Plantar fasciitis

Plantar fasciitis

Foot and Ankle ​Condition

Plantar fasciitis

Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year.

Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.

Anatomy

The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.

The plantar fascia is designed to absorb the high stresses and strains we place on our feet.

Causes

In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:

  • Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
  • Obesity
  • Very high arch
  • Repetitive impact activity (running/sports)
  • New or increased activity
Heel Spurs

Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

Treatment
  • Non-surgical treatment
  • More than 90% of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods.
  • Rest.
  • Ice.
  • Nonsteroidal anti-inflammatory medication.
  • Exercise (Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with this condition)
  • Cortisone injections.
  • Supportive shoes and orthotics.
  • Night splints.
  • Physical therapy.
Surgical treatment

Surgery is considered only after 12 months of aggressive nonsurgical treatment.

Gastrocnemius recession. This procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches.

Plantar fascia release. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue.