Plantar fasciitis is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and
connects your heel bone to your toes. Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar
fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position. Plantar fasciitis is particularly common in runners. In addition, people who
are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in
the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.
Heel pain is the most common symptom associated with plantar fasciosis. Your heel pain may be worse in the morning or after you have been sitting or standing for long periods. Pain is most common
under your heel bone, but you also may experience pain in your foot arch or on the outside aspect of your foot. Other common signs and symptoms of plantar fasciosis include mild swelling and redness
in your affected area, tenderness on the bottom of your heel, impaired ability to ambulate.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Shoe therapy, finding and wearing shoes that allow your feet to be in their natural position, is the most important treatment for plantar fasciosis. Shoes that possess a flat heel, are wide in the
toe box, lack toe spring, and have flexible soles are most appropriate for this foot problem. An increasing number of shoe companies are producing shoes with these design characteristics, but shoes
that include all these features are still difficult to find. For some suggested footwear models, see our clinicâs shoe list. Most conventional footwear can be modified by stretching the shoeâs
upper, stretching out the toe spring, removing the shoeâs liner, and cutting the shoe at certain key points to allow more room for your foot. Visit your podiatrist to help you with these shoe
modifications. Correct Toes is another helpful conservative treatment method for plantar fasciosis. Correct Toes addresses the root cause of your plantar fasciosis by properly aligning your big toe
and reducing the tension created by your abductor hallucis longus on the blood vessels that feed and "cleanse" the tissues of your plantar fascia. Your plantar fasciosis-related pain will diminish
when the dead tissue is washed away. A rehabilitation program, which includes targeted stretches and other exercises, for your foot may be helpful too. Dietary changes and aerobic exercise are
particularly important for overweight individuals who have plantar fasciosis. Water aerobics may be most appropriate for those individuals whose pain does not allow them to walk or cycle. Physical
therapy may be another helpful treatment modality for this problem, and includes ultrasound, electrical stimulation, contrast baths, and range-of-motion exercises. Massage, acupuncture, reflexology,
and magnet therapy are holistic approaches that may be helpful.
Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if
non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider
surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament
and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release
when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the
cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
Maintain a healthy weight. This minimizes the stress on your plantar fascia. Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency.
Don't go barefoot, especially on hard surfaces. Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new
shoes after about 500 miles of use. Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging. Apply ice. Hold a cloth-covered ice pack over the area of
pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes.
Regular ice massage can help reduce pain and inflammation. Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.