Plantar Fasciitis

What Is
Plantar Fasciitis?

The plantar fascia is a ligament-like band running from your heel to the ball of your foot. This band pulls on the heel bone, raising the arch of your foot as it pushes off the ground. But if your foot moves incorrectly, the plantar fascia may become strained. The fascia may swell and its tiny fibers may begin to fray, causing plantar fasciitis.

Causes

Plantar fasciitis is often caused by poor foot mechanics. If your foot flattens too much, the fascia may overstretch and swell. If your foot flattens too little, the fascia may ache from being pulled too tight.

Symptoms

With plantar fasciitis, the bottom of your foot may hurt when you stand, especially first thing in the morning. Pain usually occurs
on the inside of the foot, near the spot where your heal and arch meet. Pain may lessen after a few steps, but it comes back after rest or with prolonged movement.

Related Problems

A heel spur is extra bone that may grow near the spot where the plantar fascia attaches to the heel. The heal spur may form in response to the plantar fascia's tug on the heel bone.

Bursitis is the swelling of a bursa, a fluid-filled sac that reduces friction between a ligament and a bone. Bursitis may develop if a swollen plantar fascia presses against a plantar bursa.

Medical History and Physical Exam

Where and when does your foot hurt? Your podiatric physician may first ask first about your symptoms. Then he or she may feel for damaged ligaments, inflamed tendons, and displaced bones and joints. Your podiatric physician also may watch you walk to see if your symptoms are caused by incorrect foot movement.

Testing

X-rays of your foot may be taken, or you may have a bone scan to confirm a suspected heel spur or a stress fracture of the heel bone (see above). To check for plantar fasciitis and related problems, your podiatric physician may press the bottom of your foot near the heel (see right).

Can My Podiatrist Help?

Reducing symptoms is the podiatric physician's first goal. Then he or she works to correct the cause of your problem. If your pain is due to poor foot mechanics, custom-made shoe inserts (orthoses) may help.

Reduce Symptoms

To relieve mild symptoms, try aspirin or other anti-inflammatory medications. Rubbing ice on the affected area may also be
recommended.

To reduce severe pain and swelling, your podiatric physician may prescribe pills or injection. Physical therapy, such as ultrasound may also be recommended.

To reduce symptoms caused by poor foot mechanics, your foot may be taped. This supports the arch and temporally controls movement. Night splints may also help by stretching fascia.

Control Movement

If taping helps, your podiatric physician may prescribe orthoses. Built from plasters casts of your feet, these inserts control the way your feet moves. As a result, your symptoms should go away.

If Surgery Is Needed

Your podiatric physician, may consider surgery if other types of treatment don't control your pain. During surgery, the plantar fascia cut to release tension. As you heal, fibrous tissue fills the space between the heel bone and the plantar fascia.