Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of Heel Pain
and is sometimes called a heel spur. Plantar fasciitis is the correct
term to use when there is active inflammation. Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead. Acute plantar fasciitis is defined as inflammation of
the origin of the plantar fascia and fascial structures around the area. Plantar fasciitis or fasciosis is usually just on one side. In about 30 per cent of all cases, both feet are affected. This
guide will help you understand how plantar fasciitis develops, how the condition causes problems, what can be done for your pain.
Achilles tendon rupture, the tendon of the heel cord behind the ankle is torn. Bone bruise. Bone cyst, a solitary fluid-filled cyst (cavity) in a bone. Gout, levels of uric acid in the blood rise
until the level becomes excessive (hyperuricemia), causing urate crystals to build up around the joints. This causes inflammation and severe pain when a gout attack happens. Neuroma (Morton's
neuroma) a swollen nerve in the ball of the foot, commonly between the base of the second and third toes. Osteomyelitis , osteomyelitis means infection of the bone or bone marrow; inflammation of the
bone due to infection. Osteomyelitis sometimes occurs as a complication of injury or surgery. In some cases, the infection may get into bone tissue from the bloodstream. Patients with osteomyelitis
typically experience deep pain and muscle spasms in the inflammation area, as well as fever. Peripheral neuropathy, neuropathy is a collection of disorders that occurs when nerves of the peripheral
nervous system (the part of the nervous system outside of the brain and spinal cord) are damaged. The condition is generally referred to as peripheral neuropathy, and it is most commonly due to
damage to nerve axons. Neuropathy usually causes pain and numbness in the hands and feet. It can result from traumatic injuries, infections, metabolic disorders and exposure to toxins. One of the
most common causes of neuropathy is diabetes. Problems with your gait, wrong posture when walking/running. Rheumatoid arthritis, rheumatoid arthritis, sometimes referred to as rheumatoid disease, is
a chronic (long lasting), progressive and disabling auto-immune disease condition that causes inflammation and pain in the joints, the tissue around the joints, and other organs in the human body.
Rheumatoid arthritis usually affects the joints in the hands and feet first, but any joint may become affected. Patients with rheumatoid arthritis commonly have stiff joints and feel generally unwell
Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the
morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.
The diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished
from these conditions. Pain can be referred to the heel and foot from other areas of the body such as the low back, hip, knee, and/or ankle. Special tests to challenge these areas are performed to
help confirm the problem is truly coming from the plantar fascia. An X-ray may be ordered to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to
cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation.
Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter's syndrome, or ankylosing spondylitis. These are
diseases that affect the entire body but may show up at first as pain in the heel.
Non Surgical Treatment
If the plantar fasciitis is acute, that is, a sprain of the plantar fascia then it is basically treated as a sprain, with anti-inflammatory drugs, ice, rest, possibly physical therapy. If chronic,
the poor foot mechanics need be addressed. Foot mechanics are changed by use of specially moulded shoe inserts known as orthotics. Someone with plantar fasciitis needs an orthotic designed to relieve
strain on the plantar fascia. Orthotics are often confused with arch supports. Arch supports, by holding up the arch can remove some of the tension from the plantar fascia. Orthotics, on the other
hand, do most of their work on the heel and ball of the foot repositioning the foot for maximized function. What can you do before you see the foot doctor? First, try doing your own version of deep
tissue massage by rolling a frozen cola bottle or can from the heel forward into the arch. Do it gently. Do stretching but the key to good stretching is not to stretch too hard so generally avoid
weight bearing (standing) stretches but sit on a soft surface like your bed and pull the foot backward on the leg as far as it will go, holding for 20 seconds and relaxing for 5 seconds. Each 25
second ?set? can be repeated 5 times and you have invested about 2 minutes in giving yourself a lot of help. Watch out for the shoes you wear. It is tempting to obtain shoes that are colorful and
soft. Here is the proof that soft shoes are bad. Wrap a pillow around your foot with duct tape and walk for a block or two. You will come back with your foot hurting more because your foot sank down
deeper into the soft surface, allowing the ligament to stretch more. The shoes should be stiff in the shank and flexible at the ball. Such shoes, to running buffs, are known as motion control shoes
or stability shoes so going to one of the small specialty running shoes stores is a good place to start. If you don?t have a desk job, or have an industrial job see if light duty is available. A note
from your doc may be all that is required in most cases and most doctors are happy to oblige.
At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not
only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct
your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues.
Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.
Make sure you wear appropriate supportive shoes. Don't over-train in sports. Make sure you warm up, cool down and undertake an exercise regime that helps maintain flexibility. Manage your weight,
obesity is a factor in causing plantar fasciitis. Avoid walking and running on hard surfaces if you are prone to pain. You should follow the recognized management protocol "RICED" rest, ice,
compression, elevation and diagnosis. Rest, keep off the injured ankle as much as possible. Ice, applied for 20 minutes at a time every hour as long as swelling persists. Compression, support the
ankle and foot with a firmly (not tightly) wrapped elastic bandage. Elevation, keep foot above heart level to minimize bruising and swelling. Diagnosis. Consult a medical professional (such as a
Podiatrist or doctor) especially if you are worried about the injury, or if the pain or swelling gets worse. If the pain or swelling has not gone down significantly within 48 hours, also seek
treatment. An accurate diagnosis is essential for proper rehabilitation of moderate to severe injuries.