Heel pain and Plantar fasciitis
What is Plantar Fasciitis?
The name of the condition refers most commonly to an inflammation of the plantar fascia.Plantar fasciitis is a condition caused by degeneration of the plantar fascia which can happen with or without inflammation.
The plantar fascia is a strong band of connective tissue which is responsible for maintaining the arch profile of the foot. The typical presentation of plantar fasciitis is pain in the heel area which is often the most painful during the first few steps in the morning or after periods of rest, and ease off with walking / gentle exercise. More extreme cases can lead to extreme pain whilst walking.
Plantar fasciitis can be diagnosed in clinic by experienced podiatrists without any requirement for further examinations. However, sometimes imaging can also be used to confirm the diagnosis or rule out other differential diagnoses. Differential diagnoses of plantar fasciitis include fat pad atrophy, Achilles tendinitis, heel contusion, posterior tibial tendonitis, and Sever’s disease (in adolescents).
Treatment options for plantar fasciitis symptoms normally include RICE therapy (Rest, Ice, Compression, and Elevation), stretching exercises, change of footwear, strapping, NSAIDs (anti-inflammatory medications), low level laser therapy, and therapeutic ultrasound therapy. In some severe cases, steroid injection may be considered, and if all else fails occasionally surgery may be required although this is very rare.
The above treatment options mostly concentrate on treating the existing symptoms of plantar fasciitis. However, they might not be able to address the possible underlying cause of plantar fasciitis which is poor feet and lower limb mechanics. Functional insoles to improve the mechanics of the feet and lower limbs should also be considered as a long term treatment plan to assist improvements of the symptoms and prevent reoccurrence of the condition.
Some likely causes:
- Stretching the long band of tissue that connects the heel and the ball of the foot.
- Muscle imbalance
- Bone deformity
- Obesity
- Trauma
- Tightness of the muscles on the back of the leg
What we can do
- Prescribe orthotics
- Perform a physical examination
- Perform taping and strapping
- Prescribe orthotics
- Administer injections
- Instruct in appropriate exercise