Many patients present to the office with pain in the heels. Most patients describe it as a stabbing sensation that is worse in the morning and usually begins to improve as they walk around. They also state that the symptoms will return if they sit for an extended period of time.
Although I tell most of my patients that all heel pain isn't Plantar Fasciitis, majority of the time, it is. That being said though, when patients present to the office, I still get x-rays to help rule out a fracture, Tarsal Tunnel, or plantar fibromas.
Some patients present to the office with pain in the feet and heels which is originating from the back. So I always try to perform a thorough physical examination.
Q: So what is Plantar Fasciitis?
A: It is pain and inflammation of the Plantar Fascia
Q: What is a plantar fascia?
A: The plantar fascia is a band of ligaments that connects your heel bone to your toes. It helps to support the arch of your foot. If you strain the plantar fascia, it gets weak, swollen, inflamed and irritated. This often leads to pain of your heel bone or the bottom of your foot hurts when you stand or walk.
Q: How did I get this?
A: There are numerous reasons
- You have flat feet which cause the foot to roll inward toward the midline of the body when you walk. This is known as excessive pronation.
- You have high arches
- You are overweight
- Your shoes are worn out or don't fit well
- You spend large periods of time walking, standing or running on hard or uneven surfaces
- Your Achilles tendon or calf muscles are too tight
Q: How can I make this pain better?
A: There are several treatment options that I discuss with my patients
- Stretching with a towel or resistance band or stretching the toes against a hard surface such as a wall several times per day
- A steroid injection. I usually mix this injection with a local anesthetic to reduce pain. The steroid is to reduce inflammation, which also helps to relieve pain as well.
- Referral to physical therapy. There are several modalities that can be used to reduce the painful symptoms of plantar fasciitis and these usually help a lot of people
- Orthotics. The use of orthotics can help reduce the painful symptoms. The must be worn in a pair of good supportive shoes. Unfortunately, flip flops are not the type of shoes that orthotics can be worn in (#1 question asked by patients). The cost of orthotics may not be covered by some insurance plans.
- Surgical management. I tell patients that this is the last resort. It is important to try to exhaust all conservative methods first before undergoing surgery.
Fun fact: There is 2 I's in Fasciitis. Although most people write it with only 1.