Painful Heels/Plantar Fasciitis
A common patient complaint is an intense pain along the bottom inside edge of the heel and arch of the foot. This pain is often described as worse when first placing weight on the foot in the morning or after prolonged periods of sitting or resting. This pain usually decreases after several minutes of standing or walking. It may again intensify after prolonged periods of activity throughout the day. This is characteristic of a condition known as plantar fasciitis.
A popular belief is that only flat-footed people develop plantar fasciitis. However, high arched people are frequently diagnosed with the ailment as well. The most accepted theory as to the actual cause of the syndrome is a lack of normal shock absorption due to mechanical abnormalities in the foot. This creates an abnormal pull on the tendons, ligaments and/or a thick band of tissue on the bottom of the foot called the Plantar Fascia that attaches to the heel which may produce an irritation or inflammation. A bone spur may develop in response to this stress.
Individuals prone to develop plantar fasciitis are commonly overweight and middle-aged, but this is a condition frequently seen in runners and other athletes due to increased loads and stresses with activity. In both situations, some type of structural abnormality in their feet exists. To evaluate the problem, your doctor will thoroughly examine your feet and may obtain x-rays. Occasionally, additional studies such as lab work or specialized tests may be needed.
There are a number of treatments available for plantar fasciitis. These include: taping or padding, injection, oral medication, foot orthotics, activity modification, physical therapy and weight reduction. Surgery is sometimes used as a last resort, and is effective when all conservative measures fail to provide relief. These treatment forms may be used alone or in combination depending on doctor or patient preference. It is important to remember that no one treatment works best and the response to treatment may vary between patients.