Plantar fasciitis is one of the most common explanations of heel pain. It is caused by inflammation to the thick band that connects the toes to the heel bone, called the plantar fascia, which runs
across the bottom of your foot. The condition is most commonly seen in runners, pregnant women, overweight people, and individuals who wear inadequately supporting shoes. Plantar fasciitis typically
affects people between the ages of 40 and 70. Plantar fasciitis commonly causes a stabbing pain in the heel of the foot, which is worse during the first few steps of the day after awakening. As you
continue to walk on the affected foot, the pain gradually lessens. Usually, only one foot is affected, but it can occur in both feet simultaneously. To diagnose plantar fasciitis, your doctor will
physically examine your foot.
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.
Plantar fasciitis has a few possible symptoms. The symptoms can occur suddenly or gradually. Not all of the symptoms must be present at once. The classic symptom of plantar fasciitis is pain around
the heel with the first few steps out of bed or after resting for a considerable period of time. This pain fades away a few minutes after the feet warm up. This symptom is so common that it symbols
the plantar fasciitis disorder. If you have it then probably you have plantar fasciitis. If you donât suffer from morning pain then you might want to reconsider your diagnosis. Pain below the heel
bone at the connection of the bone to the fascia. As the condition becomes more severe the pain can get more intense during the day without rest. Plantar fasciitis symptoms include pain while
touching the inside of the heel or along the arch. Foot pain after you spend long periods of time standing on your feet. Pain when stretching the plantar fascia. Foot pain that worsens when climbing
stairs or standing on the toes. Pain that feels as though you are walking on glass. Pain when you start to exercise that gets better as you warm up but returns after you stop.
Plantar fasciosis is confirmed if firm thumb pressure applied to the calcaneus when the foot is dorsiflexed elicits pain. Fascial pain along the plantar medial border of the fascia may also be
present. If findings are equivocal, demonstration of a heel spur on x-ray may support the diagnosis; however, absence does not rule out the diagnosis, and visible spurs are not generally the cause of
symptoms. Also, infrequently, calcaneal spurs appear ill defined on x-ray, exhibiting fluffy new bone formation, suggesting spondyloarthropathy (eg, ankylosing spondylitis, reactive arthritis. If an
acute fascial tear is suspected, MRI is done.
Non Surgical Treatment
Over-the-counter arch supports may be useful in patients with acute plantar fasciitis and mild pes planus. The support provided by over-the-counter arch supports is highly variable and depends on the
material used to make the support. In general, patients should try to find the most dense material that is soft enough to be comfortable to walk on. Over-the-counter arch supports are especially
useful in the treatment of adolescents whose rapid foot growth may require a new pair of arch supports once or more per season. Custom orthotics are usually made by taking a plaster cast or an
impression of the individual's foot and then constructing an insert specifically designed to control biomechanical risk factors such as pes planus, valgus heel alignment and discrepancies in leg
length. For patients with plantar fasciitis, the most common prescription is for semi-rigid, three-quarters to full-length orthotics with longitudinal arch support. Two important characteristics for
successful treatment of plantar fasciitis with orthotics are the need to control over-pronation and metatarsal head motion, especially of the first metatarsal head. In one study, orthotics were cited
by 27 percent of patients as the best treatment. The main disadvantage of orthotics is the cost, which may range from $75 to $300 or more and which is frequently not covered by health
Most practitioners agree that treatment for plantar fasciitis is a slow process. Most cases resolve within a year. If these more conservative measures don't provide relief after this time, your
doctor may suggest other treatment. In such cases, or if your heel pain is truly debilitating and interfering with normal activity, your doctor may discuss surgical options with you. The most common
surgery for plantar fasciitis is called a plantar fascia release and involves releasing a portion of the plantar fascia from the heel bone. A plantar fascia release can be performed through a regular
incision or as endoscopic surgery, where a tiny incision allows a miniature scope to be inserted and surgery to be performed. About one in 20 patients with plantar fasciitis will need surgery. As
with any surgery, there is still some chance that you will continue to have pain afterwards.