Plantar Fasciitis

The plantar fascia is a long, thin tissue present along the bottom of the foot that supports the arch of the foot. Plantar fasciitis is a condition where the plantar fascia becomes inflamed from stretching or overuse, causing pain in the heel and bottom of the foot. It can occur in one or both feet due to excessive standing and is one of the most common orthopedic complaints.

Causes

Repeated strain can result in tiny tears in the plantar fascia, leading to pain and swelling, which can make walking difficult.

Symptoms

The major complaint associated with plantar fasciitis is pain and stiffness in the heel and foot. The pain associated with this condition becomes more intense:

• In the morning when you step out of bed
• Walking after sitting or standing for some time
• Climbing stairs
• After exercise

Treatment

Treatment involves conservative measures to resolve the condition. Conservative treatment measures include:

Rest: Rest is the first step that is considered for reducing pain and preventing further damage to the ligament.

Ice: Rolling your foot over ice can be very effective in reducing swelling, and is recommended for 20 minutes, 3-4 times a day

Medications:NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed for relief of pain and inflammation

Exercise:calf stretches and plantar fascia stretches are effective in relieving pain

Night splints may be suggested by your doctor to help stretch the plantar fascia while sleeping

Physical therapy may be recommended for instruction on stretching exercises, massage and ice treatments

Surgery

Surgical treatment is considered only if conservative therapy does not provide effective relief after 12 months. There are two surgeries your surgeon may perform and will depend on your particular condition.

Gastrocnemius recession- Tight calf muscles or gastrocnemius muscles can stress the plantar fascia. To release this stress, your surgeon will surgically lengthen the calf muscle.

Plantar fascia release- Your surgeon will partially cut the plantar fascia to relieve the tension. The surgery can be performed endoscopically.

Risks and Complications

Complications are rare following surgery to treat plantar fasciitis, but as with any surgical procedure, they can occur.  Some complications include:

• Infection
• Nerve Damage
• Unresolved Pain