Plantar Fasciitis

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of your foot — connecting your heel bone to your toes. Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot.

Plantar fasciitis causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.

Plantar fasciitis is particularly common in runners. People who are overweight, women who are pregnant and those who wear shoes with inadequate support are at a higher risk of plantar fasciitis.

The plantar fascia is a very thick band of tissue that holds up the bones on the bottom of the foot. This fascia can become inflamed and painful in some people, making walking more difficult.

Risk factors for plantar fasciitis include:

Foot arch problems (both flat foot and high arches)
Obesity
Running
Sudden weight gain
Tight Achilles tendon (the tendon connecting the calf muscles to the heel)

This condition is one of the most common orthopedic complaints relating to the foot.

Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.

Symptoms

The most common complaint is pain in the bottom of the heel. It is usually worst in the morning and may improve throughout the day. By the end of the day the pain may be replaced by a dull aching that improves with rest.

Most people complain of increased heel pain after walking for a long period of time.

Typical physical exam findings include:

Mild swelling
Redness
Tenderness on the bottom of the heel

X-rays may be taken to rule out other problems, but having a heel spur is not significant.

Treatment

Conservative treatment is almost always successful, given enough time. Treatment can last from 1-3 months before symptoms get better. Most patients will improve with chiropractic care.

Initial treatment usually consists of:

Heel stretching exercises
Shoe inserts - Foot Leveler Orthodics
Low level laser treatments

About 90 percent of the people who have plantar fasciitis recover with conservative treatments in just a few months.

Prognosis

Nearly all patients will improve within 1 year of beginning non-surgical therapy, with no long-term problems. In the few patients requiring surgery, most have relief of their heel pain.

Complications

Complications with surgery include:

Infection
Nerve injury
No improvement in pain
Rupture of the plantar fascia

With other treatments, a complication is continued pain.