On the bottom of our feet we have a large ligament that runs from the heel to the ball of the foot. This ligament is called the plantar fascia. If the mechanics of the foot is improper, then this ligament may take-on excessive strain resulting in a sprain (micro tears of the ligament fibers). This is a very common symptom that occurs in the foot, and is said to be the most frequently treated condition in a podiatrists office.
In some case this symptom is associated with a bone spur (a bony outgrowth) on the bottom of the heel where the ligament attaches to the heel bone.
“My foot kills me first thing in the morning when I get out of bed”. Pain in the heel and arch after rest is a very common complaint for those suffering with this condition. Most people find the pain will lighten-up after the first 2-3 minutes of walking, but as their activity and time on their feet increase, the pain often returns.
Usually the doctor can identify an area of tenderness with just gentle pressing on the bottom of the heel or in the arch area of the foot.
X-rays are often used to evaluate for a bone spur, or to rule-out any injury to the heel bone.
Diagnostic Ultrasound is also frequently used to assess the ligament and surrounding soft tissues. This test is very helpful in determining if the ligament is inflamed.
The treatment of this condition is very broad based and varies from over the counter arch supports, to surgical release of the ligament. Typically treatment will begin using some sort of support in the shoe. Walking barefoot is discouraged in anyone suffering with this condition. Oral anti-inflammatories and stretching of the ligament is encouraged.
If the symptoms persist then your podiatrist will usually try a specialized taping technique, or prescription orthotics (arch supports made from a mold of the persons foot). Injectable cortisone or Rx. Medication may also be used. Casting or boot immobilization may also be required.
In the most severe cases of plantar fasciitis, surgery may be considered. During this procedure the ligament is partially cut to release tension.