Plantar fasciitis (PF), sometimes called heel spur syndrome, is an inflammatory condition that causes pain in the connective tissue located on the bottom of the foot, running along heel to the arch of the foot. PF is a very common ailment that can become difficult to cure if not cared for properly. Tendons and ligaments develop small tears that accumulate from overuse that become worse over time.
Plantar Fasciitis Symptoms
The most common symptoms of plantar fasciitis are:
- A stabbing feeling in the heel of your foot
- Pain at the arch of the foot
- Pain with the first few steps after a long period of rest
- Increase in pain during activities or exercises
- Pain is worst upon awakening
Plantar Fasciitis Causes
The most common reason for plantar fasciitis to develop is not because of a sudden injury but because of repetitive stretching and tearing of the tendon due to overuse. Middle-aged individuals are most likely to be diagnosed with PF, but any age group may be affected. Sometimes plantar fasciitis can be due to a stress fracture, tendonitis, nerve irritation or a cyst. Other causes for PF may include:
- A very high arch or overly flat feet
- Heel spurs
- Bone spurs
- New or increased activity
While taking a complete medical history and performing a physical examination of the foot, your orthopedist will ask about your symptoms. Your doctor will also take imaging studies such as X-rays or MRI scans to distinguish the particular disorder you may have. In 70 percent of patients, heel spurs will show up on an X-ray, but these are rarely the source of pain. Your doctor will look for specific signs of PF while performing a physical examination, such as a high arch, tenderness at the bottom of the foot in front of the heel bone, and a limited range of motion of the ankle.
Plantar Fasciitis Treatment
Nonsurgical treatment begins with conservative methods, such as:
- Shoe modification: such as wearing supportive, comfortable shoes with a good arch and slightly raised heel to take pressure off the plantar fascia. PF patients should avoid going barefoot, as walking without shoes can put more strain on the plantar fascia. Padding in the shoes can soften the impact walking puts on the plantar fascia, and strapping can help support the feet. Orthotic devices can help correct the structural abnormalities of the PF.
- Walking cast: a removable foot cast can help keep the foot immobile to allow it to rest and heal.
- Night splint: because many people sleep with their feet pointed down, this can cause more heel pain in the morning. A night splint helps stretch the plantar fascia as you sleep.
- Medication: medicine may be helpful in relieving pain and inflammation.
- Injections: corticosteroids may help relieve inflammation and pain.
- Stretching: exercises can stretch out the calf muscles and ease pain and assist with recovery.
- Extracorporeal shockwave therapy: ESWT stimulates the healing process in damaged plantar fascia tissue.
Most plantar fasciitis can be treated non-surgically with rest, stretching, or medication but if the condition lasts for a long period of time or gets worst surgery may be necessary. There are two types of surgery that doctors commonly preform: Gastrocnemius Recession – Gastrocnemius recession – With this surgery doctors lengthen the calf muscles because the tight muscles increase stress on the bottom of the foot. The procedure is typically done on people who have difficulty flexing their feet even with constant stretching. Plantar Fascia Release – During this surgery the ligament in the bottom of the foot is partially cut to relieve tension in the tissue. If the damage was done because of a bone spur, it will be removed by the doctor.
Like with any surgery there are risks involved. Complications that may arise include:
- Damage to the surrounding nerves
- Persistent pain
- Damage to nerves or blood vessels
- Damage to the joint
- Blood clots
- Difficulty healing bones
Let's face it, walking is important. And walking with constant pain is not easy to deal with. Treatment for plantar fasciitis is effective and lasting. West Medical is here to help.To learn more about plantar fasciitis symptoms, causes, and treatment options available throughout Southern California, please contact West Medical offices at (855) 690-0565, and our helpful medical staff will answer any questions you may have.
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