Plantar fasciitis is a painful condition of the foot. It is hallmarked by heel pain and pain on the bottom of the foot. Patients often report having pain when they first step out of bed in the morning and after periods of sitting and rest. The pain with walking often improves after a few minutes of movement but will worsen with prolonged standing and walking. Pain is often worse in the evening after a day of walking around. Plantar fasciitis can often occur in both feet at the same time. It can be associated with tight calf muscles, decreased ankle dorsiflexion, abnormally high arches or flat feet.
What causes it?
It is caused by structural changes in the plantar fascia where it inserts on the calcaneus (heel). The role of this area to sto support the arch of the foot by acting as a shock absorber when walking and running. While this tissue can become inflamed, it can also thicken and degenerate. Risk factors include age, obesity, nerve entrapment (Baxter’s nerve), and overuse (runners).
Diagnosis and Treatment
Diagnosis can usually be made with a history and physical exam but sometimes imaging can be appropriate to rule out unusual differentials like bone spurs, stress fractures, or other less common conditions. For the same reason, laboratory tests may be indicated to rule out endocrine or inflammatory conditions.
90% of plantar fasciitis patients can be treated conservatively, without surgery. Treatment typically includes patient education and activity modification. Orthotics can be very helpful in relieving sypmtoms, especially in the first 6 weeks. Initial treatment should include manual therapy and joint manipulation coupled with therapeutic exercise tp resolve the condition. Activity modification will likely be necessary as well. Secondary treatments can include injections, extracorporeal shockwave therapy, and therapeutic laser.
Are you struggling with plantar fasciitis in Charlottesville? Give us a call to see if we can help (434)293-3800