Plantar fasciitis (fashee-EYE-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.
There are many different causes of flat feet, which can be separated into two main categories. The first category, congenital flat foot, is a condition that one is born with or is predisposed to at birth. This type includes the completely asymptomatic, pediatric flexible flat foot-by far the most common form of congenital flat foot. Flexible means that an arch is present until weight is put on the foot, at which time the arch disappears. This foot type is a result of the fact that all people are born with different physical features. Some people have bigger noses than others, just as some people have flatter feet (of course, there is no known correlation between the two). Any alteration in the many building blocks of the foot can influence its shape.
Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. The condition is diagnosed with the classic symptoms of pain well focused deep in the heel area of the bottom of the foot. Often the pain from plantar fasciitis is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking. Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. It is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the fibrous tissue that forms the arch of the foot.
The medical practitioner will examine how the muscles of your foot function. These tests may involve holding or moving your foot and ankle against resistance; you may also asked to stand, walk, or even run. Pain caused by movements may indicate the cause of the pain. The nerves in the foot will be tested to make sure no injury has occurred there. An x-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are changes in the makeup of the bone.
Non Surgical Treatment
Rest and icing the swollen area are a good way to practice in-home treatment for mild foot arch pains. Anti inflammatory medications can also be applied to the area. It is important to reduce your activity to avoid worsening the arch pain. Wearing shoes that fit properly is important as well. Make sure to use shoes that are designed with adequate arch support to prevent over pronating. When running, avoid uneven surfaces, as this may contribute to your foot arch pain. Also, orthopedic pads or other padded heel cups and devices can be inserted into shoes to provide support and prevent more strain to the foot.
As with most surgeries, patients and physicians should consider the surgery only after other, less invasive treatments have proven unproductive. Indications for surgery include Pain. Inability to function. Failure to improve after a six-month course of specific, directed physical therapy. Failure to improve after using arch supports, orthotics, or ankle and foot bracing. Once patients are at that point, the good news is that the procedure has considerably better outcomes than more traditional flat foot surgery. In the past, surgeons would realign and fuse the three hind joints, which would cause patients to lose motion, leaving them with a significantly stiff hind foot, With these newer procedures, if the foot is still flexible, surgeons can realign it and usually restore a close-to-normal or functional range of motion in the joints.
Because most cases of flatfeet are inherited, the condition is usually impossible to prevent. Even when children with flexible flatfeet are treated with arch supports and corrective shoes, there is little evidence that these devices prevent the condition from lasting into adulthood.