Plantar Fasciitis is the most common form of heel pain that we treat. “Plantar” means the bottom of the foot; “fascia” is a type of connective tissue, and “itis” means “inflammation”.
With the latest technology and treatments for plantar fasciitis we are rapidly approaching an impressive 95-97% success rate of treating this cause of heel pain non-surgical. This page provides information about our most current and successful treatments for plantar fasciitis.
Symptoms of Plantar Fasciitis: Patients describe the symptoms of plantar fasciitis as a burning, stabbing or aching pain in the heel. This is most noticeable in the morning when first rising from bed or after periods of rest. When patients with this condition take their first steps in the morning they will often limp for a period before the pain subsides. However, the pain will return either later in the day or again the next morning.
Do you experience heel pain when getting out of bed in the morning?
Pain experienced with the first few steps in the morning is often a symptom of plantar fasciitis. This is very common for people suffering from plantar fasciitis and can easily be alleviated. Failure to address plantar fasciitis can lead to the formation of painful heel spurs.
Plantar fasciitis is not the only cause of morning stiffness or heel pain but it is one of the most common. Another possible cause of heel pain in the morning is the presence of a heel spur. There are many reasons for morning heel pain and morning stiffness, however, one of the most common is attributed to microscopic tearing of the plantar fascia which causes the pain when you initially takes their first steps after a night of rest. If the strain on this ligament continues, the body responds by producing more bone in the area, which is the creation of a heel spur.
When you are sleeping the tension is reduced on the plantar fascia and Achilles tendon. The fascia has a chance to begin the process of repair during rest. When you step out of bed in the morning, the inflammatory cycle is initiated and pain is experienced. Typically, the pain begins to subside with more walking. However, it usually returns again towards the end of the day, when standing after sitting and always returns again overnight. Stretching of the Achilles complex and plantar fascia can often greatly reduce this pain.
Causes of Plantar Fasciitis: This condition is caused by reoccurring injuries to the large connective tissue that attaches at the toes and the heel. This connective tissue is prone to injury from repetitive or excessive stress. The result of this kind of stress in this area of the foot is minuscule tears in the plantar fascia.
This condition can also be a result of the actual mechanics of the foot. Conditions such as flat feet, high arches, pronation, or having an abnormal gait (walking pattern, or how the foot contacts the ground), can cause overuse of the fascia. If overused or stretched abnormally this will result in tears and inflammation.
Treatment: Treatment should focus on from types of treatment and rarely requires surgery. 97% of patients that develop plantar fasciitis respond well to non-surgical care. Plantar fasciitis is a reoccurring injury that can be prevented. Some individuals, based on their unique foot structure, are more susceptible to plantar fasciitis. Every patient has a unique foot structure and depending upon the severity of plantar fasciitis, they will require different non-surgical treatment protocols.
- Cortisone Injections: An injection for plantar fasciitis is most effective between the plantar fascia and the fat pad on the bottom of the foot. Injections may take two to three days before the cortisone injection is effective. This is because the cortisone has a longer acting component in a crystalline form and will take time after the injection to become usable by the body. Pain from plantar fasciitis will likely still be noticeable during this time and could possibly be magnified until the cortisone is absorbed. However, once the cortisone has passed this period, there is a dramatic reduction in pain and inflammation.
- Custom Orthotics: Prescription custom orthotics available at our office often provide the best relief and immediately begin to address any bio-mechanical issues that may have contributed to the cause of the pain by supporting the arch and plantar fascia.
- Night Splints and/or Stretching: Theses are used to lengthen the Achilles tendon and proximal muscles.
- Non-steroidal Anti-inflammatory Drugs: An example is ibuprofen.
- Surgery: Surgery should be the patients last option after exhausting all conservative options over a period of 6-9 months.
Regardless of the treatment, identifying the cause will allow the doctors to properly identify the best treatment protocol and incorporate treatments that will prevent future heel pain.
Before considering surgery, get an opinion from us. We have seen hundreds of people and have prevented them from having surgery.