Ayurvedic Management for Plantar Fasciitis
By Sajimon George BAMS. AAA. ATMS
Plantar fasciitis is a common condition of pain on the heel or under the feet. This condition is common in people of age 40 – 60 years. Prevalence is more in male. Around 10% of the people might have experienced this pain at least once in their lifetime. In this condition, inflammatory changes happen at the site of insertion of plantar ligament on calcaneal bone leading to scarring and finally leading to degenerative changes of plantar fascia. Main complaint of the patient is heel pain that will be worse during first few steps after getting up in the morning or after long rest. After walking a few steps, pain start to subside. Obesity, aging, sedentary lifestyle, excess physical activity and unsuitable foot wear are known causes. Flat foot and abnormally increased arch of the foot also increase chance of plantar fasciitis. In flat foot, while walking or running there is an increased inward movement of the sole which exert additional pressure on the planar fascia. Plantar fascia is a ligament connecting antero medial aspect of calcaneum or heel to the base of the toes supporting the arch of the foot like a bow string. In high arch condition of the foot, pressure exerted on the bow string or plantar fascia is increased many fold resulting to development of fasciitis. Above causes, put excess pressure on calcaneal tuberosity. Modern science considers this as a non inflammatory structural change. Imaging techniques are useful to rule out calcaneal spur or stress fracture.
- Pain in the heel and under surface of the feet.
Achilles tendon stiffness, calf muscle tightness, restriction in dorsiflexion or upward movement of foot are also felt by the patient with plantar fascitis.
Plantar fasciitis is related to Vathakandaka mentioned in Classical texts. This is the pain felt in the foot caused by walking along uneven surface.
This is not a systemic disease but a localized disease. Nidana parivarjana or avoiding causative factors is the beginning of the disease. This includes weight reduction and walking along uneven surface.
Treatment procedures depend on the stage of the disease.
When presented with edema, pain and redness , dhara (pouring of herbal decoction), lepa (application of herbal paste) are done in addition to oral medication.
Pouring of suitable herbal decoction (Kashaya) / medicated milk / medicated oil to the heel is very useful.
Suitable herbal paste is applied to the heel till it gets dry itself. When dry it is removed using lukewarm water.This process is repeated many times a day.
- Raktha moksha
When there is severe pain and edema, rakthamoksha or bloodletting gives sudden relief.
- Daha karma
When the condition is not responding to other treatment procedures, then dahakarma (Cauterization) is employed.
- Herbal decoctions such as Amruthotharam Ks, Rasnasaptaka Ks, Maharasnadi Ks, Gugguluthikthaka Ks
- Guggulu preparations like Kaishoraguggulu, Yogarajaguggulu and Kanchanara guggulu
- Medicated ghee like gugguluthikthaka ghrita are useful here.
Very aggressive treatment procedures may cause shrinkage of plantar fat pad which give cushion function
Yoga and Exercise
- Yoga postures providing stretching to lower extremities relieve pain and prevent further episode of plantar fasciitis.
- Stretching and massage of calf muscles, Achilles tendon, plantar fascia with suitable medicated oil give better results.
- Reduce physical activities resulting strain to foot.
- Proper foot wear
- Keep body weight under control
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