Plantar Fasciitis is a painful foot condition that affects the Plantar Fascia tendon that runs along the bottom of the foot (as seen in the picture). This tendon runs along the arches of the foot.
Sometimes this tendon can become sore from normal use or strenuous activity, but this is not to be confused with the pain associated with Plantar Fasciitis. Small tears in the plantar fascia tendon
can cause foot discomfort and pain, if left untreated, can become unbearable (seen in picture below). These tears are made worse by over-use, strenuous activity, weight gain, improper foot wear and a
variety of other factors. Although there is no one absolute cause for the condition, it remains clear that this condition, while painful, can be corrected with products such as footwear, night
splints, insoles and a variety of other plantar fasaciitis products.
You're more likely to develop the condition if you're female, overweight or have a job that requires a lot of walking or standing on hard surfaces. You're also at risk if you walk or run for
exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches also are more prone to plantar fasciitis.
A sharp pain in the center of your heel will most likely be one of the biggest symptoms of plantar fasciitis. A classic sign of plantar fasciitis is when the pain is worst during the first steps you
take in the morning.
Plantar fasciitis is usually diagnosed by a health care provider after consideration of a personâs presenting history, risk factors, and clinical examination. Tenderness to palpation along the
inner aspect of the heel bone on the sole of the foot may be elicited during the physical examination. The foot may have limited dorsiflexion due to tightness of the calf muscles or the Achilles
tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis.
However, in certain cases a physician may decide imaging studies (such as X-rays, diagnostic ultrasound or MRI) are warranted to rule out other serious causes of foot pain. Bilateral heel pain or
heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Lateral view x-rays of the ankle are the recommended first-line imaging modality to
assess for other causes of heel pain such as stress fractures or bone spur development. Plantar fascia aponeurosis thickening at the heel greater than 5 millimeters as demonstrated by ultrasound is
consistent with a diagnosis of plantar fasciitis. An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in
up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of
the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.
Non Surgical Treatment
In general, plantar fasciitis is a self-limiting condition. Unfortunately, the time until resolution is often six to 18 months, which can lead to frustration for patients and physicians. Rest was
cited by 25 percent of patients with plantar fasciitis in one study as the treatment that worked best. Athletes, active adults and persons whose occupations require lots of walking may not be
compliant if instructed to stop all activity. Many sports medicine physicians have found that outlining a plan of ârelative restâ that substitutes alternative forms of activity for activities
that aggravate the symptoms will increase the chance of compliance with the treatment plan. It is equally important to correct the problems that place individuals at risk for plantar fasciitis, such
as increased amount of weight-bearing activity, increased intensity of activity, hard walking/running surfaces and worn shoes. Early recognition and treatment usually lead to a shorter course of
treatment as well as increased probability of success with conservative treatment measures.
Surgery may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar
fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can
cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.