Heel Spur/ Plantar Fasciitis


 

What is Plantar Fasciitis?

  • Plantar fasciitis is a common condition affecting the ligament (plantar fascia) that supports the arch of the foot.  
  • The ligament attaches to the bottom of the heel and courses at the bottom of the foot(the arch) and connects to the ball of the foot.  
  • When the ligament becomes strained, the area where it attaches to the heel becomes inflamed and causes pain. 

What are the causes of Plantar Fasciitis?

  • The most common cause of pain on the bottom of the heel stems from tight muscles in the calf. 
  • Other contributing factors include flat feet, obesity, and excessive walking and standing.  
  • An associated heel spur may sometimes cause pain on the bottom of the heel, but most commonly it is not a contributing factor.  
  • The spur develops from progressive strain on the plantar fascia, which pulls at the area where the ligament attaches, thus resulting in the formation of a heel spur.  

What are the symptoms ?

  • Patients complain of pain directly on the bottom of the heel, or in the arches. 
  • The pain may be dull and mild or severe and sharp.  In severe cases, patients may not be able to put weight on the heel at all.  
  • Most common symptom is pain in the morning or with the first step after periods of rest or inactivity(post-static dykenesia).

Non surgical treatments

  • Custom foot and ankle orthotics- A custom foot orthotic is a doctor prescribed arch support that is made directly from a mold of your feet, which can aid in realigning the foot to a proper position to prevent the stretch of the plantar fascia. 
  •  Physical Therapy - therapy is aimed at stretching the tight posterior muscle group, which extends its fibers to the plantar fascia and causes tightness in the plantar fascia as well 
  • Immobilization - Taping the foot and ankle in proper position, may take the strain off the plantar fascia and lead to relief of symptoms and allow for transition into foot/ankle orthosis. 
  • Anti-inflammatory medications - these medications fight the inflammatory process which causes pain within joints or tendons. When combined with other conservative options, it can aid in the resolution of pain. 

Corticosteroid injections -  A cortisone injection is a powerful anti-inflammatory medication that is used to rapidly reduce the pain associated with inflammation.  Cortisone shots can be extremely effective in alleviating symptoms.

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