Dealing with Plantar Fasciitis - Research Paper Example

?Running Head: PLANTAR FASCIITIS Dealing with Plantar Fasciitis School Cynthia, a 35-year-old patient suffering from plantar fasciitis was investigated. Factors that led the patient to develop plantar fasciitis including improper footwear, obesity and heel spurs were carefully traced to find out appropriate treatment. Conservative treatment of plantar fasciitis and health promotion strategies are discussed. Dealing with Plantar Fasciitis Many people suffer from body pains caused by overuse of glands and organs. When a part of the body is abused, it will malfunction and hurt. Sometimes, the condition is irreversible, and operation is the only resort to solve the problem. Nevertheless, with prompt medical treatment, proper diet and exercise, the disease could be controlled or even cured in time. This paper discusses nursing practices in dealing with patients with plantar fasciitis, a condition common to people who had history of heavy walking and running. The paper details the complaints of the client, subjective and objective data to be collected, rationale for collecting additional data, and health promotion strategies that a nurse can give to the client. The Patient’s Complaint Waking up with painful heel and finding it difficult to walk and climb down the stairs in the morning have become the usual scenarios in the life of Cynthia. At age 35, Cynthia wondered why she developed arthritis. She thought that the pain in her heel was due to arthritis, given the fact that arthritis is common among her father’s relatives. Her father has been suffering from arthritis for nine years, and he is now 73. Cynthia first felt the pain three years ago when she started working as a freelance writer for several publishing companies. Working at home, she did not go out frequently and only did so when attending meetings, conferences and the like. She submitted write-ups through email, allowing her to stay at home without needing to dress up smartly. That time, Cynthia gained some weight, thus making her quite obese. She did not think of her ailment as permanent; she barely thought that she got the pain from walking as she did her shopping twice monthly. Three years passed and the pain occurred from time to time whenever she went out to do the grocery. Six months ago, she found a new job as a full-time office-based editorial manager. This time around, she has to wear office clothes and use shoes to pair with them. She has been using ballet flats for three months prior to the consultation. Thinking ballet flats look cute and feel comfortable, she bought three pairs of the shoes. Ballet flats are trendy; they are very popular especially among youngsters and are preferred by those who do walking most of the time. These shoes are very colorful and nice to wear because they are usually made of cotton or textile materials so the feet can breath even with long-time wear. The smooth material does not cause blisters unlike leather shoes. Most of all, ballet flats are cheap so one can practically change shoes everyday. Cynthia was attracted to this kind of shoes, not knowing that they could aggravate her condition. When she consulted with an orthopaedist, Cynthia was instructed to undergo x-ray of both feet to find out if bone spurs grew in her heels. The results are positive. Cynthia has inferior calcaneal exostoses or heel spurs on both feet. These results gave the doctor an impression that she has plantar fasciitis. Plantar fasciitis, otherwise known as “policeman’s heel,” is the painful condition of the plantar fascia, the connective tissue found on the soul of the foot, usually at the heel part. According to Roxas (2005), the cause of this pain is multifactorial, including excessive mobility, wearing tough shoes, walking or running on hard surfaces, and being overweight. These characteristics of plantar fasciitis determine the additional data required to be collected. Additional Objective and Subjective Data to be Collected Identifying plantar fasciitis is easy in consideration of the patient’s complaint of pain in the heel when taking her first few steps in the morning. Nevertheless, additional data are required to identify the cause of the condition. By identifying the cause, the problem can be addressed more efficiently. Among objective data tools to verify plantar fasciitis include magnetic resonance imaging (MRI) and blood and urine samples. Subjective data should likewise be collected to identify the causes or factors that trigger the pain such as everyday activities and footwear. Recommendations for lifestyle changes (if ever) will be based on subjective information. Rationale for Objective Data Collection One objective examination that can be done to confirm plantar fasciitis is magnetic resonance imaging (MRI). According to Cole, Seto and Gazewood (2005), MRI can reveal thickening of the plantar fascia. A remarkable increase in plantar fascial thickness can be detected in plantar fasciitis patients (Buchbinder, 2004). Bone scanning may also be helpful to identify between plantar fasciitis and calcaneal stress fractures but it is only secondary to MRI. Cynthia may be recommended to have her blood and urine samples examined in order to make sure that the heel pain is not caused by diabetes. According to the Web site Heal that Pain, a person suffering from diabetes could have heel pain due to nerves that are affected by poor blood circulation. Laboratory examinations such as CBC and urinalysis are needed to rule out diabetes and confirm plantar fasciitis. Rationale for Subjective Data Collection Lifestyle and work-related information are important to determine the cause of plantar fasciitis. It was noted that Cynthia used to be an athlete when she was in college. She used to be in marathon races in school and in her community. When she started working, Cynthia wore high-heeled shoes all the time, making her foot arch more than ever. After eight years of office work, she decided to work from home as a freelance writer. Such events in her life could have contributed to the heel spurs and plantar fasciitis. Cynthia’s plantar fasciitis may have developed during her college years when she ran marathons. Plantar fasciitis is common to runners like her who overuse their feet (Uden, Boesch & Kumar, 2011). Meanwhile, the heel spurs may have occurred when Cynthia rested or worked from home. After having worn high heels for eight years, the arch in her feet became more developed, thus calcium built up in the heels as she remained at home and did not wear her usual high heeled shoes. According to PubMed Health Web site (2013), heel spurs are also common among people with high foot arch, and although heel spurs are not the real cause of plantar fasciitis, they were found to be common among plantar fasciitis patients. The kind of footwear that Cynthia wears also matters a lot in her case. The ballet flats that she has been wearing for three months do not provide adequate support to her plantar fascia, thus worsening the pain caused by her heel spurs. In addition, the ballet flats do not support the high arch of her feet, causing more trauma to her plantar fascia with every step she makes. Further to the above, being overweight may have worsened the patient’s plantar fasciitis. According to Uden, Boesch and Kumar (2011), some studies report the presence of plantar fasciitis among overweight subjects. This information about Cynthia’s weight will help to identify health promotion strategies she needs to take. Health Promotion Strategies To relieve the patient of plantar fasciitis, she should be advised of some health promotion strategies. First, Cynthia needs to lose some weight to lessen the tension on her heels. Second, she has to wear proper support for her feet such as foot orthoses, night splint and heeled shoes. Third, she can use cold packs to lessen the inflammation of her plantar fascia. These strategies can work for Cynthia but her condition could last for nine months to two years. During such time, she should never abuse her feet or wear the same ballet flats she used to. Losing weight The cause of Cynthia’s plantar fasciitis is multi-factorial. Her weight and bone spurs combine to cause trauma or damage to her plantar fascia. If she loses some weight, she can prevent the heel spurs from hitting the plantar fascia as there will be less pressure on the heels. Therefore, she should be advised to watch her diet, eat plenty of fruits and vegetables, drink a lot of water for proper digestion, and avoid fattening foods. Using proper feet support The footwear that Cynthia uses should not aggravate her present condition. In particular, she can use foot orthoses to support the arch on her feet, thus lessen the pressure and inflammation of the plantar fascia. Likewise, she can use night splints while sleeping in order to flex the Achilles tendon and plantar fascia. In a study conducted by Winemiller, Billow, Laskowski, and Harmsen, mechanical treatment such as taping and foot orthoses proved better than anti-inflammatory treatments. Applying cold compress Cold compress could likewise help to lessen the inflammation of her plantar fascia. Applying ice or cold compress on her feet every night will relieve the pain she feels. Cold compress is another conservative treatment to the problem to avoid injectibles or worst, clinical operation. Conclusion The multi-factorial causes of plantar fascia requires different treatments. Although some physicians will recommend injectibles (i.e., steroids) to relieve the pain immediately, conservative treatment must be taken into consideration to avoid side effects that can be encountered when using injectibles. Above using treatments, Cynthia should avoid things that could worsen her condition such as too much walking/running and wearing wrong footwear. Diet and light exercise to flex the muscles on her feet and legs will definitely help to improve her condition. References Buchbinder, R. (2004). Plantar fasciitis. The New England Journal of Medicine.350:2159-2166. Cole, C., Seto, C. & Gazewood, J. (2005). Evidence-based review of diagnosis and therapy. American Family Physician, (72)11: 2237-2242. Diabetes and diabetic foot problem. (2013). Retrieved January 1, 2014, from http://www.heel-that-pain.com/diabetes_foot/ Plantar fasciitis. (2012). Retrieved December 30, 2013, from PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004438/ Roxas, M. (2005). Plantar fasciitis: diagnosis and therapeutic considerations. Alternative Medicine Review. 10 (2), 83-93. Uden, H., Boesch, E. & Kumar, S. (2011). Plantar fasciitis: to jab or to support? A systematic review of the current best evidence. Journal of Multidisciplinary Healthcare, 4:155-164. Read More