Plantar Fasciitis

Heel pain caused by plantar fasciitis – sometimes called heel spur syndrome

At least one in 10 of our patients come to us for relief of heel pain. For many people, getting out of bed and putting your foot down will cause a shooting pain in the heel of your foot.  Heel pain, an inflammation of a thick band of tissue that connects the heel bone to the toes, can start as a minor annoyance that people suffer with for months before seeing a foot and ankle specialist and having it correctly identified as plantar fasciitis.

What causes plantar fasciitis?

There are a number of factors that contribute to the development of plantar fasciitis:

• Faulty foot structure: For example, people who have problems with their arches, either flat feet or high-arched feet and are prone to developing plantar fasciitis.
• Non-supportive footwear: Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. 
• Overweight or overworked feet: Obesity and overuse  through high impact activity such as running or sports may also contribute to plantar fasciitis.
• Tight calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
  
  

The importance of a correct diagnosis

At Frankel Foot & Ankle, we will first obtain your medical history and thoroughly examine your foot. Through a steady process, Dr. Marc Frankel will eliminate all possible causes for your heel pain other than plantar fasciitis. Diagnostic imaging studies, such as x-rays or other imaging modalities, may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome. Once a clear diagnosis is achieved, Dr. Frankel will discuss your treatment options.

Nonsurgical treatment

Caring for plantar fasciitis includes these treatments you can begin at home:

• Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
• Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
• Ice. Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
• Limit activities. Cut down on extended physical activities to give your heel a rest.
• Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
• Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
  
  

If you still have pain after several weeks, return to Frankel Foot & Ankle where we may add the following treatments:

• Padding, taping and strapping. Placing pads in the shoe softens the impact of walking. Taping and strapping helps support the foot and reduce strain on the fascia.
• Orthotic devices. Custom orthotic devices that fit into your shoe can help correct the underlying structural abnormalities causing the plantar fasciitis.
• Injection therapy. In some cases, corticosteroid injections are used to help reduce inflammation and relieve pain.
• Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.
• Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
• Physical therapy. Exercises and other physical therapy measures may be used to help provide relief.
  
  

When Is surgery needed?

Although most patients with plantar fasciitis respond to nonsurgical treatment, a small percentage may require surgery. If, after several months of nonsurgical treatment, you continue to have heel pain, surgery will be considered. Dr. Marc Frankel is a highly experienced foot and ankle surgeon who can discuss the surgical options with you and determine which approach would be most beneficial for you.

Long-term prevention

No matter what kind of treatment you receive for plantar fasciitis, the underlying causes that led to this condition may remain. Keep on top of your symptoms with these preventive measures: 

• Wear supportive shoes
• Stretch and exercise your feet
• Use custom orthotic devices