Plantar fasciitis, << PLAN tuhr fash ee EYE tuhs, >> is one of the most common causes of heel pain . It occurs when the plantar fascia becomes inflamed . The plantar fascia is a flat band of tough tissue that extends along the bottom of the foot . It helps make up and support the foot’s arch. The sharp or shooting pain of plantar fasciitis is usually felt at the bottom of the heel. It is most painful during the first few steps after rest.
Causes.
Plantar fasciitis can occur at any age and in one foot or both feet. People who have feet that flatten when standing or walking may experience plantar fasciitis more often. The flattening increases stress and strain on the plantar fascia. People who have arches that are too high may also suffer from the condition.
Stress and strain can produce small tears in the plantar fascia during walking or standing. The tears usually occur near the heel bone and result in inflammation, swelling, and pain. Activities that can cause plantar fasciitis include standing for long periods, especially on hard surfaces, and walking and running . Excess body weight and poorly fitting shoes also contribute to plantar fasciitis.
Treatment
of plantar fasciitis begins with identification of the condition. Doctors may use ultrasound (high frequency sound waves) to measure the thickness of the plantar fascia near the heel bone. Patients with the condition usually have a plantar fascia thickness greater than 1/6 inch (4 millimeters).
Pain can be relieved through conservative treatment, including rest, the application of ice packs, and anti-inflammatory medications. Patients may also be instructed to stretch the Achilles tendon, calf muscles, and plantar fascia before getting out of bed to reduce the pain upon standing. The Achilles tendon is the large tendon at the back of the ankle . In addition to pain relief, stretching helps reduce the stress and strain placed on the plantar fascia. Patients may wear a night splint that helps to stretch the plantar fascia during sleep.
Pressure on the plantar fascia may be relieved through weight loss , well-fitting shoes, or shoe inserts called orthotics. Doctors may inject drugs called corti costeroids to alleviate the inflammation and pain.
Most patients obtain relief from conservative treatment. But some patients continue to experience pain. For these patients, doctors may perform a surgical treatment called plantar fascia release surgery, or plantar fasciotomy. This surgery involves cutting a small portion of the plantar fascia where it attaches to the heel bone. The cutting releases tension and reduces inflammation and pain.
