Plantar fasciitis is a painful condition causing heel pain and many people with the condition also have heel spurs. It affects the band of tissue (plantar fascia) that supports the middle part of the
foot and runs along the sole of the foot from the heel to the ball of the foot. Usually the plantar fascia is strong and flexible but due to certain factors it can become irritated and inflamed where
the plantar fascia joins the bone in the foot. Heel spurs occur when there's constant pulling of the fascia at the heel bone. This leads to a bony growth or spur. The symptoms of plantar fasciitis
are pain in the arch of the foot or heel. This pain is usually worse in the morning after rest when the plantar fascia tightens and shortens. Heel spurs cause a stabbing pain at the bottom or front
of the heel bone.
The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is
inflammation, which results in the heel pain and stiffness of plantar fasciitis.
People with this condition sometimes describe the feeling as a hot, sharp sensation in the heel. You usually notice the pain first thing in the morning when you stand. After walking for a period of
time, the pain usually lessens or even disappears. However, sharp pain in the center of the heel may return after resting for a period of time and then resuming activity.
Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past.
The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to
use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.
Non Surgical Treatment
Treatment initially involves offloading the plantar fascia by aoiding aggravating factors, such as running. Taping, this can work very well to alleviate pain, and can be almost immediate. It isn't a
long-term solution, but can relieve symptoms in the beginning. Using a night splint to stretch the calf, so that less load is placed on the plantar fascia (if tightness in the calf is a factor).
Using a gel heel cup, this can act to increase shock absorption, and by raising the heel there is also less stretch on the calf. So, temporarily, this may relieve pain in someone who has a tight
calf. Massage, but this depends if the plantarfascia is actually tight or just painful. If it is tight, then massage can temporarily relieve the pain, but if it is irritated then taping and
corrective footwear is preferable.
Plantar fasciotomy is often considered after conservative treatment has failed to resolve the issue after six months and is viewed as a last resort. Minimally invasive and endoscopic approaches to
plantar fasciotomy exist but require a specialist who is familiar with certain equipment. Heel spur removal during plantar fasciotomy has not been found to improve the surgical outcome. Plantar heel
pain may occur for multiple reasons and release of the lateral plantar nerve branch may be performed alongside the plantar fasciotomy in select cases. Possible complications of plantar fasciotomy
include nerve injury, instability of the medial longitudinal arch of the foot, fracture of the calcaneus, prolonged recovery time, infection, rupture of the plantar fascia, and failure to improve the
pain. Coblation (TOPAZ) surgery has recently been proposed as alternative surgical approaches for the treatment of recalcitrant plantar fasciitis.
The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. Take care of your feet. Wear shoes with good arch support and heel
cushioning. If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet. Do exercises to stretch the Achilles tendon at the back of the heel. This
is especially important before sports, but it is helpful for non-athletes as well. Ask your doctor about recommendations for a stretching routine. Stay at a healthy weight for your height. Establish
good exercise habits. Increase your exercise levels gradually, and wear supportive shoes. If you run, alternate running with other sports that will not cause heel pain. Put on supportive shoes as
soon as you get out of bed. Going barefoot or wearing slippers puts stress on your feet. If you feel that work activities caused your heel pain, ask your human resources department for information
about different ways of doing your job that will not make your heel pain worse. If you are involved in sports, you may want to consult a sports training specialist for training and conditioning
programs to prevent plantar fasciitis from recurring.