Plantar Fasciitis is inflammation of the plantar fascia, the tough connective tissue that makes up the bottom of the foot.
What causes Plantar Fasciitis?
Tightness of the Achilles tendon is the most common cause of plantar fasciitis. Other causes include shoe wear, weight gain, and increased activity. Patients with flat feet or high arches, are also at risk.
What are the symptoms?
Patients complain of pain in the bottom of the foot near the heel. This pain is usually worse in the morning, because the plantar fascia shortens at night. Stepping on the foot lengthens the fascia, causing pain.
How is Plantar Fasciitis diagnosed?
Your surgeon will take a careful history and press on the attachment of the plantar fascia to the calcaneus and along the border of the fascia. This will reproduce pain in a patient with plantar faciitis. X-rays may show a bone spur at the attachment site of the plantar fascia to the calcaneus.
How is it treated?
Non-operativeYour surgeon will identify stretching exercises for the Achilles tendon and plantar fascia. Other treatment will include anti-inflammatory medication, rest, heel cushions, or orthotics. Night splints keep the fascia stretched out while a patient sleeps, preventing pain that occurs in the morning. Physical therapy to stretch tight Achilles tendons should be considered. A cortisone injection can be given into the heel to help reduce inflammation. Care must be taken in administering this injection, as it may cause atrophy of the fat pad. The fat pad protects the calcaneus from injury. Atrophy, or wasting, of the fat pad places the inferior surface of the calcanous just underneath the skin, leading to pain with walking. High frequency ultrasound can be prescribed to stimulate healing as well. Most patients will improve with conservative treatment
OperativeSurgery for plantar fasciitis is seldom indicated, and should be considered only after a patient has failed six months to a year of non-operative treatment. Your surgeon will release the plantar fascia from its attachment, eliminating the patient's pain.
Kevin Lutta, MD, specializes in foot and ankle surgery.