Plantar fasciitis is one of the most common conditions causing heel pain. The condition involves inflammation of the plantar fascia -- a tough, fibrous band of tissue that runs along the sole of the
foot with attachments to the heel bone (calcaneus) proximally and to the base of the toes distally. The plantar fascia provides support to the arch of the foot and has an important role in normal
foot mechanics during walking. Tension or stress in the plantar fascia increases when one places weight on the foot (such as with standing) and as one pushes off on the ball of the foot and toes --
motions which occur during normal walking or running. Inflammation and pain start in the fascia either as a result of an increase in activity level (as in initiating a walking or running program), or
in association with the normal aging process. With aging, the fascia loses some of its normal elasticity or resilience and can become irritated with routine daily activities. Less commonly, plantar
fasciitis can develop in association with general medical conditions such as lupus or rheumatoid arthritis.
Plantar fasciitis is caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia, the connective tissue that runs
from the heel to the base of the toes. The plantar fascia may look like a series of fat rubber bands, but it's made of collagen, a rigid protein that's not very stretchy. The stress of overuse,
overpronation, or overused shoes can rip tiny tears in it, causing pain and inflammation, a.k.a. plantar fasciitis.
If you have Plantar Fasciitis, you will most likely feel a sharp pain under the ball of you heel and it will often give pain when standing after a period of rest. For example when you get out of bed
in the mornings or after being sat down. Some patients describe this feeling as a stone bruise sensation, or a pebble in the shoe and at times the pain can be excruciating. Patients with Plantar
Fasciitis can experience pain free periods whereby the think they are on the mend, only for the heel pain to come back aggressively when they appear to have done nothing wrong. If your plantar
fasciitis came on very suddenly and the pain is relentless, then you may have Plantar Fascial Tears. We will be able to differentiate between these 2 conditions, sometimes with ultra sound imaging.
The treatment for each of these conditions will need to be very different.
During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause. Usually no tests are necessary. The diagnosis is made based
on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a
stress fracture or a pinched nerve. Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed
surgically. But many people who have bone spurs on their heels have no heel pain.
Non Surgical Treatment
Treatment for plantar fasciitis includes medication, physical therapy, shock wave therapy, or surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are used to treat
the inflammation and pain of plantar fasciitis, but they wonât cure the condition. Corticosteroids can also be used to ease pain and reduce inflammation. Corticosteroids are applied either as a
topical solution in conjunction with a non-painful electric current or through injections to the affected area.
Surgery is not a common treatment for this condition. Approximately 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical
procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament. Potential risks of this surgical procedure include irritation of the nerves around the
heel, continued plantar fasciitis, heel or foot pain, infection, flattening of the arch, problems relating to the anesthetic.
Preventing plantar fasciitis is crucial. There are many choices to help prevent the occurrence of this condition, and keep it from returning. One of the most important is maintaining a healthy weight
in order to reduce tension on the plantar fascia. In addition, shoes are very important, and should fit well and provide ample cushioning and support throughout the heel, arch, and ball of the foot
so that weight is distributed evenly throughout the foot. Try to avoid walking barefoot on hard surfaces and replace old shoes before they wear out, especially shoes that you run or exercise in. When
exercising, start off slow and ease into new routines to prevent sudden or excessive stress on tissue. Lastly, keep your calf muscles and the tissue of your feet stretched. Greater flexibility in the
tissue makes them less susceptible to damage.