Plantar Fasciitis, Plantar Fascia Pain, Heel Pain
Plantar fasciitis (“plarn-tar fashy-eye-tiss”) is one of the most common musculoskeletal conditions affecting the feet. If you wake up one morning, put your foot down and suffer a sudden, agonizing pain in your heel, a really sharp pain, then you’ve got plantar fasciitis.
Typically the pain of plantar fasciitis is very sharp and located on the sole of the foot under the middle of the heel. The problem can be associated with a heel spur, a bony outgrowth under the heel where the plantar (sole) ligament inserts.
What Happens In Plantar Fasciitis?
Plantar fasciitis is thought to be the result of increased stretching stresses on the plantar fascia/ligament where it inserts into the heel spur area. The repeated pulling stresses can cause multiple micro-traumas to the insertion area, resulting in chronic inflammation of the region.
Repeated damage and inflammation in this area can cause acute pain, especially with the first steps after getting up from a chair or from bed.
Problems Caused By Plantar Fasciitis
In bad cases people can have worsening and quite disabling pain in the heel part of the sole, causing a limp and restricting functional activities such as running and walking.
How Plantar Fasciitis Pain Behaves
An unexpected, very sharp and unpleasant pain in the heel is the first thing most people know about getting plantar fasciitis. This is the main symptom. The pain is worst during the first few steps after getting up from resting such as sitting or sleeping, then eases to a repeated, but less severe pain on walking.
Taking weight off the foot is the only relieving factor for the symptoms and people can be worse at the end of the day if they are on their feet a lot. A new activity taken up such as running or a change in typical footwear can be risk factors for developing plantar fasciitis.
Investigations For Plantar Fasciitis
There are no diagnostic or especially useful investigations for plantar fasciitis. X-rays of the foot, particularly from the side, may show the heel spur resulting from this condition. In some cases bone scans and CT scans may be used but these would be specific requests from an orthopaedic specialist.
Treatment For Plantar Fasciitis
Physiotherapy is the main treatment for this condition.
Medical And Surgical Treatments
Surgery is rarely necessary but the plantar fascia can be released from its insertion under the heel bone, similar to the operation to release tennis elbow.