Plantar fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia—a thick band of tissue running along the bottom of the foot from the heel to the toes—becomes inflamed or irritated. This structure helps support the arch of the foot and absorbs shock with each step. When the plantar fascia is overstretched or overloaded, small tears can develop, leading to pain and stiffness in the heel and arch.
What is Plantar Fasciitis?
Causes and Risk Factors
- Tight calf muscles or Achilles tendon: Reduced flexibility in the lower leg can cause additional stress on the plantar fascia.
- Foot structure: Flat feet, high arches, or abnormal walking patterns can increase strain on the plantar fascia.
- Overuse or repetitive stress: Activities that place excessive stress on the heel, such as running, dancing, or prolonged standing, can lead to inflammation.
- Poor footwear: Shoes with inadequate arch support, cushioning, or a poor fit can exacerbate the condition.
Symptoms
- Sharp heel pain: Especially noticeable with the first steps in the morning or after periods of rest.
- Pain that decreases with activity: Symptoms often improve as the foot warms up but can return after prolonged standing or intense activity.
- Tenderness and stiffness: Along the bottom of the foot, near the heel.
Diagnosis
A diagnosis of plantar fasciitis is typically based on a detailed medical history and a thorough physical examination. Key elements of the diagnostic process include:
- Identifying hallmark symptoms: Heel pain that is worst in the morning or after rest.
- Physical examination: Pressing on the plantar fascia and assessing flexibility, foot structure, and gait.
- Imaging studies: X-rays or ultrasound may be used to rule out other causes of heel pain, such as fractures or heel spurs.
Treatment for Plantar Fascia Pain
Most cases of plantar fasciitis improve with conservative care. Treatment options include:
- Rest and activity modification: Reducing activities that aggravate symptoms.
- Stretching and strengthening exercises: Targeted stretches for the calf muscles and plantar fascia help relieve tension.
- Orthotic devices: Custom or over-the-counter orthotics provide arch support and cushioning.
- Proper footwear: Shoes with good arch support and shock absorption.
- Night splints: Wearing night splints keeps the foot in a stretched position.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
- Injections: Corticosteroid or platelet-rich plasma (PRP) injections may be recommended for persistent pain.
- For severe or persistent cases, advanced treatments may be necessary. Minimally invasive surgery to release the plantar fascia or address underlying issues may be considered.
Plantar fascia release surgery
Plantar fascia release surgery is a procedure designed to relieve chronic heel pain caused by plantar fasciitis that has not responded to conservative treatments. During the surgery, a small incision is made to partially release the tight plantar fascia, reducing tension and allowing for improved mobility and pain relief. This can be performed using an open or minimally invasive approach. In some cases, additional procedures, such as removing bone spurs or addressing nerve compression, may be performed at the same time. After surgery, most patients wear a boot or supportive shoe for a few weeks and gradually return to normal activities. Physical therapy and stretching exercises help promote healing and prevent recurrence. Plantar fascia release is generally considered when all other treatments, such as orthotics, injections, and physical therapy, have failed. With proper recovery, most patients experience significant improvement in their pain and a return to an active lifestyle.
Bone Spurs and Bone Spur Removal
A bone spur is a bony growth that can develop on the heel bone (calcaneus), often as a response to chronic inflammation or excessive stress on the foot. Heel spurs frequently occur in patients with long-term plantar fasciitis and may contribute to ongoing heel pain. While many bone spurs do not cause symptoms, in some cases, they can irritate surrounding soft tissues and lead to persistent discomfort. If a bone spur is identified during plantar fascia release surgery and is contributing to pain, it can be removed at the same time. The procedure involves carefully shaving down or excising the excess bone to relieve pressure and irritation. Bone spur removal is typically performed alongside plantar fascia release when necessary, ensuring comprehensive treatment of heel pain. Recovery from bone spur removal is similar to that of plantar fascia release, with gradual return to normal activities. Most patients experience significant pain relief, especially when combined with proper rehabilitation, supportive footwear, and stretching exercises to prevent recurrence.
Why Choose Us for Plantar Fasciitis Treatment
Plantar fasciitis can severely affect quality of life. Dr. Cates specializes in comprehensive care for plantar fasciitis, tailoring treatment to meet the unique needs of each patient. As a board-certified, fellowship-trained foot and ankle surgeon, Dr. Cates offers expertise in both non-surgical and advanced surgical solutions. With extensive experience in cutting-edge treatments, including minimally invasive procedures and PRP therapy, our patients benefit from personalized care and excellent outcomes. We focus on restoring function, relieving pain, and helping patients return to their active lifestyles as quickly as possible.
