If your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis, an overuse injury that affects the sole of the foot. A diagnosis of
plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.
Plantar fasciitis can be confused with a condition called tarsal tunnel syndrome. In tarsal tunnel syndrome, an important nerve in the foot, the tibial nerve, is trapped and pinched as it passes
through the tarsal tunnel, a condition analogous to carpal tunnel syndrome in the wrist. This may cause symptoms similar to the pain of a plantar fasciitis. There are also other less common problems
such as nerve entrapments, stress fractures, and fat pad necrosis, all of which can cause foot pain. Finally, several rheumatologic conditions can cause heel pain. These syndromes such as Reiter's
syndrome and ankylosing spondylitis can cause heel pain similar to plantar fasciitis. If your symptoms are not typical for plantar fasciitis, or if your symptoms do not resolve with treatment, your
doctor will consider these possible diagnoses.
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other
medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience âFirst stepâ pain (stone bruise
sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.
A health care professional will ask you whether you have the classic symptoms of first-step pain and about your activities, including whether you recently have intensified your training or changed
your exercise pattern. Your doctor often can diagnose plantar fasciitis based on your history and symptoms, together with a physical examination. If the diagnosis is in doubt, your doctor may order a
foot X-ray, bone scan or nerve conduction studies to rule out another condition, such as a stress fracture or nerve problem.
Non Surgical Treatment
Night splints are treatment that can help stretch your calf and the arch of your foot. Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and
Achilles tendon overnight. This can prevent morning pain and stiffness. Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and can
prevent further damage to the plantar fascia. A boot cast may be used to immobilize your foot and reduce strain while the plantar fascia heals. A boot cast looks like a ski boot and can be removed
Most studies indicate that 95% of those afflicted with plantar fasciitis are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don't improve
with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and
relieve the inflammation of the ligament. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. While the success rate is very high following surgery,
one should be aware that there is often a prolonged postoperative period of discomfort similar to the discomfort experienced prior to surgery. This pain usually will abate within 2-3 months. One
should always be sure to understand all the risks associated with any surgery they are considering.
While there are no sure ways to prevent plantar fasciitis, these prevention tips may be helpful. Keep your weight under reasonable control. Wear comfortable, supportive shoes. Use care when starting
or intensifying exercise programmes.