What is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia which is a layer of dense connective tissue that begins on the heel bone (calcaneus) and attaches to the base of each of the toes. Occasionally, an x-ray will demonstrate a heel spur. It is, however, generally becoming accepted that the spurs themselves are not painful and that it is the inflammation in the plantar fascia that causes the symptoms by overload of the fascia. Tight calf muscles and high arched or flat feet are common attributable factors.
What are the symptoms?
Pain in the heel whilst weight bearing is the main presenting symptom. First few steps out of bed in the morning causing pain in the heel is characteristic.
What are the treatment options?
Treatment of plantar fasciitis is almost always non surgical which is effective in
85-90% of cases
- Reduce weight if overweight
- Application of ice to the sore area for 20 minutes three or four times a day
- Orthoses or soft cushioned insoles
- Anti-inflammatory medication
- Night splint or positional splint when you sleep
- A program of home exercises to stretch your Achilles tendon and plantar
- Mainstay of treating the condition and lessening the chance of recurrence
- Injection of a mixture of steroid and local anaesthetic into the heel is effective
Extracorporeal Shockwave Therapy
This is proved to have 60-70% improvement in 3-5 weeks.
Surgery is often an option of last resort. It involves releasing the fascia and the nerves at its attachment to the heal bone.