Plantar fasciitis is an inflammatory process localized to the plantar fascia, and it is one of the most frequent causes of so-called “leg pain.” It affects about 2 million Americans annually, with approximately 10% of the population developing the condition as some point during their lifetime.
The plantar fascia is a band of fibrous tissue that originates at the heel and extends up to the five toes (the metatarsal bones). It is one of the structures that provides resistance of the foot as it is the medial longitudinal arch support of the plant (foot). When the foot arch is flattening out, the fascia is stretched and absorbs the impact force when the heel contacts the ground. The plantar fascia is not very flexible; therefore, after repeated shocks, small breaks or tears can occur.
Who is at Risk?
Plantar fasciitis appears most commonly after the age of 40. It is more common in women, being influenced by changes in body weight (obesity, pregnancy), but it also may be correlated with body mass index (BMI). It most often occurs in people who by profession sit down too long or walk for too long: teachers, waiters, military, police, postman, dancers and even athletes (especially those who run long distance).
There are several factors that can lead to plantar fasciitis, such as:
- Flat feet – or the opposite – too high of an arch
- Orientation to the inside of the foot during walking
- Excessive pronation
- Inappropriate footwear – high heels or shoes that do not provide arch support (sole too thin)
- Running on the heels or on soft surfaces (sand)
- Inflammatory trauma (rheumatoid arthritis, ankylosing spondylitis, lupus, reactive arthritis, psoriatic arthritis, etc.)
- Hereditary factors
The Clinical Picture – Signs and Symptoms
Plantar fasciitis is manifested by sharp pain in the heel, usually at 4 cm below the heel or sole of the foot and median. The pain is intense in the morning or at other times when you are taking the first steps after resting. It can get worse when you start walking or do activities such as running. Typically, it only affects one foot and does not appear at night.
The plantar fasciitis stretching site can be painful, and in runners there is increased likelihood of knee pain. 70% of plantar fasciitis patients may experience the development of bone growths, or a “spur” on the heel, which is often considered responsible for painful symptoms. In fact, chronic plantar fasciitis can lead to the calcaneus “spur” and its surgical removal does not ease symptoms because the true cause of the pain is actually in the fascia.
Diagnosis and Treatment
Usually clinical diagnosis is required. Patient examination includes inspection and palpation of the plant, and observing the leg while standing and during walking. After examination the doctor will decide if you need additional tests.
Plantar fasciitis treatment is complex and long lasting, and includes hygienic-dietary treatment, physical therapy, massage, and physiotherapy All of these treatment options are offered at our office. If conservative therapy does not give the desired results, the alternative is to intervene surgically. This should only be done as a last resort, because the risk of complications is relatively high.
It is important to keep in mind that everyone’s body is different. The only sure way to understand the cause of your pain is to visit a highly qualified doctor. Dr. Mohr has treated numerous patients with this condition, and he will help to assess your symptoms and bring you relief as quickly as possible.