If your first step in the morning often feels like it involves a rusty nail being inserted into your heel, youâre not alone. Heel pain resulting from plantar fasciitis is the most prevalent
condition treated in podiatric clinics, and an additional 1 million Americans annually are seen by medical doctors for the condition, according to the Centers for Disease Control and Prevention. The
plantar fascia is the ligament that runs from the heel bone across the entire bottom of the foot and connects at the base of the toes. Ligaments connect bone to bone, and donât really constrict or
contract, but can become thickened because of inflammation. Inflammation of the plantar fascia can cause strain when you walk, specifically heel pain that is especially bad for the first few steps
after prolonged inactivity. It then typically loosens up once youâre up and about.
Plantar Fasciitis is frequently cited as the number one cause of heel pain. The condition affects both children and adults. Children typically outgrow the problem, but affected adults may experience
recurring symptoms over the course of many months or years. The syndrome afflicts both highly active and sedentary individuals. Typically, Plantar Fasciitis results from a combination of causes,
including, pronation, a condition in which the plantar fascia doesn't transfer weight evenly from the heel to the ball of the foot when you walk. Overuse of the feet without adequate periods of rest.
High arches, flat feet or tightness in the Achilles' tendon at the back of the heel. Obesity. Working conditions that involve long hours spent standing or lifting heavy objects. Worn or ill-fitting
footwear. The normal aging process, which can result in a loss of soft tissue elasticity. Physical trauma to the foot, as in the case of taking a fall or being involved in a car accident.
The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs
right after getting up in the morning and after a period of sitting. If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity,
and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.
Most cases of plantar fasciitis are diagnosed by a health care provider who listens carefully to your description of symptoms. During an examination of your feet, your health care provider will have
to press on the bottom of your feet, the area most likely to be painful in plantar fasciitis. Because the pain of plantar fasciitis has unique characteristics, pain upon rising, improvement after
walking for several minutes, pain produced by pressure applied in a specific location on your foot but not with pressure in other areas, your health care provider will probably feel comfortable
making the diagnosis based on your symptoms and a physical examination. Your health care provider may suggest that you have an X-ray of your foot to verify that there is no stress fracture causing
Non Surgical Treatment
Conservative treatment is almost always successful, given enough time. Traditional treatment often includes, rest, NSAIDs, and new shoes or heel inserts. Some doctors also recommend avoiding walking
bare-footed. This means youâd have to wear your shoes as soon as you wake up. Certain foot and calf exercises are often prescribed to slowly build strength in the ligaments and muscles that support
the arch of the foot. While traditional treatment usually relieves pain, it can last from several months to 2 years before symptoms get better. On average, non-Airrosti patients tend to get better in
about 9 months.
If you consider surgery, your original diagnosis should be confirmed by the surgeon first. In addition, supporting diagnostic evidence (such as nerve-conduction studies) should be gathered to rule
out nerve entrapment, particularly of the first branch of the lateral plantar nerve and the medial plantar nerve. Blood tests should consist of an erythrocyte sedimentation rate (ESR), rheumatoid
factor, human leukocyte antigen B27 (HLA-B27), and uric acid. Itâs important to understand that surgical treatment of bone spurs rarely improves plantar fasciitis pain. And surgery for plantar
fasciitis can cause secondary complications-a troubling condition known as lateral column syndrome.