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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 heel 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 heel 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 about your symptoms. Then he or she may feel for damaged
ligaments, inflamed tendons, and displaced bones or 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.
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 help.
To reduce severe
pain and swelling, your podiatric physician may prescribe
pills or injections. 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 temporarily controls movement. Night splints
may also help by stretching the fascia.
Control Movement
If taping helps, your podiatric physician may prescribe orthoses.
Built from plaster casts of your feet, these inserts control the
way your foot 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 is cut to release tension. As you heal, fibrous tissue fills
the space between the heel bone and the plantar fascia.
What Can I Do?
You can’t stay off your feet altogether, but you can reduce
overuse and the risks that come with it. Also, be sure to follow
your podiatric physician’s treatment plan. Take medications
as directed, and wear orthoses if you have them.
Reduce Overuse
Every time your foot strikes the ground, the plantar fascia is stretched.
You can reduce the strain on the plantar fascia and the possibility
of overuse by following these suggestions:
- Lose any excess weight.
- Avoid running on hard or uneven ground.
- Wear shoes that support your arch.
Consultant: Brad L. Naylor, DPM, MS With contributions
by: James R. Black, DPM, PhD, Richard P. Jacoby, DPM, ABPS and Michael
J. Trepal, DPM, FACFAS
This information is not intended as a substitute
for professional health care.
©1995, 1999, 2000 The StayWell Company
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