Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of Heel Pain
and is sometimes called a
heel spur. Plantar fasciitis is the correct term to use when there is active inflammation. Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead. Acute
plantar fasciitis is defined as inflammation of the origin of the plantar fascia and fascial structures around the area. Plantar fasciitis or fasciosis is usually just on one side. In about 30 per
cent of all cases, both feet are affected. This guide will help you understand how plantar fasciitis develops, how the condition causes problems, what can be done for your pain.
If you have pain behind your heel, you may have inflamed the area where the Achilles tendon inserts into the heel bone (retrocalcaneal bursitis). People often get this by running too much or wearing
shoes that rub or cut into the back of the heel. Pain behind the heel may build slowly over time, causing the skin to thicken, become red and swell. You might develop a bump on the back of your heel
that feels tender and warm to the touch. The pain might flare up when you first start an activity after resting. It often hurts too much to wear normal shoes. You may need an X-ray to see if you also
have a bone spur.
Usually worse with the first few steps in the morning or at the initial point of activity. The latter usually gets better with continued activity (squeaky hinge analogy). Walking, running, sprinting,
hill running and jumping will increase the pain. Often, the natural response is to walk on the outside of the foot - in supination - to lessen the stress on the plantar fascia - resulting in new
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric
long-term solution to his problem.
Non Surgical Treatment
Recommended treatments, heel Spurs: cushioning for the heel is of little value. Your chiropodist/podiatrist may initially apply padding and strapping to alter the direction of stretch of the
ligament. This is often successful at reducing the tenderness in the short term. Your chiropodist/podiatrist may suggest a course of deep heat therapy to stimulate the healing processes, allowing
damage to respond and heal faster. In the long term, your chiropodist/podiatrist may prescribe special insoles (orthoses) to help the feet to function more effectively, thereby reducing strain on the
ligaments and making any recurrence less likely. If pain from heel spurs continues, you may be referred to your GP who can prescribe an oral non-steroidal anti-inflammatory. Alternatively, localised
hydrocortisone injection treatment may be given by your GP or an appropriate chiropodist/podiatrist. If pain persists, surgery may be considered. Heel Bursitis: in most cases, attention to the cause
of any rubbing, and appropriate padding and strapping by your chiropodist/podiatrist will allow the inflammation to settle. If infection is present, your chiropodist/podiatrist will refer you to your
GP for antibiotics. Heel Bumps: adjustments to footwear is often enough to make them comfortable. A leather heel counter and wearing boots may help. However, if pain persists, surgery may be
At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not
only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct
your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues.
Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.
Wear properly fitting shoes. Place insoles or inserts in your shoes to help control abnormal foot motion. Maintain a healthy weight. Exercise and do foot stretches as they have been shown to decrease
the incidence of heel pain.