Plantar fasciitis is a poorly understood condition. There is little consensus among medical professionals about what causes the problem, and no treatments have been reliably proven to treat it. A
number of theories exists for why plantar fasciitis develops, but the ineffectiveness of conventional treatments suggests something is missing. The plantar fascia is a band of connective tissue that
runs along the underside of the foot from the heel to the toes. The fascia helps maintain the integrity of the arch, provides shock absorption, and plays an important role in the normal mechanical
function of the foot.
The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is
inflammation, which results in the heel pain and stiffness of plantar fasciitis.
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But
your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as
arthritis, or a nerve problem such as tarsal tunnel syndrome.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Treatment for plantar fasciitis includes medication, physical therapy, shock wave therapy, or surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are used to treat
the inflammation and pain of plantar fasciitis, but they wonât cure the condition. Corticosteroids can also be used to ease pain and reduce inflammation. Corticosteroids are applied either as a
topical solution in conjunction with a non-painful electric current or through injections to the affected area.
In very rare cases plantar fascia surgery is suggested, as a last resort. In this case the surgeon makes an incision into the ligament, partially cutting the plantar fascia to release it. If a heel
spur is present, the surgeon will remove it. Plantar Fasciitis surgery should always be considered the last resort when all the conventional treatment methods have failed to succeed. Endoscopic
plantar fasciotomy (EPF) is a form of surgery whereby two incisions are made around the heel and the ligament is being detached from the heel bone allowing the new ligament to develop in the same
place. In some cases the surgeon may decide to remove the heel spur itself, if present. Just like any type of surgery, Plantar Fascia surgery comes with certain risks and side effects. For example,
the arch of the foot may drop and become weak. Wearing an arch support after surgery is therefore recommended. Heel spur surgeries may also do some damage to veins and arteries of your foot that
allow blood supply in the area. This will increase the time of recovery.
The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. Take care of your feet. Wear shoes with good arch support and heel
cushioning. If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet. Do exercises to stretch the Achilles tendon at the back of the heel. This
is especially important before sports, but it is helpful for non-athletes as well. Ask your doctor about recommendations for a stretching routine. Stay at a healthy weight for your height. Establish
good exercise habits. Increase your exercise levels gradually, and wear supportive shoes. If you run, alternate running with other sports that will not cause heel pain. Put on supportive shoes as
soon as you get out of bed. Going barefoot or wearing slippers puts stress on your feet. If you feel that work activities caused your heel pain, ask your human resources department for information
about different ways of doing your job that will not make your heel pain worse. If you are involved in sports, you may want to consult a sports training specialist for training and conditioning
programs to prevent plantar fasciitis from recurring.