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Plantar Fasciitis - a Common Foot Complaint

Plantar Fasciitis is the most common cause of heel and foot pain, being diagnosed as the cause in 80% of cases where moderate to severe heel pain is reported. It is most common amongst people aged between 40 and 60 and certain lifestyle factors play a major role in both the cause and treatment of symptoms. It is also reported to be more common amongst females than males, although the reason for this has not yet been established. Physicians will question patients on during which activities or times of the day the symptoms appear; as people with Plantar Fasciitis tend to experience the most pain in the morning just after getting out of bed or after prolonged periods of rest. You will find more info on diagnosis, causes and treatments later on in this article.

What is Plantar Fasciitis?

Plantar Fasciitis is a condition that causes a sharp, dull or burning pain primarily in the heel of the foot but, has been reported to extend to the arch or ball of the foot in some cases. This pain is popularly known to be caused by the swelling of the plantar fascia ligament, but new research suggests that it may be a result of the partial structural breakdown of this ligament which connects the heel of the foot to the toes. This structural breakdown is believed to be caused by repetitive strain and micro-traumas of the plantar fascia.

Risk Factors

Certain lifestyle factors may cause increased susceptibility for developing this condition but can also be cause by naturally present irregularities such as an inequality between the length of the left and right leg, high arches or flat feet and excessive pronation (inward rolling feet).

Apart from the naturally occurring causes mentioned, people who spend more than 6 hours a day on their feet (particularly on flat surfaces), athletes and obese or inactive individuals are at a higher risk for developing Plantar Fasciitis. Susceptibility also increases with age and with the wearing of improper-fitting shoes.

Diagnosis

Plantar Fasciitis is typically diagnosed by considering the medical history of the patient as well as questioning the patient regarding where and when pain is felt. Finally a medical examination will be preformed where the doctor will view the arch of the foot, observe the patient walking and finally observe whether there is limitation in dorsiflexion.

Dorsiflexion refers to the ability of the foot to flex or bend upwards towards the shin and many patients with Plantar Fasciitis will have limited dorsiflexion due to stiff or tight calf muscles and Achilles Tendons. If a serious underlying cause is suspected, an x-ray or MRI will be required to rule out the possibility of a fracture or tumor.

Treatment

Plantar Fasciitis is usually treated by nonsurgical methods and most patients will see a major or complete reduction of symptoms within 3-6 months of treatment. It is even reported that symptoms may cease completely even without treatment after a year. Most patients respond well to anti-inflammatory drugs such as ibuprofen and will also be advised to perform daily heel pain exercises to stretch tight calves or Achilles tendons. Recommended exercises include those that stretch and strengthen the toes, calves and plantar fascia. Placing a tennis ball or cylindrical object under the foot and rolling it back and forth can loosen the plantar fascia and reduce pain substantially. Self and professional massages are also a good option to try especially for those who have been advised to limit all types of physical activity to allow the foot to heal. It is important to note that these exercises require active consistency over a long period of time to produce significant results.

Another treatment that is known to be highly effective is the use of Footlogics or custom orthotic devices, which support the arch of the foot, provide comfort and distribute pressure while absorbing shock. They are very popular amongst people who suffer from Plantar Fasciitis because they produce great results and can be used as a long-term solution, unlike medications and injections. Night splints which serve to keep the foot flexed upwards thereby stretching the calf muscle and arch of the foot are also a popular and effective treatment that is safe for long-term use.

Obese patients will be advised to lose some weight to reduce the strain placed on their feet and athletes will be advised to rest and use ice-packs to reduce swelling and pain. For more severe pain corticosteroid injections may be administered, but these are short-term solutions and have no proven, lasting effects.

Plantar Fasciitis which does not respond to the above mentioned treatments may be considered for a surgical procedure such as a Plantar Fasciotomy which is commonly accompanied by plantar nerve release. This procedure will only be used if all other forms of treatments have been unsuccessful over a period exceeding 6 months and side effects and risks are present.

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