The plantar fascia is a strong band of tissue, like an elastic band, that runs underneath the bones of the foot. It attaches at one end to the heel bone and at the other near the toes. Plantar fasciitis is an inflammation (swelling) of plantar fascia. It causes foot pain.
The cause is damage to the plantar fascia. The stress of walking around, running, and being on the feet for long periods can strain and injure the fascia. Wearing shoes with poor cushioning or no arch support increases the risk of plantar fasciitis. Pain results. About half of people with this condition also have a bone spur attached to the heel bone, but the spur itself doesn’t cause pain.
Symptoms include sharp or dull, achy pain in the bottom of the heel. This pain is usually worse during first steps after getting up in the morning or getting up after a rest. Pain usually gets better with walking. In the more severe condition, pain may occur all the time during walking. Sometimes pain spreads from the heel toward the toes, and the heel becomes swollen or bruised.
The health care provider makes a diagnosis from the symptoms and a foot examination. Other tests, including x-rays of the foot, bone scan, and magnetic resonance imaging (MRI), may also be done if the diagnosis is unclear and other diseases are suspected.
Stress on the heel may be reduced by not standing for long periods and by resting the foot. Losing weight will also decrease stress on the heel and lessen pain. Painkillers such as acetaminophen and antiinflammatory medicine may help milder symptoms.
If these measures don’t work, referral to an orthopedic physician, physiotherapist or podiatrist may be needed. A physiotherapist can teach simple stretching exercises or massage, which are good for a tight Achilles tendon. The physiotherapist may also tape the heel and arch of the foot. A podiatrist can measure the feet for insoles. Insoles can improve problems caused by high arches or flat feet or may just be shock absorbers for the heel.
A night splint can help continuing pain by resting the foot and stopping the Achilles tendon from tightening overnight. Anti-inflammatory steroid injections into the painful heel may also help. Lasting pain may need other treatments such as a plaster cast over the foot and ankle, transcutaneous nerve stimulation (TENS), and acupuncture.
Surgery is for severe pain that remains. Surgery involves relieving tension of the plantar fascia by detaching it from the heel bone.
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