plantar fascitis

What is plantar fascitis?

Plantar fasciitis or “heel spur pain” is the most common cause of pain under the heel.  Most patients complain of the pain when they first get out of bed in the morning or when they stand up after being seated. Once they are up and moving around for a while, the pain usually improves.  The pain is usually located at the center of the heel, but can also extend into the arch.
Plantar fasciitis is caused by small tears in the ligament along the bottom of the foot called the plantar fascia.  Only 50% of patients have an actual bone spur underneath the heel bone, and this is NOT believed to be the cause of the pain.

What causes plantar fascitis?

There has been no definite cause found for plantar fascitis. Repetitive stress to the heel such as jumping or sudden increased running may contribute to it. Women are also more likely to get this condition than men. Being overweight is also thought to contribute to this condition. The average age of patients who develop it is 45 years.

How is this condition diagnosed?

Your consultant will examine your foot clinically and this usually makes the diagnosis clear.

Can the condition worsen?

This is a condition which normally runs its course and can take up to two years to gradually settle down.

What treatment options are there?

It is extremely unlikely that any surgery will be required for this condition and the main treatment options are non surgical.

These are:

Physiotherapy and stretching exercises
This needs to be done on a daily basis for a long period of time for it to be effective. More information on the specific exercises is found under ‘exercise regimes’ on this website.

Footwear modification
The use of a silicone gel heel cushion used as an insole is extremely useful.

Night splints are also useful.

Steroid Injections
These are not very useful and care needs to be taken when being given an injection, as it can cause tears to the plantar fascia. This is only used very sparingly when other treatment options have failed.

Is surgery necessary?

Surgery is the last option as the results are not very predictable. It involves releasing the lining of the muscle of your calf. This is rarely necessary.