What is Plantar Fasciitis/Heel Spur Syndrome?
Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Plantar fasciitis refers to the inflammation of the plantar fascia, a thick band of tissue that is present at the bottom of the foot. It runs from the heel bone to the toes and forms the arch of your foot.
Plantar fasciitis is one of the most common causes of heel pain. It is most often seen in middle-aged men and women, but may also occur in those who are constantly on their fee.
What are the Causes of Plantar Fasciitis?
The plantar fascia functions as a shock absorber and supports the arch of your foot. Excessive pressure over the fascia may strain and tear the tissue, causing heel pain. Repeated overstretching or overuse causes irritation or inflammation of the fascia.
Other risk factors may include:
- Foot arch problems such as flat feet or high arches
- Activities such as long-distance running, ballet and dance aerobics
- Occupations that necessitate walking or standing on hard surfaces for a long period
- Wearing thin-soled shoes or shoes with poor arch support
What are the Symptoms of Plantar Fasciitis?
The symptoms of plantar fasciitis are:
- Pain on the bottom of the heel
- Pain in the arch of the foot
- Pain that is usually worse upon arising
- Pain that increases over a period of months
- Swelling at the bottom of the heel
People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.
How is Plantar Fasciitis Diagnosed?
Your doctor will examine your foot for signs of flatfoot or high arch, tenderness, swelling, redness, stiffness or tightness of your foot arch. Your doctor may suggest an X-ray or MRI scan to rule out other causes of heel pain such as a stress fracture or pinched nerve.
What are the Treatment Options for Plantar Fasciitis?
Most often, you are effectively treated with the following measures:
- Medications: Your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) or inject corticosteroids directly into the plantar fascia to reduce the pain and inflammation.
- Rest: Reduce or avoid the activities that worsen the pain.
- Ice: Apply ice packs over a towel on the painful area at least twice a day for 10 to 15 minutes for the first few days.
- Night splints: You may be prescribed night splints to stretch the plantar fascia and allow it to heal.
- Supportive shoes and orthotics: Your doctor may recommend shoes with good support and cushioning. Custom orthotics (shoe inserts) may also be helpful.
- Physical therapy: Your physical therapist may design an exercise program that focuses on stretching your plantar fascia and Achilles tendon, and strengthening the muscles of the lower leg. In addition to exercises, application of athletic tape to support the bottom of your foot may also help relieve symptoms.
- Extracorporeal shock wave therapy: During this procedure, sound waves are targeted on to the painful area to stimulate the healing process.
- Surgery: Occasionally, surgery may be suggested to release the tight plantar fascia.
When is surgery needed for Plantar Fasciitis?
Although most patients with plantar fasciitis respond to nonsurgical treatment, a small percentage of patients may require surgery. If, after several months of nonsurgical treatment, you continue to have heel pain, surgery will be considered.
Doctors Performing Foot & Ankle
Sara E. Suttle, D.P.M.Foot & Ankle
Elliott N. Wityk, D.P.M.Foot & Ankle