One of the most common foot problems encountered is a painful heel on the bottom of the foot. This pain is commonly worse with the first step after rest (i.e. First step in morning or getting out of bed during the night). This pain is caused by inflammation due to excessive pull on the ligament of your arch (plantar fascia). The Plantar Fascia is a continuation of the Achilles Tendon (large tendon of the calf muscles). In many individuals, the arch of the foot collapses causing excessive pull on the Plantar Fascia. The body responds with inflammation, leading to pain. A common misconception is that the pain is caused by a heel “spur”. This is FALSE. The spur itself rarely causes pain, but is rather a manifestation of the body responding to the excessive pull of the fascia on the heel bone.
Plantar Fasciitis is commonly a clinical diagnoses base on the history and physical exam. X-rays are commonly taken to rule out fractures and other bone problems.
Conservative treatment begins with stretching, anti-Inflammatories, supportive shoe gear and arch supports.
Corticosteroid injections are a common second line of therapy before surgically releasing the Plantar Fascia.
Most pain is resolved before surgical intervention but a small percentage of the population requires incising the fascia at it’s insertion. Very few continue to have recurrent Plantar Facial pain after surgical intervention.
It is always recommended to continue conservative modalities even after surgery, including arch supports.
ALWAYS consult with a physician before self-diagnosis and follow up if problems persist.