Chronic plantar fasciitis is a major health care problem worldwide, affecting nearly 10 percent of the United States. Most commonly affected are athletes that participate in sports that require a lot of running, including: track and field, cross-country, baseball and soccer. However, any active person can be diagnosed with plantar fasciitis.
The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of the foot. It connects the heel to the front of the foot and supports the arch of the foot.
The plantar fascia is designed to absorb high stresses and strains that are placed on the feet. But sometimes, too much pressure damages or tears the tissues. This causes inflammations, which results in heel pain and stiffness.
“One of the most common symptoms of plantar fasciitis is heel pain in the morning that usually gets better throughout the day and then worse again after resting,” said Dr. Mihir Patel, OrthoIndy foot and ankle specialist. “Inflammation at the plantar fascia attachment causes acute and sometimes disabling pain.”
According to Dr. Patel, symptoms may begin in a subtle way and then progress to chronic pain as time goes on due to long standing inflammatory changes.
“At the first consultation concerning plantar fasciitis I will have the patient describe their symptoms and I will examine their foot,” said Dr. Patel. “Sometimes X-rays or other imaging tests are necessary in extreme cases, but not always.”
Nonsurgical treatment options for plantar fasciitis include: rest, painkillers, walking shoe inserts, heel cups, night splints, physical therapy, a walking boot or cortisone injections.
Surgical procedures for plantar fasciitis include open or endoscopic assisted plantar fasciectomies with or without gastrocnemius recession. Gastrocnemius recession is the surgical lengthening of the calf muscles.
“Most patients have good results from surgery,” said Dr. Patel. “However, surgery is not recommended until all nonsurgical measures have been exhausted.”
Presented by OrthoIndy.