Foot & Ankle Pain | Plantar Fasciitis - Orthopaedics SA

Plantar Fasciitis

Plantar fasciitis is a common foot problem. It starts as a dull intermittent pain in the heel that may progress to a sharp persistent pain.

Classically, it is worse in the morning or after a period of rest when taking the first few steps. It may also be apparent when commencing a sporting activity.

The plantar fascia is a thick broad band of fibrous tissue on the bottom (plantar surface) of the foot. It is attached to the heel bone (calcaneus) and fans out to attach to the metatarsal bones in the ball of the foot. It is responsible for maintaining the arch of the foot. The problem usually occurs when the part of this inflexible fascia is pulled away from the heel bone. This causes an inflammation and pain.

As the fascia pulls away from the bone, the body reacts by fillings the space with new bone, which causes a classic ‘heel spur’.

Plantar fasciitis starts as a dull intermittent pain in the heel that may progress to a sharp persistent pain. Classically, it is worse in the morning or after a period of rest when taking the first few steps. It may also be apparent when commencing a sporting activity.

Plantar fasciitis is more common in females and increases with age. Significant increase in weight can also be a factor. Plantar fasciitis is more common in runners and those with poor feet biometrics.

Diagnosis is made based on the history of injury and physical examination. In addition, the surgeon may order X-ray, ultra sound or MRI.

Based on the cause and severity, the recommended treatment for plantar fasciitis usually involves a combination of:

  • Rest
  • Ice
  • Stretching program
  • Heel pads
  • Physiotherapy
  • Weight loss
  • Medication
  • Cortisone
  •  Shock wave therapy
  • Night splints
  • Surgery – which in some cases can now be done with keyhole techniques

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