Plantar Fasciitis

When your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis (fashee-EYE-tiss). It's an overuse injury affecting the sole or plantar surface of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.

You're more likely to get the condition if you're a woman, if you're overweight, or if you have a job that requires a lot of walking or standing on hard surfaces. You're also at risk if you walk or run for exercise, especially if you have tight calf muscles that limit how far you can flex your ankles, or wear shoes that have poor support or are worn-out.

People with very flat feet or very high arches are also more prone to plantar fasciitis.

The condition starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs again after arising from a midday lunch break.

If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis changes the way you walk.

Treatments

• Rest is the first treatment for plantar fasciitis. Try to keep weight off your foot until the inflammation goes away.
• Ice. You can also apply ice to the sore area for 20 minutes three or four times a day to relieve your symptoms.
• NSAIDS. Often a doctor will prescribe non-steroidal anti-inflammatory medication such as ibuprofen.
• Stretching.  A program of home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treating the condition and lessening the chance of recurrence.
• Night splinting.
• Orthotics. You may be advised to use shoes with shock-absorbing soles or fitted with a standard orthotic device like a rubber heel pad.
• Short leg walking cast for 3-4 weeks.

About 90 percent of people with plantar fasciitis improve significantly after two months of initial treatment.

If your plantar fasciitis continues after a period of conservative treatment, a steroid injection under ultrasound may be given. This is very rarely required as there is a risk of causing a rupture of the plantar fascia.

Surgery to release the fascia has been performed but I do not believe in its routine use for treatment of this condition.