Plantar fasciitis is a condition that involves inflammation of the plantar fascia, plantar fasciitis va rating a thick band of tissue that runs across the bottom of the foot, connecting the heel bone to the toes. The plantar fascia acts as a shock absorber and supports the arch of the foot. When this tissue becomes inflamed, it can cause significant pain, especially in the heel.
The primary symptom of plantar fasciitis is heel pain, typically experienced during the first steps in the morning or after periods of rest. The pain may also be present after long periods of standing or intense physical activity. In addition to pain, individuals with plantar fasciitis may experience stiffness and tenderness in the affected foot.
Causes and Risk Factors
Several factors can contribute to the development of plantar fasciitis. One common cause is excessive strain on the plantar fascia, often resulting from overuse or repetitive stress. This can occur in individuals who engage in activities that involve prolonged standing, walking, or running.
Other risk factors for plantar fasciitis include:
Age: Plantar fasciitis is more common in individuals between the ages of 40 and 60.
Foot Structure: Flat feet or high arches can increase the risk of developing plantar fasciitis.
Obesity: Excess body weight puts additional stress on the plantar fascia.
Occupation: Jobs that require prolonged periods of standing or walking on hard surfaces can contribute to the condition.
Improper Footwear: Wearing shoes with inadequate support or poor arch support can contribute to the development of plantar fasciitis.
Diagnosing and Treating Plantar Fasciitis
Diagnosis
Diagnosing plantar fasciitis typically involves a thorough examination of the foot and a review of the individual’s medical history. Imaging tests, such as X-rays or MRI scans, may be ordered to rule out other potential causes of heel pain, such as fractures or nerve compression.
Treatment Options
The treatment of plantar fasciitis aims to alleviate pain, reduce inflammation, and promote healing. Common treatment options include:
Rest and Ice: Resting the affected foot and applying ice can help reduce inflammation and relieve pain.
Stretching Exercises: Stretching exercises for the Achilles tendon and calf muscles can help alleviate tension on the plantar fascia.
Orthotic Devices: Custom-made or over-the-counter shoe inserts can provide additional support and cushioning.
Footwear: Wearing supportive shoes with proper arch support is crucial for managing plantar fasciitis.
Physical Therapy: Physical therapy may be recommended to strengthen the muscles in the foot and improve flexibility.
Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation.
In cases where conservative treatments are not effective, more advanced interventions may be considered, including corticosteroid injections or shockwave therapy. Surgery is typically reserved for severe cases that do not respond to other treatments.
VA Rating for Plantar Fasciitis
For military veterans who developed plantar fasciitis during their service, obtaining a VA disability rating is crucial for accessing disability benefits. The VA uses the Schedule for Rating Disabilities (38 CFR Part 4) to evaluate the severity of various medical conditions, including musculoskeletal disorders like plantar fasciitis.
VA Rating Criteria
The VA rates plantar fasciitis under the Musculoskeletal System, specifically under Diagnostic Code 5276. The rating is based on the severity of symptoms, including pain, muscle weakness, and limited motion. The criteria for rating plantar fasciitis are as follows:
10% Rating: Pronounced tenderness of plantar fascia or ligamentous calcaneus, with marked excess fat pad atrophy on weight-bearing, nonweight-bearing, and during manipulation, pain on manipulation, or localized tenderness exacerbated by foot movement.
30% Rating: Severe tenderness of plantar fascia or ligamentous calcaneus; marked excess fat pad atrophy on weight-bearing and nonweight-bearing; persistent, severe pain on manipulation or palpation of the plantar fascia or ligamentous calcaneus; and limitation of ankle motion.
50% Rating: Pronounced symptoms as described in the 30% rating, but with persistent swelling and inflammation that are not controlled by continuous use of orthotics or physical measures.
Notes: For all ratings, it is essential to consider functional loss due to pain, decreased motion, weakness, and any other symptoms that impact the veteran’s ability to work and perform daily activities.
Appealing a Decision
In some cases, a veteran’s initial VA disability claim for plantar fasciitis may be denied or assigned a lower rating than expected. In such situations, veterans have the right to appeal the decision. The appeal process involves submitting additional evidence, attending hearings, and presenting arguments for why the initial decision should be reconsidered.
It is advisable for veterans to seek assistance from veterans’ service organizations or legal representatives specializing in VA claims to navigate the appeals process successfully.