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Plantar fasciitis is a painful inflammatory condition caused by excessive wear to the plantar fascia of the foot. The pain usually is felt on the underside of the heel, and is often most intense with the first steps of the day. It is commonly associated with long periods of weight bearing. Obesity, weight gain, jobs that require a lot of walking on hard surfaces, shoes with little or no arch support, and inactivity are also associated with the condition. This condition often results in a heel spur on the calcaneus, in which case it is the underlying condition, and not the spur itself, which produces the pain.
Treatment
The mainstays of treatment are stretching the Achilles tendon and the plantar fascia, rest, ice, losing weight, arch support, and taping. To relieve pain and inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are often used but are of very limited benefit.
Local injection of corticosteroids often gives temporary or permanent relief, but may be painful during application if not combined with a local anesthetic and injected slowly with a small-diameter needle. Recurrence rates may be lower if injection is performed under ultrasound guidance.
Night splints can be used to keep the foot in a dorsi-flexed position during sleep to improve calf muscle flexibility and decrease morning pain. Patients should be encouraged to lessen activities which place more pressure on the balls of the feet. Weight on the heel does not cause plantar fasciitis. Over-the-counter insole arch support may help. Prescription orthotics are often too high and rigid and very expensive.
Therapeutic ultrasound, with or without iontophoresis, and more recently, extracorporeal shockwave therapy (ESWT) have been used with some success in patients with symptoms lasting more than 6 months. Surgical treatments, such as plantar fascia release, are a last resort, and often lead to further complications such as a lowering of the arch and pain in the top lateral side of the foot due to compression of the cuboid bone.
References
External links
"Plantar fasciitis"