Affecting two million Americans each year and 10% of the U.S. population over a lifetime, plantar fasciitis is the most common cause of heel pain. The condition causes pain in the heel at the first step in the morning, and can manifest itself in various ways: as a bruise-like feeling, a sharp shooting pain, or a dull ache. Patients with plantar fasciitis may find it difficult to flex the foot upward, toward the shin, as the plantar fascia becomes tense and restricts mobility.
Plantar fasciitis is caused by the inflammation of the plantar fascia, a long, thick connective tissue supporting the arch on the bottom of the foot. Microscopic tears occur at the connection of the plantar fascia with the heel bone (calcaneus), leading to pain, inflammation, and the development of bone spurs and osteoarthritis. The condition commonly occurs in patients with high body mass index, as it is associated with long periods of weight bearing.
For athletic individuals, plantar fasciitis is commonly caused by improper footwear that fails to support the foot during repetitive motions. As a runner takes strides against pavement, each step can cause trauma to the foot and the plantar fascia. Patients with a workplace that requires standing for prolonged periods of time are at risk of developing the condition as well. This risk is heightened by excess weight, which puts additional strain on the weight-bearing structures.
Plantar fasciitis can become debilitating when intense foot pain in the morning limits a patient's mobility. The condition is progressive and worsens over time. Additionally, plantar fasciitis can cause an increased occurrence of knee pain, particularly among athletic individuals.
Plantar fasciitis is typically diagnosed upon clinical examination, in which a podiatrist, such as Dr. Weaver, will check a patient's feet, stance, and walking gait. Patient's medical history, physical activity, and foot pain symptoms will be taken into account as well. Additionally, imaging tests (X-rays, MRI, ultrasound) may be ordered to make a definitive diagnosis. Imaging tests may reveal the existence of a heel spur, a bony overgrowth caused by plantar fasciitis.
Plantar fasciitis is best treated conservatively, through the use of night splints, orthotics, weight loss, and physical therapy. In most cases, these conservative options can provide temporary relief that allows the patient to successfully manage pain and symptoms. Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can relieve pain and inflammation, and corticosteroid injections directly into the heel, can sometimes provide permanent relief.
Foot surgery for plantar fasciitis is typically performed as a last resort, when conservative treatments fail to eliminate pain. Plantar fascia release, a surgery that involves cutting part of the plantar fascia to relieve tension and inflammation, often leads to complications affecting the foot's natural arch.
It is best to speak to an experienced podiatrist, such as Dr. Jamie Weaver of the Joint Replacement Institute, who can best evaluate the patient's foot condition and determine a suitable treatment option. Dr. Weaver believes in taking the time to educate patients on diagnoses, treatment options, and realistic expectations. Dr. Weaver is licensed with the American Board of Podiatric Surgery and is affiliated with the Bonita Springs Community Health and Surgery Center. To speak with Dr. Weaver, schedule an appointment at the Joint Replacement Institute's Bonita Springs office.