Plantar fasciitis was previously believed to be inflammation of the fascia near its insertion on the heel bone. The suffix (-itis) means inflammation. Studies, however, reveal that changes in the
tissue associated with the injury are degenerative and not related to inflammation, at least not in the way most people typically think of inflammation. Sudden onset of heel pain may indeed be
related to acute inflammation. For persistent heel pain the condition more closely resembles long-standing degeneration of the plantar fascia near its attachment than inflammation. This could explain
why anti-inflammatory medications and injections have been unsuccessful at treating it. But there is more to heel pain than just the plantar fascia.
You're more likely to develop the condition if you're female, overweight or have a job that requires a lot of walking or standing on hard surfaces. You're also at risk if you walk or run for
exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches also are more prone to plantar fasciitis.
Plantar fasciitis and heel spur pain usually begins in the bottom of the heel, and frequently radiates into the arch. At times, however, the pain may be felt only in the arch. The pain is most
intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of
walking, the pain usually becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this
pain may radiate into the ankle. In the early stages of Plantar Fasciitis and Heel Spurs, the pain will usually subside quickly with getting off of the foot and resting. As the disease progresses, it
may take longer periods of time for the pain to subside.
Diagnosis of plantar fasciitis is based on a medical history, the nature of symptoms, and the presence of localised tenderness in the heel. X-rays may be recommended to rule out other causes for the
symptoms, such as bone fracture and to check for evidence of heel spurs. Blood tests may also be recommended.
Non Surgical Treatment
No single treatment works best for everyone with plantar fasciitis. But there are many things you can try to help your foot get better. Give your feet a rest. Cut back on activities that make your
foot hurt. Try not to walk or run on hard surfaces. To reduce pain and swelling, try putting ice on your heel. Or take an over-the-counter pain reliever like ibuprofen (such as Advil or Motrin) or
naproxen (such as Aleve). Do toe stretches camera.gif, calf stretches camera.gif and towel stretches camera.gif several times a day, especially when you first get up in the morning. (For towel
stretches, you pull on both ends of a rolled towel that you place under the ball of your foot.) Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or try heel cups or
shoe inserts. Use them in both shoes, even if only one foot hurts. If these treatments do not help, your doctor may recommend splints that you wear at night, shots of medicine (such as a steroid) in
your heel, or other treatments. You probably will not need surgery. Doctors only suggest it for people who still have pain after trying other treatments for 6 to 12 months. Plantar fasciitis most
often occurs because of injuries that have happened over time. With treatment, you will have less pain within a few weeks. But it may take time for the pain to go away completely. It may take a few
months to a year. Stay with your treatment. If you don't, you may have constant pain when you stand or walk. The sooner you start treatment, the sooner your feet will stop hurting.
Surgery should be reserved for patients who have made every effort to fully participate in conservative treatments, but continue to have pain from plantar fasciitis. Patients should fit the following
criteria. Symptoms for at least 9 months of treatment. Participation in daily treatments (exercises, stretches, etc.). If you fit these criteria, then surgery may be an option in the treatment of
your plantar fasciitis. Unfortunately, surgery for treatment of plantar fasciitis is not as predictable as a surgeon might like. For example, surgeons can reliably predict that patients with severe
knee arthritis will do well after knee replacement surgery about 95% of the time. Those are very good results. Unfortunately, the same is not true of patients with plantar fasciitis.
Stretching exercises for your foot are important. Do the stretches shown here at least twice a day. Don't bounce when you stretch. Plantar fascia stretch. To do the plantar fascia stretch, stand
straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower
part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Calf stretch. Stand with your hands against a wall and your injured leg behind your other leg. With your
injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the
stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Other exercises. You can also strengthen your leg muscles by standing on the ball of your foot at the edge of a step and raising up as
high as possible on your toes. Relax between toe raises and let your heel fall a little lower than the edge of the step. It's also helpful to strengthen the foot by grabbing a towel with your toes as
if you are going to pick up the towel with your foot. Repeat this exercise several times a day.