Plantar fasciosis is essentially a term used to describe chronic plantar fasciitis. Plantar fasciitis is the tearing and resultant inflammation of the plantar fascia, the most common cause of heel pain. “Itis” means inflammation and many studies have shown that after the first few weeks following injury and development of plantar fasciitis, the inflammation decreases. After a few months, the blood flow which was increasing the inflammation initially, has disappeared and the fascial band starts to thicken. The blood supply and initial inflammation are important in the healing of any injury. The blood supply brings needed nutrients and cells which clean up an injury site and stimulate healing. Normally this phase should last only a few weeks.
Eventually, the blood supply gradually starts to disappear. The plantar fascia changes from a normal ligament type tissue into disorganized strands of connective tissue. Without an adequate blood supply, the injured site is without needed nutrients for healing, including oxygen and growth factors. The tissues can then start to degenerate (deteriorate). The exact point of this transition is unique to each individual and still up for some debate.
The change of the name from fasciitis to fasciosis is important in that much of our treatment efforts in the past have focused on decreasing inflammation. Although decreasing inflammation is important in the first few weeks to few months of the development of heel pain, treatment of chronic plantar fasciitis (plantar fasciosis) should not focus on anti-inflammatory measures.
Coblation Therapy is a bipolar radiofrequency-based technology that uses low temperatures to stimulate the release of hydrogen, oxygen and growth factors from tissues and stimulate the formation of new blood vessels within the tissue. The idea is to jump start the body’s own healing response. Coblation therapy has recently emerged onto the scene for treating plantar fasciosis. Coblation is a surgical procedure and involves anesthesia and a small incision at the heel.
The results from Coblation Therapy are promising with patients back into regular shoe gear within 2 weeks and a low risk of complications. There have been reports of infections and small wound dehiscences, but this is expected with any surgical procedure.
More on plantar fasciitis/fasciosis .
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