HEEL PAIN | PLANTAR FASCIITIS
Plantar Fasciitis is defined as inflammation of the plantar fascia due to microtrauma over a long period of time. The most tender spot tends to be on the bottom of the heel (medial tubercle of the calcaneus, where the medial band of the plantar fascia originates). Sometimes pain may also occur in the central or lateral band of the fascia. Often patients complain of severe heel pain which gets worse during the first steps in the morning or after long periods of walking.
Risk factors for this pathology include flat feet that lead to overpronation and abnormal gait, high arches that cause the plantar fascia to shorten and tighten and limb length discrepancies. If these risk factors are not addressed, plantar fasciitis will not resolve and may worsen over time. Other risk factors include prolonged standing due to occupation and obesity.
It is important to visit a foot specialist in the area to receive the proper diagnosis of plantar fasciitis. Some other common differentials for heel pain include plantar fascia rupture, retrocalcaneal bursitis and fat pad atrophy.
Risk factors for this pathology include flat feet that lead to overpronation and abnormal gait, high arches that cause the plantar fascia to shorten and tighten and limb length discrepancies. If these risk factors are not addressed, plantar fasciitis will not resolve and may worsen over time. Other risk factors include prolonged standing due to occupation and obesity.
It is important to visit a foot specialist in the area to receive the proper diagnosis of plantar fasciitis. Some other common differentials for heel pain include plantar fascia rupture, retrocalcaneal bursitis and fat pad atrophy.
TREATMENT
Chiropodists at the Royal City Foot Clinic will examine your foot for swelling, redness, and tenderness of the area. A full biomechanical and gait analysis will be performed. Conservative treatment options may include ice, rest, anti-inflammatory medication (NSAIDs), taping and strapping, stretching exercises, or custom footwear and orthotics. The vast majority of cases will resolve with conservative care. That being said, if plantar fasciitis does not resolve there are more invasive techniques which can be performed at the Royal City Foot clinic such as corticosteroid injections or surgery. The most common surgical procedures for plantar fasciitis include needling or plantar fascia release.
Treatment can span from a matter of weeks to several months and may involve a number of management approaches. Patients should be advised that "guaranteed" or "fast fixes" by unregulated persons or non-foot-specialists will often not work for lasting relief. We work with you to find the best management plan for your foot type using evidence based medicine.
Treatment can span from a matter of weeks to several months and may involve a number of management approaches. Patients should be advised that "guaranteed" or "fast fixes" by unregulated persons or non-foot-specialists will often not work for lasting relief. We work with you to find the best management plan for your foot type using evidence based medicine.
WITHOUT TREATMENT
Without treatment plantar fasciitis will most often not improve. The main biomechanical and gait problems must be addressed to reduce pain and prevent future reoccurrence of the injury. Predisposing factors should be considered to rid the pain and inflammation of the tissue. Pain can become so debilitating that individuals may stop exercising, may require time off work, or completely refrain from activities they love. Eventually permanent damage to the plantar fascia and surrounding tissue can occur.
