Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band
of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects
the heel to the front of your foot, and supports the arch of your foot.
There are multiple potential causes and contributing factors to plantar fasciitis heel pain. The structure of a personâs foot and the way that they walk or run usually play a significant role in
the development of plantar fasciitis. Those with an arch that is lower or higher than the average person are more likely to be afflicted. Overexertion and/or participating in activities that a person
is not accustomed to also place a person at risk. This can include a heavy workout, a job change, or even an extended shopping trip. Additionally, inappropriate shoes are also often a factor.
Exercising in shoes that are worn out or donât have enough support and/or wearing inexpensive, flimsy or flat-soled dress or casual shoes are common culprits. In warm climates, such as here in
Southern California, people who wear flip-flop sandals or even go barefoot throughout the year increase their chances of developing heel pain. Many athletes and weekend warriors develop heel or arch
pain from over-exertion during running or other sports. People who work at jobs that involve long periods of standing, such as grocery checkers, cashiers, warehouse workers, postal workers, and
teachers are more susceptible as well. Adults of all ages can develop plantar fasciitis. Heel pain in children is usually caused by a different type of condition.
Plantar fasciitis commonly causes a stabbing pain in the heel of the foot, which is worse during the first few steps of the day after awakening. As you continue to walk on the affected foot, the pain
gradually lessens. Usually, only one foot is affected, but it can occur in both feet simultaneously.
Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about your past health, including what illnesses or injuries you have had. Your symptoms, such as
where the pain is and what time of day your foot hurts most. How active you are and what types of physical activity you do. Your doctor may take an X-ray of your foot if he or she suspects a problem
with the bones of your foot, such as a stress fracture.
Non Surgical Treatment
A change to properly fitting, appropriate shoes may be useful in some patients. Some individuals wear shoes that are too small, which can exacerbate many types of foot pain. Patients often find that
wearing shoes with thicker, well-cushioned midsoles, usually made of a material like high-density ethylene vinyl acetate (such as is found in many running shoes), decreases the pain associated with
long periods of walking or standing. Studies have shown that with age, running shoes lose a significant portion of their shock absorption. Thus, simply getting a new pair of shoes may be helpful in
decreasing pain. For individuals with flat feet, motion control shoes or shoes with better longitudinal arch support may decrease the pain associated with long periods of walking or standing. Motion
control shoes usually have the following characteristics: a straight last, board or combination lasted construction, an external heel counter, a wider flare and extra medial support. A change in
shoes was cited by 14 percent of patients with plantar fasciitis as the treatment that worked best for them.
Most studies indicate that 95% of those afflicted with plantar fasciitis are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don't improve
with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and
relieve the inflammation of the ligament. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. While the success rate is very high following surgery,
one should be aware that there is often a prolonged postoperative period of discomfort similar to the discomfort experienced prior to surgery. This pain usually will abate within 2-3 months. One
should always be sure to understand all the risks associated with any surgery they are considering.