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Plantar fasciitis is the most common cause of heel pain in America. More than 2 million patients are treated for this condition every year.
The plantar fascia is the strong band of tissue that radiates from the heel bone towards the front of the foot. You can easily feel it on the bottom of your arch.
Plantar fasciitis is caused by small tears or strains which occur in the ligament. These tears can be caused by a traumatic injury (such as landing on the foot), over-using the area, taking up a new activity (such as jogging), or starting a new job that involves spending a lot of time on your feet. People with very high arches and those who are overweight are also more susceptible to plantar fasciitis.
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The most common symptom of plantar fasciitis is pain on the bottom of the foot near the heel. The pain is usually worse in the morning when you first get out of bed, or when you stand up after sitting for a long period of time, such as after a long car ride.
The problem is usually evaluated with direct examination of the foot. Your physical will look for pain directly in the plantar, or bottom of the heel, along the inside that radiates towards the toes. Evaluation of the problem may also require X-rays or even MRI scans on occasion to rule out other possible causes.
The majority of the time plantar fasciitis is treated non-operatively. More than 90 percent of patients will get better within six to ten months after starting simple treatment methods. The most common treatment for plantar fasciitis is stretching—this includes the calf, the Achilles tendon, and the plantar fascia. Your physician may also prescribe icing, nonsteroidal anti-inflammatory medications, and arch supports or lifts in shoes. Rarely, your physician may recommend cortisone injections or the use of night splints to stretch the fascia as you sleep. Physical therapy may also be necessary to help reduce inflammation around the plantar fascia.
If surgery is necessary, the surgeon will most likely perform a procedure called a plantar fascial release. Surgery is usually only considered if symptoms are non-responsive to more conservative treatments. Recovery after plantar fascia surgery requires a period of immobilization to let the area heal followed by a course of physical therapy. The majority of the time the symptoms do resolve after about three months.
Dr. Jason Rudolph is an orthopedic surgeon at Coordinated Health who specializes in foot and ankle procedures.