Plantar Fasciitis is surprisingly common in patients of all ages, foot types, body weights and occupations. The plantar fascia is a strong piece of soft tissue that is made up of three connected bands (medial, central and lateral bands) of soft tissue that runs from the bottom of the heel along the underside of your foot and into each of the toes. Plantar fasciitis occurs when there is inflammation, irritation and mechanical strain of the plantar fascial band as it inserts into the heel bone (calcaneus). The typical presentation of plantar fasciitis is that when you first wake up in the morning and when you step down, the heel hurts so badly that you have to hobble or limp. As you continue to walk, the plantar fascia will get stretched out and ‘warms up’ and then the pain improves. Usually, every time you sit down for any length of time and have to stand up and walk again — the process repeats itself.
However, not all heel pain is plantar fasciitis. Many other conditions can mimic plantar fasciitis, including:
*Calcaneal Stress Fracture (stress fracture of the heel bone)
*Partial or complete tear of the Plantar Fascia
*Radiculopathy (pinched nerve in the spine) causing burning pain in the heel
*Foot Fractures / Broken Bones
*Tarsal Tunnel Syndrome
*Achilles Tendonitis
*Nerve Entrapment of the Medial Calcaneal Nerve
*Calcaneal Cyst
*Soft Tissue Mass (Benign or Malignant)
*Rheumatoid Arthritis
*Psoriatic Arthritis
*Injury to the Fat Pad
*Bone Malignancy
*Gout
*Flexor Tendonitis or Tear
*Effects of long-term Compensation (limping) caused by another underlying foot, ankle, knee, hip or lower back issue.
Making basic shoe changes should significantly help with the pain caused by plantar fasciitis. However, if the heel pain is not quickly resolving, I highly recommend that you follow up with your local podiatrist for an office consult and x-rays. There are many excellent conservative, non-surgical treatments for plantar fasciitis, including physical therapy, orthotics, stretching, icing, elevation, topical pain relievers, NSAIDS and rest.
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