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.

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 both with and without plantar fasciitis.

SYMPTOMS

The most common complaint is pain in the bottom of the heel. It is usually worse 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.

Plantar fasciitis is particularly common in patients with:

• Foot and arch problems (both flat foot and high arches.)
• Tight Achilles Tendon (the tendon connecting the calf muscles to the heel.)
• High impact lifestyles, like runners
• Obesity and weight issues.
• Women who are pregnant.
• Inadequate arch support, proper shoe wear can lower the risk of plantar fasciitis.

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 or Foot Leveler Orthotics.
• Low level laser treatments.

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

PROGNOSIS

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