Plantar Fasciitis

Of the many causes of foot pain, the clinical syndrome known as Plantar Fasciitis is one of the most challenging.

The plantar fascia is a tough band of tissue that stretches from the forefoot to the heel, and is responsible for maintenance of arch integrity.

Plantar fascia

Due to persistent mechanical stress resulting from prolonged walking, standing and stretching, the plantar fascia withstands remarkable mechanical challenges during routine activity.  As a result of microtrauma subsequent to jumping, jogging, and running, the plantar fascia can develop small areas where it is torn from the attachment on the heel.
Plantar fasciitis

The pain of plantar fasciitis is usually stabbing or burning pain in nature,  usually worse
in the morning.  The pain seems to be worse when your feet hit the floor after sleep, and the pain eases with motion and mobility. The pain will come and go, worse with certain types of shoes and with pressure on localized areas.

Kink ease plantar fasciitis

Conservative treatment of plantar fasciitis include:

Oral anti-inflammatory medicines. Prescription NSAID combined with oral MSM

  1. Pads, splints and orthotics.
  2. Topical analgesics, including capsaicin, aspercream and counterstimulants.

Anti-inflammtory medicines by mouth are essential, but they tend to cause fluid retention, and this causes the pain to worsen.  Particularly true in women who find that their fingers and toes swell with menstruation, diuretics (fluid pills) must be co-administered with the anti-inflammatory medicines to prevent paradoxical worsening of the pain.  Salt restriction is essential, as well.

We have found that a useful approach is to use transdermal MSM (Kink-Ease) in conjunction with the NSAID/diuretic combination.  The NSAID is administered in the evening, with the diuretic being taken at dinner.  The MSM (Kinkease) is used first thing in the morning, last thing before bed, and during the day, if possible.

The choice of NSAID is a matter of personal preference.  It must be noted that individual variance dictates which agent to use.  That is, one might work where another will not.  It varies from patient to patient, which is the real challenge in medication selection.

The choice of diuretic is a bit easier, but  alerting the physician to sulfa allergy will shorten the list from which to select.

The skin of the foot is very thick.  For this reason kink-ease is a good choice for the MSM lotion, due to it’s very high concentration.

About David S Klein, MD 149 Articles
David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.