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Can Cannabis Help Plantar Fasciitis?

by Ayesha Rashid, PhD

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Cannabis has the potential to help alleviate chronic inflammatory pain associated with plantar fasciitis, though there is limited research specifically on cannabinoid treatment and this condition. 

Cannabis acts on the endocannabinoid system (ECS) in the body, which is involved in regulating several processes including pain and inflammation. Activation of the ECS may, therefore, help alleviate chronic inflammatory pain associated with plantar fasciitis. 

Cannabis can help reduce pain in multiple conditions including chronic back and neck pain, osteoarthritis, rheumatoid arthritis, fibromyalgia, neuropathy, and migraines

Studies have shown that cannabis is particularly effective in treating chronic pain. It has been shown to have significant analgesic effects in arthritic conditions such as rheumatoid arthritis and osteoarthritis, which are associated with chronic joint and fascial tissue pain. Both rheumatoid arthritis and osteoarthritis may be closely involved in the development of plantar fasciitis. As such, cannabis could be used to treat chronic pain associated with this inflammatory foot condition.

Medical studies on plantar fasciitis and cannabis

There is a large body of evidence supporting cannabis as an effective pain reliever in many conditions. More specifically, cannabis has been shown to reduce pain in conditions such as arthritis, which affect similar parts of the body as plantar fasciitis.

The following studies demonstrate the benefits of cannabis for pain and inflammation.

  • In a systematic review of 18 different randomized controlled trials involving patients with chronic pain conditions such as rheumatoid arthritis, fibromyalgia, neuropathic pain, and mixed chronic pain, it was found that cannabis led to significant analgesic effects in over 80% of the trials.
  • One 2015 review of 28 studies concluded moderate to quality evidence supporting the use of cannabinoids for treating chronic pain.
  • A 2004 study showed that the administration of cannabis led to reduced inflammation in the paws of rats along with pain relief. 

While the research on cannabis and pain is promising, there is limited research on the use of cannabis for plantar fasciitis. Given cannabis helps with other arthritic conditions it wouldn’t be surprising if future clinical trials show positive results for cannabis and plantar fasciitis.

CBD and plantar fasciitis

There is growing evidence to suggest that CBD may be effective in relieving chronic pain and inflammation in joints and tissues in the body. In particular, CBD has been shown to help relieve pain associated with osteoarthritis. Since this condition may be directly implicated in plantar fasciitis, there is strong potential for CBD to be effective for it. 

The following are key research studies that demonstrate the effectiveness of CBD in chronic pain and inflammation in arthritic conditions:

  • There is currently a clinical trial underway (initiated in 2018) that aims to evaluate CBD as a treatment for osteoarthritis and psoriatic arthritis. The trial is expected to be completed in December 2020.
  • A meta-analysis of clinical studies that evaluated the use of CBD for various chronic pain conditions including rheumatoid arthritis, osteoarthritis and fibromyalgia revealed that CBD demonstrates some clinical benefit in reducing chronic pain. 
  • A 2015 pre-clinical study reported that the topical application of CBD provides relief for arthritis-related pain and inflammation in a rat model.
  • Interestingly, a 2018 study assessed the potential preventative effects of CBD in early-stage inflammation and pain in a rat model of osteoarthritis. The researchers found that CBD administration prevented the development of later-stage pain and prevented nerve damage in osteoarthritic joints. 

At present, there is limited research on the use of CBD for plantar fasciitis. However, given that CBD has demonstrated effectiveness in inflammatory conditions like arthritis, there is significant potential for CBD to be an effective therapeutic for plantar fasciitis.

How cannabis works on plantar fasciitis 

The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.

Cannabinoids bind to specific endocannabinoid receptors (CB1 and CB2) found throughout the brain, spinal cord, and associated neural networks. These endocannabinoid receptors are involved in the regulation of pain and inflammation, and cannabis can interact with this system. 

The activation of the endocannabinoid system has been shown to help reduce chronic pain and inflammation in conditions such as arthritis — particularly osteoarthritis — which is closely linked to arthritis. Pain in plantar fasciitis and associated forms of arthritis result from inflammation of bands of connective tissue called ‘fascia’ that connect joints in the body. CB1 and CB2 receptors are expressed in fascia throughout the body, including in joints such as the hip joint. 

Due to the presence of cannabinoid receptors in fascial tissue, cannabis could be used to target the endocannabinoid system and provide pain relief for plantar fasciitis, although studies still need to confirm this.

Side effects 

 

Cannabis Side EffectsCannabis is an effective therapeutic option for treating chronic pain and inflammation associated with plantar fasciitis. It has minimal side effects when taken in appropriate doses, as recommended by a medical professional.

Prolonged and higher dose usage of cannabis can lead to cognitive and memory impairments, particularly in youth who begin using it early on in life. Also, taking cannabis orally in large amounts can lead to a condition called cannabis hyperemesis syndrome (CHS), which leads to severe bouts of nausea and vomiting. 

CBD is generally well-tolerated but can have possible side effects such as drowsiness, light-headedness, fatigue, dry mouth, diarrhea, and reduced appetite. Before taking any CBD-based products, it is advisable to speak to your doctor.

Disclaimer

The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.

About Plantar fasciitis

Overview

Plantar fasciitis is an inflammation of the thick band of tissue, called the plantar fascia, that runs underneath your foot to connect your heel to your toes. It can lead to severe pain in your heel and the arch of your foot, and it’s the most common cause of heel pain.

Around 2 million Americans complain of heel pain every year, although not every case of heel pain is due to plantar fasciitis. It affects women 2.5 times more than men, probably because high heels increase the risk of plantar fasciitis and make the heel pain worse. You’re most likely to experience it when you’re aged 45-64. 

Plantar fasciitis occurs frequently among runners, especially if they don’t wear shoes that properly support the foot, but it’s also connected with being overweight. If you have a BMI of 30 or more, you are five times more likely to develop plantar fasciitis than someone with a BMI of under 25. 

Symptoms

Plantar fasciitis causes a stabbing pain in the bottom of your foot, usually near to the heel. The pain is typically at its worst first thing in the morning or after you’ve been resting for a long time, but it can ease up as you move around. Plantar fasciitis pain is also likely to hit you after you finish exercising, or if you’ve been on your feet for too long.

Complications

If plantar fasciitis goes untreated, it can have a significant impact on your quality of life. You’re likely to avoid walking or exercising if you have plantar fasciitis pain, which can lead to obesity and overall poor health. You could also change the way you walk to try to reduce plantar fasciitis pain, but the new unnatural gait can place pressure on your knee, hips, or back.

Plantar fasciitis can also cause heel spurs, extra knobs of bone on the back of your heel, but it’s not thought that these affect your health (though they will affect your comfort). 

Diagnosis

The diagnosis of plantar fasciitis is usually made by a simple physical examination.  Your doctor will examine your feet carefully, and ask you questions about foot and heel pain. You might be asked to walk or run so that your doctor can inspect your gait. 

Your doctor might send you for imaging tests, like an x-ray or MRI to check for fractures, heel spurs, or signs of arthritis, but usually, these aren’t necessary. 

Causes

Plantar fasciitis is caused by too much strain on the plantar fascia. Your plantar fascia is shaped like a rainbow underneath your foot, supporting your arches and acting as a shock absorber. If the plantar fascia is strained too much, it causes tiny tears in the tissue, which then get painful and inflamed. 

Doctors used to think that plantar fasciitis was caused by heel spurs, but now most scientists think that it’s the other way around, and plantar fasciitis is what causes heel spurs. 

It’s not always clear what causes plantar fasciitis to develop, but there are some known risk factors which make it more likely:

  • Regular exercise which places a lot of stress on your heel, like running, ballet, and some kinds of dance
  • Obesity, because the more you weigh, the more strain you place on your plantar fascia
  • Spending a lot of time walking, standing, or exercising on hard surfaces
  • Age and gender – women are more likely to develop plantar fasciitis than men, and your risk is also greater when you’re aged between 40 and 65
  • Flat feet, high arches, or an abnormal gait can affect your weight distribution across your foot and increase stress on the plantar fascia
  • Tight Achilles’ tendons or calf muscles pull on the plantar fascia
  • Wearing shoes that don’t support and cushion your feet properly, like shoes with thin soles and/or high heels
  • Overstretching your feet when you walk or exercise

Treatment 

The first line of treatment for plantar fasciitis is to try simple over-the-counter medications and home remedies. These include:

  • Allowing your feet to rest for a few days or weeks, without straining them through too much exercise or standing
  • Changing your shoes to ones that provide more support and cushioning for your feet, such as sneakers.
  • Applying ice to the bottom of your foot for up to 20 minutes every 2-3 hours
  • Taking over-the-counter painkillers and anti-inflammatories, such as ibuprofen and naproxen sodium

 

Therapies 

Physical therapy is usually very effective for treating plantar fasciitis. Your therapist will usually show you how to do some gentle stretches which loosen the calf muscle and ease the strain on your plantar fascia. You might also be given exercises to strengthen your lower leg and ankle to make your foot more stable. 

Night splints stretch out your calf and the arch of your foot overnight, helping to stretch and loosen the Achilles tendon and plantar fascia and ease the pain of plantar fasciitis. 

You might also be prescribed orthotics, which are insoles that fit inside your shoes to support your arch and distribute pressure more evenly across your foot. 

 

Other procedures

If your plantar fasciitis doesn’t get any better after these treatments, you might be prescribed one or more of these procedures. 

  • Cortisone injections. This is a type of steroid that’s injected into the bottom of your foot. Although they stop you from feeling the pain, too many shots can weaken the plantar fascia and might rip it entirely. 
  • Surgery. This is the last resort for people with severe, painful plantar fasciitis that hasn’t responded to any other treatment. It involves a small incision to detach the plantar fascia from the heel bone. 
  • Extracorporeal shock wave therapy. This uses sound waves to stimulate healing in your heel, but it’s still not conclusively proven to be effective. 
  • Ultrasonic tissue repair. This uses ultrasound imaging to guide a needle into the damaged plantar fascia. The needle then vibrates to break up the damaged tissue so it can be suctioned out.
  • Plasma injections. This uses ultrasound imaging to obtain platelet-rich plasma from your own bloodstream, which is injected into your foot to speed up healing. 

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