The plantar fascia runs the length of the sole of the foot and functions to assist in maintaining its inner arch; like a thick rubber band.
Plantar fasciitis is an inflammation of the origin of the fascia at the calcaneus (heel bone). Common causes are flatfeet, repetitive strain, sports injury and wrong footwear. Typical symptoms are localized mechanical heel pain, pain after prolonged standing and taking the first few steps in the morning.
Heel spurs have long been associated with heel pain. However, heel spurs are usually the result, and not the cause of heel pain associated with plantar fasciitis. They form because of the local inflammation in the soft tissue, with the body forming bone mistakenly in its attempt to repair the plantar fascia.
Initial management of plantar fasciitis involves a multi-modal non-operative approach. For 80-90% of people, this is all that is required. Statistically 85% of patients get better by 6 weeks using a structured rehabilitation protocol.
A very small group of patients may have ongoing pain despite adequate non-operative management. Chronic plantar fasciitis is pain that persists beyond 3 months. These group of patients usually have a chronic plantar fascial tear or scarring that may need further investigation and intervention.
There are several office procedures that can be done for plantar fasciitis.
Surgery for plantar fasciitis is uncommon and its indicated in less that 10% of patients. Rarely it is indicated in conditions where there is a plantar fascia tear or in a patient with flatfeet that are not responding to insoles. Sometimes patients have calf muscles that are very tight.
Some of the procedures include:
The above procedures are minimally invasive procedures done with keyhole techniques as aday surgery. The patient walks home same day and begins a protocol of physiotherapy the very same week.
It is best to consult a foot & ankle specialist surgeon if the pain persists to avoid missing more serious injuries like a calcaneus stress fracture or a plantar fascia tear. This is a condition that can be easily treated.