Plantar fasciitis (PLAN-tur fas-e-I-tis) or heelspur affects one out of every 20 people at one time or another. The plantar fascia is a thick fibrous band of tendon like connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the five toes.  This problem is a painful “inflammatory” process that often demonstrates more degenerative changes than inflammatory, in which case plantar fasciosis is better term  (the suffix “osis” implies a state of chronic abnormality or pathology). Injury to this tendon is usually the result of an accumulation over time of microscopic tears and disruption at the cellular level with stimulation of the pain fibers.

It is commonly associated with long periods of weight bearing.  Among non-athletic

populations, it is related to an increase body mass index. Plantar fasciitis or heel spurs are common in sports which involve running, dancing or jumping. Runners who overpronate (feet rolling in or flattening) are particularly at risk as the biomechanics of the foot pronating causes additional stretching of the plantar fascia.

Plantar fasciitis commonly causes stabbing pain that usually occurs with the very first steps in the morning. Once the foot limbers up, the pain usually decreases, but it may return after long periods of standing or after getting up from a seated position. Sometimes there may also be pain along the outside border of the heel. This may occur due to the offloading the painful side of the heel by walking on the outside border of the foot.

An incidental finding associated with this condition is a heel spur, a small bony calcification, on the calcaneus, which is an epiphenomenon. The condition is responsible for the creation of the spur, the plantar fasciitis is not caused by the spur!

Treatment options for plantar fasciitis include rest, steroid/lidocaine injection, acupuncture, massage therapy, stretching, weight loss, night splints, motion control running shoes, physical therapy, cold therapy, heat therapy, orthotics, extracorporeal shockwave therapy, iontophoresis, and tape strapping, Also ultrasound-guided needle fasciotomy,  radiofrequency ablation, extracorporeal shock wave therapy, Botox Injections, Prolotherapy,  and Platelet Rich Plasma or PRP therapy. This is a procedure which involves an injection of special plasma, made out of the patients own blood, and placed into the injured area. Platelets have special blood components that play a major role in the healing process. Blood is taken from the patient and separated into its components. The platelet rich part of the blood is injected into the injured tendon attachment. The procedure supposedly maximizes the body’s natural healing response of the treated area. Surgery preformed by an orthopod or a podiatrist is used when all else fails because of the risk of nerve injury, infection, rupture of the plantar fascia, and failure to improve the pain. For us the best treatment is the minimally invasive procedure with an injection of a Tri- mix into the damaged tendon attachment. The three ingredients in the mixture are Sarapin^R, Long acting cortisone and Lidocaine. The last drug gives immediate pain relief and stops the recurrent reflex of pain amplification through spinal reflex mechanisms. The cortisone of course is anti-inflamatory.

Sarapin^R is a biologic derived from the Pitcher plant.  It works by inhibiting pain signals and initiates healing in the surrounding tissue.  It does not affect any other nerve functions or motor functions like local anesthesia such as lidocaine.  Research published by Bernard Judovich MD in 1935 who did not only did original in vitro research, but used this preparation in over 5,000 patients found it almost as a miracle drug.  Toxicity tests on Serapin published by William Bates MD in the Ohio State Medical Journal in 1942 revealed that it was harmless and no evidence of tissue coagulation or sclerosis could be found.  In that it is an alkaline extract, which releases an ammonium ion from the organic matrix, it was theorized that this was the active ingredient in the solution.  It is known that this ion does affect nerve conduction, but Sarapin^R does more. It was postulated that there was another yet unidentified biological fraction of the plant that is in the mix that is the active ingredient along with the ammonium molecule. We know the C fibers in the nerve carries the pain sensation and this chemical tells them not to.  Acute pain is a useful mechanism for us to know that there is something wrong that must be remedied. But once it has been identified and there is no easy fix, then to quiet these C fibers makes sense. Serapin^R does not only that, but also initiates the healing process. So if you or your love one has plantar fasciitis, consider this almost natural therapy