Heel Pain (Plantar Fasciitis)
Plantar fasciitis is a common podiatric condition caused by inflammation of the plantar fascia. Plantar fascia is a band of tissue that extends from the heel to the toes. It functions to maintain the arch of the foot and allows proper function of foot movement. The most common cause of plantar fasciitis is abnormal foot architecture. People with overly high arch, or flat feet tend to develop plantar fasciitis. Increased activity, which places more strain on the plantar fascia, can also contribute to the inflammation. Wearing non supportive shoes that does not fully support the feet can also cause plantar fasciitis.
Symptoms:
Symptoms of plantar fasciitis include pain on the bottom of the heel, along the arch of the foot, and pain that is usually present upon arising. Many patients experience pain when they take their first few steps in the morning. Furthermore, the pain usually improves after walking for a while. If the inflammation is severe, the pain can worsen, with development of swelling at the site of pain.
Diagnosis:
Medical history and careful examination can help arrive at the diagnosis. During examination, the physician can rule out other causes of heel and arch pain in the foot. If the presentation is atypical, or there is concern regarding other pathologies, X-rays of the foot can be ordered. Bone spurs are often found at the site of the pain at the heel. However, research has shown that the spur does not cause the pain, it is the inflammation of the plantar fascia that is causing the pain.
Treatments:
Conservative treatments for plantar fasciitis can include the following:
Approximately 90% of patients will have symptom relief with conservative treatment. However, If the symptoms do not improve with conservative treatment, surgical treatment may be considered. There are multiple different procedures for treatment of plantar fasciitis.
Plantar fasciitis is a common podiatric condition caused by inflammation of the plantar fascia. Plantar fascia is a band of tissue that extends from the heel to the toes. It functions to maintain the arch of the foot and allows proper function of foot movement. The most common cause of plantar fasciitis is abnormal foot architecture. People with overly high arch, or flat feet tend to develop plantar fasciitis. Increased activity, which places more strain on the plantar fascia, can also contribute to the inflammation. Wearing non supportive shoes that does not fully support the feet can also cause plantar fasciitis.
Symptoms:
Symptoms of plantar fasciitis include pain on the bottom of the heel, along the arch of the foot, and pain that is usually present upon arising. Many patients experience pain when they take their first few steps in the morning. Furthermore, the pain usually improves after walking for a while. If the inflammation is severe, the pain can worsen, with development of swelling at the site of pain.
Diagnosis:
Medical history and careful examination can help arrive at the diagnosis. During examination, the physician can rule out other causes of heel and arch pain in the foot. If the presentation is atypical, or there is concern regarding other pathologies, X-rays of the foot can be ordered. Bone spurs are often found at the site of the pain at the heel. However, research has shown that the spur does not cause the pain, it is the inflammation of the plantar fascia that is causing the pain.
Treatments:
Conservative treatments for plantar fasciitis can include the following:
- Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
- Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
- Ice. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
- Limit activities. Cut down on extended physical activities to give your heel a rest.
- Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Padding, taping and strapping. Placing pads in the shoe softens the impact of walking. Taping and strapping help support the foot and reduce strain on the fascia.
- Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.
- Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.
- Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.
- Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
- Physical therapy. Exercises and other physical therapy measures may be used to help provide relief.
Approximately 90% of patients will have symptom relief with conservative treatment. However, If the symptoms do not improve with conservative treatment, surgical treatment may be considered. There are multiple different procedures for treatment of plantar fasciitis.