Plantar Fasciitis

Plantar Fasciitis is inflammation in the plantar fascia. The plantar fascia runs from the heel bone through to just behind the ball of the foot. Pain can be felt in the heel area and under the arch. This is one of the most common orthopedic conditions relating to the foot. This is commonly caused by torsional stress on the plantar fascia, associated with poor rear-foot forefoot alignment or a grossly supinated foot. This ultimately is a developmental problem. More recent research points to there being problem with some of the structures deeper to the plantar fascia such and the long and short plantar ligaments. In many patients this may also be associated with bursitis, bone spurs and nerve impingement, particularly in the heel area.

The pain associated with Plantar Fasciitis can be a mild ache to extreme pain that makes walking difficult. Typically pain is worse in the morning, and late afternoon. Untreated, this will progress to continual pain.

Diagnosis

Diagnosis is easily made from the history, symptoms and by physical examination. Often heel pain is called Plantar Fasciitis, when in fact there are many conditions that can cause heel pain and patients should never self-diagnose.

Treatment

Once a thorough bio-mechanical assessment confirms the diagnosis, specific treatment can begin.

Initial treatment may involve stretching the plantar fascia, calf muscles and possibly the hamstrings.This stretching should not be initiated prior to diagnosis as it can aggravate some heel conditions such as nerve impingement.

As this is an inflammatory condition, heat or the use of liniments is not advised. Ice packs can be used. Further treatment depends on the underlying bio-mechanical problem and may involve Orthotics. Orthotics are recommended if the fasciitis is related to bio-mechanical problems rather than a simple injury. Night splints may also be used. With treatment, it generally takes 6-8 weeks for symptoms to completely resolve.

Without Treatment

Foot pain can continue, and progress into a severe condition that affects the ability to walk. Eventually, permanent damage may occur, which includes calcification of the plantar fascia.