Plantar Fasciitis/Heel Spur

Plantar Fasciitis is a painful inflammatory process of the plantar fasciia. The plantar fascia is a thick fibrous ligament originating on the bottom surface of the calcaneous (heel bone) and extending along the sole of the foot towards the toes. It is commonly associated with long periods of weight bearing or strenuous activity. Among the non-athletic population, it may be associated with a high body mass index. (

The pain is usually felt on the underside of the heel and arch area, but can also be painful around the sides of the foot. The pain is typically more intense first thing in the morning, or after a person has been sitting for extended periods. Although some people suffer constant pain, and may also suffer from knee and back pain due to the fact they are compensating.

X-rays are taken to rule out any bony abnormalities of the heel. A common incidental finding associated with this condition is a heel spur, a small bony calcification on the heel bone, in which case it is the underlying condition, and not the spur itself which produces the pain.

Conservative treatment is always initially recommended for the treatment of plantar fasciitis. Local cortisone injections are highly effective in treating the symptoms of this condition, and they are fast-acting in most cases. Another option would be oral anti-inflammatory drugs, which can take up to 5-7 days and only provide short-term relief. Another option is custom-made foot orthotics. In our experience, the custom orthotics are the most successful treatment for long-term plantar fasciitis relief. A patient who has pes planus (flat foot), as well suffers from plantar fasciitis, is going to get the best results from the custom orthotics.

Most people respond very well to the above conservative treatments. Less than 5% of patients do not get an adequate response to the treatment methods listed above, and may proceed with a surgical procedure to release the plantar fascia.

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