Plantar Fasciitis/heel Spur
What is Plantar Fasciitis/Heel Spur?
Plantar fasciitis is inflammation of the plantar fascia, a thick band of tissue running along the bottom of the foot. Heel spurs may develop at the calcaneus where the fascia inserts.
- Common cause of heel pain
- Often worse with the first steps in the morning
Overview of the Condition
Repeated stress on the plantar fascia can cause microtears and inflammation. Over time, a bony spur may form at the heel, though it is not always the source of pain.
Symptoms
- Sharp heel pain, especially upon waking
- Pain that improves with mild activity but worsens after prolonged standing
- Tenderness at the heel’s medial side
Causes
Risk factors include tight calf muscles, high BMI, prolonged standing or running, and poor footwear support. Microtrauma builds over time, causing chronic inflammation.
Diagnosis
Clinical exam with tenderness at the plantar fascia origin, often confirmed by imaging. X-rays may show a heel spur; ultrasound or MRI can reveal fascia thickness.
Treatment Options
- Stretching exercises and physical therapy
- Orthotic inserts or supportive shoes
- Night splints to keep the foot in dorsiflexion
- Anti-inflammatory medications or injections
Conservative Management
Majority of patients improve with rest, ice, and stretching. Avoiding barefoot walking and wearing well-cushioned footwear are key steps.
Rehabilitation Exercises
- Calf stretches (gastrocnemius, soleus)
- Plantar fascia stretch by pulling toes upward
- Rolling the foot on a frozen water bottle for massage and ice therapy
When is Surgery Needed?
Surgery is considered only after 6-12 months of failed conservative treatments. It involves partially releasing the fascia or removing bony spurs.
Surgical Procedures
- Endoscopic plantar fasciotomy
- Open release of the plantar fascia with or without spur resection
- Post-op rehab to maintain foot strength and flexibility
Anatomy Overview
The plantar fascia supports the foot’s arch and absorbs shock during weight-bearing. Its origin is near the medial calcaneal tuberosity, a frequent site of irritation.
Affected Areas
- Medial aspect of the heel
- Fascia spanning from heel to toes
- Possible development of a spur at the calcaneus
Frequently Asked Questions
| Question | Answer |
|---|---|
| Is a heel spur the cause of the pain? | Not always. Many people with spurs have no pain, and plantar fascia inflammation is often the main culprit. |
| How long does it take to recover? | Mild cases can improve in weeks, but more chronic conditions may take several months of consistent stretching and therapy. |
Prevention Strategies
- Use supportive footwear with good arch support
- Stretch calves and plantar fascia regularly
- Maintain a healthy body weight