In this section Cypress Foot and Ankle specialist Dr. Christopher Correa discusses plantar fasciitis sometimes known as heel spurs or "stone bruise". Plantar fasciitis is a condition that causes pain in the bottom of the heel during weight bearing and is one of the more common conditions seen in foot and ankle offices. While not all sources of plantar heel pain are plantar fasciitis, it is by far the most common cause of pain in the plantar heel.
Diagnosing Plantar fasciitis
Symptoms for plantar fasciitis are typically characterized by sharp, stabbing, aching pain at the bottom of the heel which is worse with the first step out of bed in the morning or after prolonged periods of rest. Typically, symptoms improve after stretching out or “walking off” the pain but may not completely get rid of it. While the pain is often times located at the inside (medial) portion of the heel it can be located anything on the plantar surface. Many patients report that throughout the day their symptoms are tolerable but the longer they are on their feet the worse the symptoms become by then end of the day. The purpose of the plantar fascia is to support the plantar arch of the foot and assist in restoring the height of the arch when toeing off during the gait cycle. As such the purpose of the band is to stretch (elastically) and store kinetic energy to be expended at a later portion during the gait cycle to help with recreation of the arch and provide for a smoother, more energy efficient gait cycle. When excess stress it put on the ligament inflammation and pain begin. The symptoms of plantar fasciitis are due to increased inflammation of the medial band of the plantar fascia from over activity, increased stretching or load on the medial plantar fascial band stems from a tight calf muscle, lack of arch support, or internal degeneration of the plantar ligament from prolonged stress. The plantar fascia is made up of three bands (medial, central, and lateral) which originate from the base of the heel and fan out along the plantar surface of the foot superficial to the musculature.
Treatment for Plantar Fasciitis
In the vast majority of cases plantar fasciitis resolves with conservative treatments such as direct massage, calf stretching and stretching of the plantar fascia with a soup can or water bottle, P.R.I.C.E., non-steroidal anti-inflammatory medication (Aleve, Ibuprofen), and arch supports. It is important to discuss with your doctor what types of shoes you are wearing most of the time and what kind of work/activities you are doing to get a full picture of what may be aggravating the plantar fascia. Your doctor may also recommend a steroid injection into the heel to jump start the healing process and reduce the inflammation faster. If conservative treatments do not alleviate the pain, then an MRI may be necessary to rule out other diagnoses. As a last resort a partial plantar fascia release, a minor procedure where 1/3-1/2 of the plantar fascia is cut, is high effective. If you or someone you know is suffering from plantar heel pain, give the experts at Select Foot and Ankle specialists a call and take the first step towards recovery today!
