|
Plantar Fasciitis is an inflammation of the plantar fascia, a broad ligament running along the plantar (the sole of the foot), from the base of the toes and around the back of the heel, where it attaches to the heel bone. The plantar fascia provides support to the arch of the foot. The fascia may suffer unusual stress from injury or strenuous activity, or even from a weakening of this ligament due to aging. If the fascia is pulled too hard as a result of such stress, the heel bone will begin to grow in the direction of the pull. On x-rays this anomalous bone growth has a distinctive spur-like shape, and that is why the condition is commonly known as "heel spurs."
As the condition develops, the fascia itself begins to shorten, so that every step causes the fascia to overextend itself, creating the inflammation and pain characteristic of plantar fasciitis. The heel pain has been likened to having to walk with a pebble in your shoe under your heel, but it can become even more severe than that comparison suggests.
Many people, not realizing that plantar fasciitis can be easily treated, live with the pain for years. They often wait until the pain becomes excruciating, even crippling, before seeking medical care.
Because the pain is usually at its worst when the sufferer first arises in the morning--or after he has been off his feet for any length of time--and lessens when he walks around, some people will try to "walk off the pain" over the course of the day. Unfortunately, this approach, while providing some short-term relief, aggravates the inflammation of the fascia and inevitably causes the condition to grow worse. There are, however, a number of measures you can take to relieve the pain of plantar fasciitis and to prevent its recurrence.
---1. Select proper footwear.
Anyone prone to developing plantar fasciitis should value comfort over fashion when choosing shoes. Comfortable, well-fitted shoes with low heels and good arch support are essential to preventing or treating plantar fasciitis. In fact, certain high-quality brands are often recommended by podiatrists and other doctors who treat this condition. If you return to wearing inappropriate shoes once the fascia has healed, however, the condition is likely to recur.
---2. Stay off your feet.
Until the plantar fascia heals, the sufferer should avoid unnecessary walking or running. If the pain is severe, or if walking cannot be limited, the temporary use of a cane will reduce pressure on the affected foot.
---3. Take anti-inflammatory medication.
Nonsteroidal anti-inflammatory medications such as aspirin, ibuprofen, acetaminophen, or naproxen will help to reduce the inflammation of the fascia, as well as providing temporary relief from pain. Be sure to follow the label instructions carefully, because any of these over-the-counter drugs can cause potentially serious side effects if they are misused.
---4. Support your arches.
In addition to wearing only shoes with good arch support, you can also use padded shoe inserts to provide soft, firm arch support and cushioning for the heel. It is possible to purchase custom-fitted inserts, but most people find that inexpensive arch supports purchased at the supermarket or drugstore, or at a shoe store, work quite well. Another option, especially if your legs and ankles will be covered by long slacks, is to tape the arch with an elastic bandage, or to use a pre-formed elastic ankle brace. By wrapping under the arch and gently pulling up on it, the elastic brace or bandage provides particularly effective support.
---5. Submit to steroid injections, but only if the pain remains severe and does not respond to more conservative treatments.
Cortisone injections should only be used for intractable inflammation that does not respond to the treatments outlined above. Steroid injections can cause serious side effects, and the injections themselves are surprisingly painful.
---6. Have surgery to release the plantar fascia from attachment to the heel bone.
Surgery should be used only as a last resort, if at least three months of diligent compliance with the less invasive and drastic measures have not reduced the pain and inflammation.
Although plantar fasciitis is a common condition, many people have never heard of it. Consequently, they or their loved ones suffer through months or years of unnecessary pain before seeing a doctor. Even when the sufferer has heard of the condition or has consulted a doctor, he may not be aware that a simple, non-invasive course of treatment will cure most cases in about six to twelve weeks, and that a few simple precautions can prevent recurrence. Only in rare cases, when other treatments have clearly failed to produce an improvement, is it necessary to resort to such drastic measures as steroid injections or surgery.
| 
