Nociceptive Foot Pain And Plantar Disease Progression

Plantar Disease Progression?

plantar disease progression

Why do we have cats?


A condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms : sickness, malady. infectious diseases.

– Miriam-Webster Online Dictionary

plantar disease progression

You think I’m crazy training for the Ironman? This is crazy, our cat, Cat.

When Tom’s cat, Cat, scratched his hand, he didn’t have a disease. He had a painful inconvenience.

When you have your first attack of nociceptive foot pain (aka plantar fasciitis!), you don’t have a disease. You have a painful inconvenience.

In both cases, the situation can progress in a number of ways:

  1. Complete resolution – no harm done.
  2. Partial resolution, leaving some tissue or psychological damage, of varying degrees.
  3. Persistence of the condition at a low level, without resolution or serious progression, with or without mild functional impairment (disease?)
  4. Progression to moderate to severe tissue damage with functional impairment (disease).

Tom’s Cat Scratch Experience

plantar disease progressionTom’s cat-scratch wound may be infected by bacteria. This infection could progress, creating inflammation and soreness. The bacteria could proliferate and spread to Tom’s subcutaneous loose connective tissue, to create more wide-spread inflammation (cellulitis). Worse they could spread to lymph nodes and even into his blood (bacteremia) to induce a wide-spread immune response due to infection of Tom’s blood (septicemia). Septicemia can be fatal due to septic shock.

Alternatively, there may be no problem with bacteria. How about viruses. Maybe Tom contracted cat scratch fever. As a veterinarian, Tom knew this, and watched out for the warning signs.

So, when did Tom have a disease, if the condition progressed to his final doom?

Don’t worry, Tom’s fine. He took appropriate action. He let the wound bleed to wash out infectious organisms. He then cleaned the wound with an antiseptic solution and covered it with a bandaid. Tom also kept on eye on the situation, including his lymph nodes.

Don’t worry, Tom’s fine. The condition did not progress.

Progression From Nociceptive Foot Pain

plantar disease progressionNociceptive foot pain is unlikely to progress to a fatal disease, though it can contribute to one’s demise. Chronic foot pain with disability causes people to lose their jobs, which might lead to serious depression. Just read some ‘plantar fasciitis’ (NFP) stories on Facebook. You’ll learn about people’s struggles with unemployment, and the battle to gain disability benefits, for their incapacitating foot pain. First time I experienced NFP, I had to crawl along the floor to reach the bathroom in the morning. It can be incapacitating, alright!

However, this painful condition can, and often does, progress to more serious conditions. Such changes can include the following:

  1. Degeneration, and thus weakening, of the plantar fascia and other critical support structures of the foot.
  2. Rupture of the plantar fascia, as occurred to Anne –  see chapter four.
  3. Micro-tears in tendons and ligaments.
  4. Strain of the Achilles tendons.
  5. Other unknown effects.
  6. Heel spurs.

A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone.

– WebMD (2018)

I’ve made no attempt to provide a detailed review of the literature on the progressive nature of nociceptive foot pain (aka plantar fasciitis). However, here is one important report on the issue:

The authors review histologic findings from 50 cases of heel spur surgery for chronic plantar fasciitis. Findings include myxoid degeneration with fragmentation and degeneration of the plantar fascia.

(J Am Podiatr Med Assoc 93(3): 234-237, 2003).

Myxoid – resembling mucus.

plantar disease progression

This ebook (click image for link) is based on eight years of research. However, we need to work together and harvest more data, to fix this horrible condition that afflicts millions.

The problem lies in preventing the progression. But how to do this, when you don’t know the cause of your nociceptive foot pain? Re-read chapter three of Tom’s book, pain puzzles, for ideas.

Tom’s advice, Look first to your hips, but keep an eye on published research. If your condition is persistent, and if you suspect the risk of frank tissue damage of any kind, seek professional medical assistance (but not a heel injection). Tom’s first choice would be a good physical therapist, but that choice is yours.

See Chapter 10 for Tom’s approach to curing nociceptive foot pain, before it progresses to more serious issues.

Wishing you happy feet and happy trails,

kev aka FitOldDog

My thoughts on treatment always come back to this graph, from Tom’s research program. Explain it if you can. Tom does, in his latest book!

plantar disease progression


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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.