Plantar fasciitis is one of the most common sources of heel pain. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and
extending along the sole of the foot towards the toes. Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes
inflammed it is known as plantar fasciitis.
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more
prone to developing plantar fasciitis. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly
evident when oneâs job requires long hours on the feet. Obesity may also contribute to plantar fasciitis.
Patients experience intense sharp pain with the first few steps in the morning or following long periods of having no weight on the foot. The pain can also be aggravated by prolonged standing or
sitting. The pain is usually experienced on the plantar surface of the foot at the anterior aspect of the heel where the plantar fascia ligament inserts into the calcaneus. It may radiate proximally
in severe cases. Some patients may limp or prefer to walk on their toes. Alternative causes of heel pain include fat pad atrophy, plantar warts and foreign body.
Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain to make sure that itâs not caused by a different foot problem. The doctor may ask
you to flex your foot while he or she pushes on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. Mild redness or swelling will also be noted. Your doctor
will evaluate the strength of your muscles and the health of your nerves by checking your reflexes, your muscle tone, your sense of touch and sight, your coordination, and your balance. X-rays or a
magnetic resonance imaging (MRI) scan may be ordered to check that nothing else is causing your heel pain, such as a bone fracture.
Non Surgical Treatment
Night splints are treatment that can help stretch your calf and the arch of your foot. Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and
Achilles tendon overnight. This can prevent morning pain and stiffness. Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and can
prevent further damage to the plantar fascia. A boot cast may be used to immobilize your foot and reduce strain while the plantar fascia heals. A boot cast looks like a ski boot and can be removed
If you consider surgery, your original diagnosis should be confirmed by the surgeon first. In addition, supporting diagnostic evidence (such as nerve-conduction studies) should be gathered to rule
out nerve entrapment, particularly of the first branch of the lateral plantar nerve and the medial plantar nerve. Blood tests should consist of an erythrocyte sedimentation rate (ESR), rheumatoid
factor, human leukocyte antigen B27 (HLA-B27), and uric acid. Itâs important to understand that surgical treatment of bone spurs rarely improves plantar fasciitis pain. And surgery for plantar
fasciitis can cause secondary complications-a troubling condition known as lateral column syndrome.
It is not always possible to prevent heel pain, but there are measures you can take to help avoid further episodes. Healthy weight. Being overweight can place excess pressure and strain on your feet,
particularly on your heels. This increases the risk of damaging your feet and heels. If you are overweight, losing weight and maintaining a healthy weight by combining regular exercise with a
healthy, balanced diet can be beneficial for your feet. You can calculate your body mass index (BMI) to find out whether you are a healthy weight for your height and build. To work out your BMI,
divide your weight in kilograms by your height in metres squared. A BMI of less than 18.5 means that you are underweight, 18.5-24.9 means that your weight is healthy, 25-29 means that you are
overweight, 30-40 means that you are obese, over 40 means that you are morbidly obese. You can also use the BMI healthy weight calculator to work out your BMI. Healthy feet. You should always wear
footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may
damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and
heels. Avoid wearing shoes with no heels.