Technical Name
Plantar Fasciitis
AKA Name
Heel/Foot pain
Short Summary
Plantar fasciitis is a common condition affecting individuals in their middle ages. It presents as pain under the heel bone (calcaneum) made worse with any form of activity such as walking or running as is particularly troublesome first thing in the morning with the first few steps. The term plantar fasciitis refers to an inflammation of the thick fibrous tissue in the sole of the foot that connects the heel bone to the bones of the mid-foot, helping to form the arch of the foot.
With any form of either overstretching or overuse of the fascia in the sole of the foot it can become inflamed and damaged resulting in discomfort and pain.
The risk factors for developing plantar fasciitis are
- Mechanical imbalance in the foot – high arch or flat feet
- Achilles tightness
- Non-supportive footwear with poor medial arch support
- Long distance running
- Standing on hard surfaces for long periods
What are the symptoms?
The symptoms of plantar fasciitis tend to be localized to the sole of the foot with the most tender point being just in front of the heel bone. The pain can start as a dull ache around the heel that comes and goes but can progress to severe pain that limits any form of activity with pain sometimes radiating down the inner aspect of the foot.
Patients often describe the first few steps in the morning as the most uncomfortable time.
How is it diagnosed?
Plantar fasciitis can be diagnosed during your consultation with a detailed history and examination of your symptoms. On occasions it may be necessary to request additional tests or scans to gain more information about the foot.
How is it treated?
Non-operative treatment – the majority of patients who suffer from plantar fasciitis can be treated effectively with complete resolution of their symptoms without the need for surgery.
- Pain killers – anti-inflammatories
- Rest Ice and Elevation
- Supportive shoes/orthotics (insoles) – can help restore the normal foot position and help cushion the foot during walking.
- Physiotherapy – specific exercises can be recommended to stretch the Achilles tendon that will help plantar fascia function better.
- Shockwave therapy – similar to ultrasound, shockwave therapy involves targeting sound waves using a probe similar to that used with ultrasound onto the painful affected area. The sound waves then act to stimulate healing within the damaged tissue.
Operative treatment
it is very rare that surgery is considered for treatment of plantar fasciitis but in some cases can help. Sometimes a small bone spur can be seen on x-rays that may contribute to aggravating the fascia in the foot and if so can be excised (removed). Other procedures can be carried out to release the fascia from the point it joins the heel bone.