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.
Factors which may contribute to plantar fasciitis and heel spurs include a sudden increase in daily activities, increase in weight, or a change of shoes or allowing your current shoes to wear
excessively. Shoes that are too flexible in the middle of the arch or shoes that bend before the toe joints will cause an increase in tension in the plantar fascia. Make sure your shoes are not
excessively worn and that they do not bend in the "middle of the arch".
Pain tends to start gradually, often just in the heel, but it can sometimes be felt along the whole of the plantar fascia. The symptoms are initially worse in the morning and mostly after, rather
than during, activity. As the condition becomes worse, the symptoms become more persistent.
Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past.
The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to
use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.
Non Surgical Treatment
Careful attention to footwear is critical. Every effort should be made to wear comfortable shoes with proper arch support, fostering proper foot posture. Should arch supports prove insufficient, an
orthotic shoe should be considered. Fortunately, most cases of plantar fasciitis respond well to non-operative treatment. Recovery times however vary enormously from one athlete to another, depending
on age, overall health and physical condition as well as severity of injury. A broad period between 6 weeks and 6 months is usually sufficient for proper healing. Additionally, the mode of treatment
must be flexible depending on the details of a particular athleteâs injury. Methods that prove successful in one patient, may not improve the injury in another. Early treatment typically includes
the use of anti-inflammatory medication, icing, stretching activities, and heel inserts and splints. Cortisone injections may be necessary to achieve satisfactory healing and retard inflammation. In
later stages of the rehabilitation process, typically after the first week, ice should be discontinued and replaced with heat and massage.
Most practitioners agree that treatment for plantar fasciitis is a slow process. Most cases resolve within a year. If these more conservative measures don't provide relief after this time, your
doctor may suggest other treatment. In such cases, or if your heel pain is truly debilitating and interfering with normal activity, your doctor may discuss surgical options with you. The most common
surgery for plantar fasciitis is called a plantar fascia release and involves releasing a portion of the plantar fascia from the heel bone. A plantar fascia release can be performed through a regular
incision or as endoscopic surgery, where a tiny incision allows a miniature scope to be inserted and surgery to be performed. About one in 20 patients with plantar fasciitis will need surgery. As
with any surgery, there is still some chance that you will continue to have pain afterwards.