Plantar Fasciitis

Plantar fasciitis is a common type of heel aliment. It results from overuse of the plantar fascia, which is a broad, thick tendon-like band of tissue that extends from the heel to the toes. this area works to absorb the stresses and strains we place on our feet. As we step forward, our weight comes to rest first on the heel of the foot, then gradually over the length of the foot. When the foot begins to bear weight, it flattens and puts pressure on the plantar fascia that pulls on its attachment at the heel. Over time this ligament-like tissue can develop tiny tears leading to inflammation and pain. The American College of Foot and Ankle Surgeons (ACFAS) lists the symptoms of plantar fasciitis as:

• pain on the bottom of the heel
• pain that is usually worse getting out of bed in the morning
• pain that increases over a period of months

Causes

According to the American Academy of Orthopaedic Surgeons (AAOS), it is not always possible to identify the cause of plantar fasciitis. But there are several factors that increase your risk of developing the condition.

• lack of arch support
• obesity (Read about "Obesity")
• an increase in repetitive impact activities like running or jumping (Read about "Repetitive Stress")
• becoming very active in a short period of time (Read about "Avoid Sports Injury")
• standing too long
• being flat-footed or having a high arch
• constantly walking barefoot on hard surfaces

Diagnosing plantar fasciitis

Because there are several common causes of heel pain, ACFAS stresses it is important to have a specific diagnosis of plantar fasciitis in order to determine the best treatment. AAOS says the condition can often be diagnosed just on the basis of your description of symptoms. But the doctor may examine your foot and look for these signs:

• a high arch or a flat arch
• an area of tenderness on the bottom of your foot just in front of the heel
• pain that increases when you flex the foot as the doctor pushes on the plantar fascia
• pain that decreases when the toes are pointed down
• difficulty moving your ankle in an up motion

According to AAOS, an x-ray (Read about "X-rays") may be helpful in diagnosing soft tissue swelling and to distinguish plantar fasciitis from heel pain caused by other conditions, such as bone spurs. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound (Read about "MRI - Magnetic Resonance Imaging" "Ultrasound Imaging"), are rarely used to diagnose the condition, according to AAOS.

Treatment of plantar fasciitis

Conservative treatment for plantar fasciitis is almost always successful, given enough time. According to AAOS, more than 90 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.

Among those listed:

• Rest - doing less weight bearing exercises that involve running and jumping.
• Apply ice - rolling your foot over a cold water bottle or ice for about 20 minutes, three to four times a day.
• NSAIDs - nonsteroidal anti-inflammatory medication can be used to reduce pain and swelling.
• Exercise - stretching your calves can help ease pain. (Read about "Stretching and Health")

ACFAS recommends returning to see your doctor if the pain persists after several weeks. Several additional treatments may be offered:

• supportive shoes or orthotics like shoe inserts
• injections such as cortisone, a type of steroid, which is a powerful anti-inflammatory medication to reduce swelling and pain
• splints at night that stretch the plantar fascia while you sleep.
• physical therapy (Read about "Rehabilitation")
• A removable walking cast may be used to keep the foot immobile allowing it to rest and heal.

AAOS says a small percentage of patients may need surgery if conventional treatments do not work after several months.

Related Information:

    Feet, Ankles and Legs