What is Plantar Fasciitis or Heel Spur Syndrome?
Plantar means the bottom or sole of the foot. The plantar fascia is a strong, thick, ligament like band of tissue in the arch of the foot. It attaches to the bottom of the heel bone(calcaneus) and extends forward toward the toes. The fascia could be compared to a bow string. You can think of it as your own built in arch support. Too much tension in the fascia results in pain and inflammation usually on the bottom of the heel, but sometimes further out in the arch. Inflammation of the plantar fascia is called plantar fasciitis. It is sometimes associated with a heel spur seen on x-rays, called heel spur syndrome. The spur is not necessarily the cause of pain but a result of the process. Often an individual may have a large heel spur seen on x-ray but is not having pain there. So, seeing a bone spur on x-ray doesn’t necessarily mean it’s causing pain.
CAUSES of PLANTAR FASCIITIS
- Studies show that obesity is the number one cause currently. Simply put, the more weight a person carries, the more stress it places on the tendons, joints, and ligaments of the feet, ankles and legs.
- Flat feet(pes planus) and high arched feet(pes cavus) place more tension on the fascia and make it more prone to irritation.
- Unsupportive shoe wear, walking barefoot a lot, or standing on hard surfaces like concrete for extended periods of time.
- Overuse injuries in athletes performing high impact activities such as running and jumping.
- Loss of flexibility of the plantar fascia with age.
- Often times the condition occurs for no clear reason. About 1% of Americans suffer from this condition each year. That’s more than 3 million people per year! It is one of the most common reasons people visit a podiatrist.
- There are many other causes for heel pain which can include bursitis, nerve entrapments, arthritic conditions, or stress fractures.
SYMPTOMS
Plantar fasciitis is usually most painful upon standing up out of bed in the morning or after sitting for a period of time and standing up again. Many describe the pain as a sharp or bruised feeling on the bottom of the heel though symptoms may vary. Pain may also increase during long periods of standing or activity.
Often the problem may seem improved only to return a short time later. It is not unusual for the problem to continue for many months, especially without treatment. Sometimes it can happen in both heels at once. For some people it can become chronic, lasting years, and occurring sporadically off and on.
TREATMENT
We have many treatment options available for this condition. Conservative treatment for fasciitis is usually very successful though improvement can take longer than expected, especially if the problem has been present a long time. Icing, stretching, and rest can be a good starting point. Wearing supportive shoes, with or without off the shelf arch supports, or even custom inserts, called orthotics, can be very beneficial. Occasionally, if the pain is severe, a well-placed steroid injection may provide some quick relief. Other options may include therapy or a night splint.
For a small percentage of people with plantar fasciitis, conservative treatments are not effective. In those cases we can perform a less invasive surgical procedure, called an endoscopic plantar fasciotomy(EPF). The fascia is visualized with a camera and about 1/3 of it is severed using two small incisions. This has a high success rate and the recovery is much less involved than traditional open surgery. In our experience the spur, if present, rarely needs to be removed.
GET ON THE ROAD TO RECOVERY!
If you are suffering from heel pain or plantar fasciitis please contact us to set up an appointment with our podiatrist – Dr. Davis at our Colorado Springs office to get on the road to recovery.
Plantar Fasciitis Podiatrist
Judd Davis, DPM with A New Step Foot & Ankle Clinics is a compassionate podiatrist (foot and ankle doctor) who helps patients with Plantar Fasciitis (Heel Spurs), foot pain and other foot and ankle ailments. A New Step Foot & Ankle Clinics is located in Colorado Springs, Colorado.