Plantar Fasciitis Treatment
Plantar fasciitis (fashee-EYE-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year.
Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.
Heel pain is very common in all age groups. The most common cause in adults is plantar fasciitis. It is believed to be due to inflammation of the attachment of the plantar fascia to the calcaneus or heel bone. The plantar fascia is the thick fibrous covering of the muscles in the arch of the foot that connect the heel to the toes. It typically causes pain in the bottom of the heel which can be mild or severe. It is worse when a person first puts weight on it in the morning or after sitting for a time. It may be painful after standing for long periods. It is frequently associated with heel spurs but is not considered to be due to the spur but inflammation of the muscle and fascia attachment to the heel at the site of the spur. Many patients have spurs without ever having heel pain.
Typically the pain will go away but it can take months or ever over 1 year to resolve. Heel cups are shoe inserts which pad the heel and help take the pain away in some patients. Anti-inflammatory medication may be helpful in some patients. Achilles stretching and strengthening exercises are helpful. Night bracing to hold the foot in the neutral position has been shown to help most patients as well. Injection with corticosteroid locally and casting are reserved for recalcitrant cases. Surgery may be an option in patients that have had pain and treatment for over 6 months. Release of the plantar fascia and decompression of a small nerve that may be entrapped is usually successful in relieving the pain in patients that have not improved with time and nonoperative treatment.
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