Plantar fasciitis

VOL 116 / NO 3 / SEPTEMBER 2004 / POSTGRADUATE MEDICINE

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Your heel hurts when you get out of bed and when you get up to walk from the lunchroom to your office. This pain is the hallmark of plantar fasciitis (plan-ter fa-she-eye-tes), a common cause of heel discomfort.

What is plantar fasciitis?
It is an inflammation of the plantar fascia, a band of fibrous tissue that covers the bones on the bottom of the foot from the heel to the toe and supports the arch of the foot. When the plantar fascia is repeatedly stretched during physical activities, it thickens and small tears begin to weaken it. The weakened tissue becomes inflamed and causes a dull ache when it is stretched by walking after tightening while at rest. This stretching may allow calcium, a mineral, to build up on the heel bone, where it may form a heel spur, a usually painless growth.

This condition usually occurs after repeated stretching of the plantar fascia from activities over time. Runners, dancers, and people who have either a tight Achilles tendon (heel cord) or high arches, have rapidly gained a lot of weight, or wear ill-fitting shoes are most at risk.

What are the symptoms?
The pain of plantar fasciitis, which occurs in the heel but can spread to the toes, is usually worse when you take the first few steps of the day or get up after resting.

How is plantar fasciitis treated?
In most cases, no treatment is needed. The condition usually gets better over about 9 months with rest, but recovery can take up to 2 years. In severe cases, a walking cast, corticosteroid injections, surgery, or a new treatment called extracorporeal shock wave therapy may be recommended.

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (for example, Advil and Motrin), can help relieve the pain. Your doctor may recommend gentle stretching exercises or the use of shoe inserts or splints.

Stay away from activities such as running or walking barefoot on hard surfaces. If you do exercise, apply ice to your heel afterward. If you are overweight, losing weight will take a lot of pressure off your feet.

For more information on plantar fasciitis American Academy of Orthopaedic Surgeons 6300 N River Rd Rosemont, IL 60018-4262 800-346-2267 http://orthoinfo.aaol.org/fact/thr_report.cfm?thread_id=144&topcategory=foot MEDLINEplus http://www.nlm.nih.gov/medlineplus/ency/article/007021.shtml

This information is not a substitute for medical treatment.

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