Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia, which is the connective tissue on the bottom of the foot. It connects the heel bone to the toes. This is the most common cause of heel pain.

What are the symptoms of plantar fasciitis?

The patient feels sharp, "stepping on glass" pain on the bottom of the foot and on the inside of the heel. It is usually worse first thing in the morning, then decreases as the day goes on.

Who is likely to get plantar fasciitis?

People who are on their feet excessively, are overweight, or pregnant are typical victims. Plantar fasciitis affects people of all ages, but is more common in middle age. Women are more likely to get plantar fasciitis because they more often wear shoes without adequate support.

Plantar fasciitis is common among athletes, including long-distance runners and ballet dancers, and among people who must stand on hard surfaces all day at work, such as nurses.

The foot and ankle physicians frequently diagnose patients with plantar fasciitis. The physicians at Midwest Orthopaedics at Rush treat many professional athletes, including players for the Chicago Bulls and the Chicago White Sox, competitive runners, triathletes and dancers who are on their feet practicing and performing.

What causes plantar fasciitis?

The connective tissue can only take so much pounding before it develops tiny tears. Continuing to overuse the feet or tax them by carrying too much weight does not give the tears time to heal. This condition develops gradually with one or both feet.

How is plantar fasciitis diagnosed?

The foot and ankle physicians at Midwest Orthopaedics at Rush do a thorough examination for each patient that has symptoms of plantar fasciitis. First, they check the patient's feet and may order an X-ray, CT scan or MRI to rule out a fracture. They get a case history from the patient and ask the patient about his physical activity, when and where the foot hurts and if he has had any recent injuries or illnesses.

What are the treatments for plantar fasciitis?

Non-surgical Treatment Options

Most people can recover from plantar fasciitis without surgery. The physician may make these suggestions:

  • Use physical therapy to stretch and strengthen the muscles
  • Wear an immobilizing boot during the day and/or a night splint at night
  • Lose weight so the feet have less weight to support
  • Buy supportive, low-heeled shoes as opposed to flip-flops and high heels
  • Wear orthotics for added cushioning
  • Switch from weight-bearing to non-weight-bearing exercises
  • Use ice to minimize inflammation and elevate the feet to enhance blood flow
  • Use non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen to ease the pain
  • Get corticosteroid shots to reduce swelling and pain
  • Consider shock-wave therapy to stimulate healing

Surgical Treatment Options

The foot and ankle doctors at Midwest Orthopaedics at Rush rarely use surgery to treat plantar fasciitis. Surgery may be indicated if the patient has tried all other conservative methods, participated in daily stretching and exercises, and has had symptoms for more than 9 months.

If the surgery is done through an endoscope, the foot and ankle physician will make an incision on either side of the heel, below the ankle bone.