: maintaining a healthy weight, choosing supportive shoes, not wearing worn-out athletic shoes, trying swimming or bicycling instead of walking or jogging and stretching the plantar fascia, Achilles tendon and calf muscles.