What is the role of PRP injections, prolotherapy, botulinum injection and surgery to treat this not so well known condition???
Plantar fascitis is very likely associated with a chronic magnesium deficiency, which (often combined with a vitamin D deficiency) compromises the ability of the body to properly utilize serum calcium, resulting in issues (among many others) such as kidney stones, bursitis, and plantar fascitis.
It is my opinion that steroid injections help to relieve pain by expressing vitamin D receptors and thereby exploiting the ability of the active form of vitamin D (1α,25[OH]2D3) to suppress mast cell propagation and degranulation. Corticosteroids have been shown to have a synergistic effect with vitamin D. Hidalgo, Deeb, Pike, Johnson, and Trump, (2011) showed that glucocorticoids increase the expression of vitamin D receptors, thereby increasing the effectiveness of vitamin D.1 We also know that research results published by Yip et al. (2014) show that both the inactive and the active forms of vitamin D3 are capable of suppressing mast cell degranulation (that would otherwise result in the release of proinflammatory mediators).2
This observation is supported by the well known fact that corticosteroids deplete vitamin D reserves in the body. If my theory is correct, then corticosteroids should be less effective in patients who have a severe vitamin D deficiency.
1. Hidalgo, A. A., Deeb, K. K., Pike, J. W., Johnson, C. S., & Trump, D. L. (2011). Dexamethasone enhances 1α,25-dihydroxyvitamin D3 effects by increasing vitamin D receptor transcription. The Journal of Biological Chemistry, 286, 36,228–36,237. doi:10.1074/jbc.M111.244061
2. Yip, K. H., Kolesnikoff, N., Yu, C., Hauschild, N., Taing, H., Biggs L., . . . Grimbaldeston, M. A. (2014). Mechanisms of vitamin D₃ metabolite repression of IgE-dependent mast cell activation. The Journal of Allergy and Clinical Immunology, 133(5), 1,356–1,364. doi:10.1016/j.jaci.2013.11.030
Dear Mr. Vaishya,
Plantar fascitis is thickening of the plantar fascia, a band of tissue running underneath the sole of the foot. The thickening can be due to recent damage or injury, or can be because of an accumulation of smaller injuries over the years. Moreover, plantar fasciitis can be painful. In addition, we can consider that a number of factors can contribute to plantar fasciitis. While men can get plantar fasciitis, it is more common in women. You're also more likely to have this condition as you age or if you: Are overweight; Take up a new form of exercise or suddenly increase the intensity of your exercise; Are on your feet for several hours each day; Have other medical conditions such as rheumatoid arthritis or lupus (systemic lupus erythematosus); Tend to wear high-heeled shoes, and then switch abruptly to flat shoes; Wear shoes that are worn out with weak arch supports and thin soles; Have flat feet or an unusually high arch.
Have legs of uneven lengths or an abnormal walk or foot position; Have tight achilles tendons, or ‘ heel cords’. The symptoms of plantar fasciitis include: Pain in the bottom of your foot, especially at the front or centre of the heel bone; Pain that is worse when first rising in the morning (called "first-step pain"), when first standing up after any long period of sitting, or after increased levels of activity especially in non-supportive shoes.
Steroid injections do not cure plantar fasciitis, but they can relieve pain for three to six months. It is important to note that these treatment modalities are to be used in combination, as components of a multimodal therapeutic approach. If pain persists, referral to a foot and ankle specialist should be considered. Injection therapy, immobilization in a cast or walker boot, physical therapy, and custom orthotics can be employed under more controlled supervision. For severe recalcitrant cases, surgical intervention may ultimately be required.
I hope this helps.
https://www.painscience.com/tutorials/plantar-fasciitis.php
in a rheumatology setting, we get plantar fascitis which are related to spondyloarthritis which is a common diagnosis in our clinic. the other cause is mechanical. we distinguish them by asking whether pain increases after activity or after rest. the inflammatory type increases after rest and decreases after activity like walkin;hence more in morning and less i day. among the mechanical causes, faulty footwear in a frequent cause in our setting.
Vitamin Deficiency
Vitamin D3 is not a vitamin at all, it is actually a POWERFUL seco-steroid hormone that is involved in bone and joint and tissue remodeling, as well as immune system modulation. It alters the expression of 2,000+ of your genes. If you are low in Vitamin D3, your immune system will be out of focus and may accidentally attack good tissues (autoimmune disease) or ignore bad actors or defective cells (infections from bacteria, fungi or viruses, and cancer cells). Now you might not know this but when tissues need to be repaired in your body, quite often there is a lot of destruction and then rebuilding going on. And the repair mechanisms in your body borrow many of the components of your immune system to tear down tissue that needs to be remodeled (macrophages for example). Having low levels of Vitamin D3 can lead to an impaired healing process in addition to immune system problems. This impaired healing process is what causes plantar fasciitis to become a chronic ailment that can last for many years , even decades. There are various self reports of people who have cured their plantar fasciitis simply, quickly, and for a cost of next to nothing by simply boosting their Vitamin D3 levels including myself.
To make the heel spurs disappear
First Set of Required Nutrients:
- Vitamin A: Non-Synthetic/Not plant based. Cod liver oil is best option.
- Vitamin D: Sunshine exposure ideal. If that is not available, Cod Liver Oil is needed every day.
- Vitamin K2 (MK7): Required for vitamin A and D to function properly.
- Boron: Mineral that regulates calcium transport on cell membranes. Required for strong bones.
- Second Set of Required Nutrients:
- Calcium: Eat Chard/Kale/Dark leafy greens/sardines/anchovies. If you do not eat these, you need to supplement calcium with a raw, whole food based source of calcium.
- Magnesium: Required for strong bones. Most important mineral for bones beside calcium.
- Trace Minerals Concentrate: Bones require various minerals. Bestway to have these minerals is with trace mineral concentrates. These trace minerals would be available in your food, but factory farming on depleted soil make trace minerals nearly impossible to obtain from food. Trace mineral research has the best source.
Other deficient nutrients that adding will help foot pain:
Vitamin B-1 Deficiency
Scientists discovered vitamin B-1, or thiamine, first. Along with the other B vitamins, it's water-soluble, meaning it isn't stored by your body and is excreted with your urine. You need vitamin B-1 to help digest carbohydrates, use fats and proteins, manufacture red blood cells and assist the proper functioning of your immune and nervous systems. Alcoholics and the elderly are prone to deficiency of vitamin B-1, resulting in beriberi, a disease causing weakness, fatigue, an enlarged heart and confusion. It also causes edema, burning, tingling and stabbing pain in your feet and lower legs.
Vitamin B-12 Deficiency
Vitamin B-12 has the most complex chemical structure of all the B vitamins and the only one that contains the metal cobalt, according to Oregon State University. Vitamin B-12 is an integral part of DNA and enzyme synthesis, nervous system functions and red blood cell production. Unlike the other B vitamins, vitamin B-12 is stored in your liver. Deficiency of vitamin B-12 is prevalent in the Vegetarians and elderly and sometimes results in a condition called pernicious anemia. The symptoms of a vitamin B-12 deficiency include poor appetite, sore tongue, memory loss and dementia, along with difficulty walking and painful tingling sensations and numbness in your feet.
Deficiency of Biotin
Although it's classified in the B vitamin family, AltMD states biotin is actually a coenzyme that works along with the B vitamins. You get biotin through your diet. You need biotin for the synthesis of fatty acids, to build protein from amino acids and obtain energy from the breakdown of carbohydrates. It also helps maintain the health of your nerves, skin, hair and nails. Biotin deficiency causes fatigue, grayish skin color, skin rashes and problems with digestion. It also causes your skin to become painfully sensitive to touch with tingling in your feet and hands.
The deposition of ectopic fat in the plantar fascia over time is most likely the cause of plantar fasciitis. So lifestyle change may help to get rid of heel pain.
Eat moderately in the day, and stop eating 5 hours before going to bed, and then sleep for 7 to 8 hours. In this way, by fasting for around 12 to 13 hours, our body will be forced to use the ectopic fat as energy source. Over a long period like half or one year the plantar fascia will be very clean without any ectopic fat. And then the heel pain will be greatly relieved.
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