The plantar fascia is a very strong, tough band of tissue that extends along the length of the bottom of the foot, providing support for the arch while also facilitating normal movement and flexibility in the foot. In plantar fasciitis, this band becomes irritated and inflamed, and tiny tears can form along the length of the band, causing pain primarily in the heel and along the side of the foot.
Most often, plantar fasciitis occurs in people with anatomical or structural problems with their feet, including flat feet or “fallen” or very high arches. The condition can also be caused by obesity, wearing shoes that don’t provide proper support, and spending long periods of time standing.
Symptoms can range from mild to severe and can include:
Symptoms often feel worse when standing or walking after a period of rest and immobility (like when getting up after a night’s sleep), and may lessen as the foot is moved and the plantar fascia “warms up.” However, after another period of rest, the symptoms will return.
Prior to treatment, the foot will be carefully evaluated to determine the cause of pain. During the initial evaluation, the patient’s medical history and their symptoms will be carefully reviewed, and active and passive range-of-motion exercises may be used to help isolate the cause of pain. X-rays may also be ordered to rule out other conditions that may cause similar symptoms. Once plantar fasciitis is diagnosed, treatment usually begins with conservative options like:
If symptoms don’t resolve using these conservative approaches, corticosteroid injections may be recommended to relieve inflammation and pain or a removable walking cast may be prescribed. In a few cases, patients may continue to experience painful symptoms even after months of treatment. In those instances, surgery may be recommended to reposition the plantar fascia, remove heel spurs or address other underlying issues.
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