“รองช้ำ” โรคที่ทำให้เจ็บซ้ำๆ ได้ทุกก้าวเดิน

Everyone is born to walk, but believe it or not, walking and using your legs and feet improperly can lead to pain with every step. When that time comes, the joy of life will greatly diminish because walking becomes difficult and movement is inconvenient due to persistent pain. Therefore, as a guideline for prevention, today we will introduce you to “Plantar Fasciitis” more closely, so that every step you take in life is stable and pain-free.
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<h2>What is Plantar Fasciitis? Get to Know It to Stay Ahead</h2>
“Plantar fasciitis,” or officially called “Plantar Fascia Inflammation,” is a common condition caused by aging and regularly putting heavy use on the feet during work. This results in tightness and lack of flexibility in the plantar fascia. Repeated use without exercise or muscle stretching causes the muscles to become tight, leading to inflammation and pain. Heel pain on the sole can also be caused by other conditions such as plantar fibroma or heel nerve inflammation, which cause pain along with numbness. All three conditions cause pain in nearby areas or about 0.5-1 cm apart.
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<h2>What Factors Increase the Risk of Plantar Fasciitis?</h2>
The main risk factors for plantar fasciitis mostly relate to lifestyle behaviors. It is more common among working-age office workers because during school or university years, people have more opportunities for recreational activities, exercise, and travel, which involve varied foot use and stretching. However, in working life, daily routines revolve around showering, brushing teeth, working at a computer, going home, and sleeping, which can cause abnormal foot muscle tightness due to lack of diverse activity. Prolonged muscle tightness over months or years can lead to plantar fascia inflammation and pain. Abnormal calf muscle tightness is a key factor that reduces plantar fascia flexibility and increases pressure on the sole, raising the risk of plantar fasciitis. Other risk factors include being overweight, which increases foot pressure; wearing inappropriate shoes that squeeze or deform the feet; and choosing shoes with soles that are too thin, causing increased shock to the feet, bones, joints, and tendons. Repeated use of the feet under these conditions over time can eventually lead to plantar fasciitis.
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<h2>What Symptoms Suggest a Risk of Plantar Fasciitis?</h2>
Symptoms of plantar fasciitis may start with foot soreness and aching, often felt after a day of heavy foot use. However, this sensation does not always mean plantar fasciitis; it could also result from wearing inappropriate shoes for a long time. The hallmark symptom of plantar fasciitis is “pain with every step.” The first step in the morning is especially sharp because during sleep, the foot is in a pointed position, causing the Achilles tendon to remain bent. When you stand and take the first step, the tight plantar fascia tears slightly, causing pain. Subsequent steps continue to hurt, whether walking to eat or to the bathroom, or changing posture after sitting for a long time. The pain lessens after the first step but persists. If you experience these symptoms upon waking and walking, you should see a doctor immediately as the likelihood of plantar fasciitis is very high.
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<h2>How to Treat Plantar Fasciitis After Diagnosis?</h2>
The main treatment approach for plantar fasciitis focuses on “exercise” because medication has very limited effect. The real problem is the “lack of flexibility in the plantar fascia and calf muscles.” Medication only relieves pain and reduces inflammation, which results from tightness causing tearing and pain. Therefore, medication does not increase flexibility and only treats symptoms temporarily without stopping the cycle of tightness and tearing. Doctors prescribe medication only for severe pain initially to reduce discomfort, then focus on exercises to restore flexibility to the plantar fascia and calf muscles. Successful exercise will eliminate the source of pain, but the time required depends on the severity of the condition in each individual. If exercise does not improve symptoms, other treatment options include:
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<ol>
<li style="font-weight: 400;">Shock Wave Therapy is a treatment using sound waves to break up tight and inflamed fascia, stimulating self-repair. This method is effective and suitable for patients who have exercised for 3-6 months without improvement.</li>
<li style="font-weight: 400;">Steroid Injection can be effective but carries risks such as plantar fascia rupture, flat feet, chronic heel pain, fat pad atrophy causing increased heel bone pressure leading to heel bone inflammation, or worst-case infection requiring complex treatment and long recovery.</li>
<li style="font-weight: 400;">Surgery can be performed either arthroscopically or by open surgery. The goal is to cut about one-third of the tight plantar fascia to loosen it. Arthroscopic surgery causes less pain and faster recovery than open surgery.</li>
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Although plantar fasciitis is not a dangerous disease, it can cause significant problems and difficulties in daily life. Treatment may be challenging, lengthy, and costly. Therefore, taking good care of your feet, exercising regularly, stretching your feet, choosing hygienic footwear, and avoiding wearing fashion shoes for long periods are key preventive measures. This helps keep your feet strong and able to move and perform activities smoothly. Besides foot care, never forget that if you feel a sharp pain on the first step after waking up and continuing pain with subsequent steps, you should promptly consult a doctor.
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— 
Dr. Chakorn Rimchala 
Orthopedic Surgeon specializing in Foot and Ankle Surgery 
Phyathai 3 Hospital 
Tel. 02-467-1111 ext. 3100 and 3112 
Phyathai Call Center 1772

"Heel pain" or officially called "Plantar fasciitis" is a common condition caused by aging and regularly using the feet heavily in daily work.

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"Heel pain" a condition that causes repeated pain with every step

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