What is plantar fasciitis?

Heel pain in adults can be due to many different conditions, but by far the most common one is a condition known as plantar fasciitis. The pain from this typically occurs under the heel and the classic symptom is that the pain is worse when getting out of bed first thing in the morning for those first few steps. After those initial steps the pain does ease somewhat, but gets worse again as the day goes on. The plantar fascia is a long ligament under the bottom of the foot that is responsible for supporting the arch of the foot, so plantar fasciitis is caused by there being too much load on the arch of the foot. The main risk factors for this are tight calf muscles, being overweight and having higher levels of activity. Foot biomechanical problems that increases the load in the plantar fascia are also a factor in increasing the load.

The initial approach to plantar fasciitis is pain relief with the use of ice after activity and maybe the use of anti-inflammatory and pain relief medication. Strapping can also be used in the short term to help with the pain. Foot orthotics can be used to reduce the strain on the arch of the foot and correct any biomechanical problems that maybe a factor in caused. It is important to stretch the calf muscles as that is a big risk factor. Night splints can also be used to help with that stretching if needed. Strengthening the muscles that also support the arch can also be of great benefit as they take some load if the plantar fascia. Over the long term, weight loss is important as this really does create a lot of load in the foot. If these approaches are not working to well, then it is time to try things like shockwave therapy or corticosteroid injections. A final resort would be surgical treatment.

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