Plantar
fasciitis
(inflammation
of
the
plantar
fascia)
|
Definition
Plantar
Fasciitis,
an
inflammation
(irritation
and
swelling
with
presence
of
extra
immune
cells)
of
the
thick
tissue
on
the
bottom
of
the
foot
that
causes
heel
pain
and
disability.
Cause
The
plantar
fascia
is
a
very
thick
band
of
tissue
that
covers
the
bones
on
the
bottom
of
the
foot.
This
fascia
can
become
inflamed
and
painful
in
some
people,
making
walking
more
difficult.
Some
risk
factors
for
development
of
this
problem
include
foot
arch
problems
(both
flat
foot
and
high
arches),
obesity,
sudden
weight
gain,
running
and
a
tight
Achilles
tendon
(the
tendon
connecting
the
calf
muscles
to
the
heel).
A
typical
patient
is
an
active
male
between
the
ages
of
40
and
70
years
old.
This
condition
is
one
of
the
most
common
orthopedic
complaints
relating
to
the
foot.
Plantar
fasciitis
is
commonly
though
of
as
being
caused
by
a
heel
spur,
but
research
has
found
that
this
is
not
the
case.
On
X-ray,
heel
spurs
are
seen
commonly
both
in
people
with
and
without
plantar
fasciitis.
Symptoms
The
most
common
complaint
is
pain
in
the
bottom
of
the
heel,
usually
worst
in
the
morning
and
improving
throughout
the
day.
By
the
end
of
the
day
the
pain
may
be
replaced
by
a
dull
aching
that
improves
with
rest.
Signs
and
Tests
Typical
physical
exam
findings
include
tenderness
on
the
bottom
of
the
heel,
closer
to
the
midline,
and
mild
swelling
and
redness.
X-rays
may
be
taken
to
rule
out
other
problems,
but
the
presence
or
absence
of
a
heel
spur
is
not
significant.
Treatment
Conservative
treatment
is
almost
always
successful
in
this
population,
given
enough
time.
Duration
of
treatment
can
be
anywhere
from
several
months
to
two
years
before
symptoms
resolve,
although
about
90%
of
patients
will
be
better
in
9
months.
Initial
treatment
usually
consists
of
heel
stretching
exercises,
shoe
inserts,
night
splints,
and
anti-inflammatory
medications.
If
these
fail,
casting
the
affected
foot
in
a
short
leg
cast
(a
cast
up
to
but
not
above
the
knee)
for
3
to
6
weeks
is
very
often
successful
in
reducing
pain
and
inflammation.
Some
physicians
will
offer
steroid
injections,
which
provide
lasting
relief
in
about
50%
of
people.
However,
this
injection
is
very
painful
and
not
for
everyone.
In
few
patients,
non-surgical
treatment
fails
and
surgery
to
release
the
tight,
inflamed
fascia
becomes
necessary.
Expectations
(prognosis)
Nearly
all
patients
will
improve
within
one
year
of
the
initiation
of
non-operative
therapy
with
no
long-term
problems.
In
the
few
patients
requiring
surgery,
over
95%
have
relief
of
their
heel
pain.
Complications
A
complication
of
non-operative
therapy
is
continued
pain.
In
surgical
therapy,
there
is
a
risk
of
nerve
injury,
infection
and
failure
of
the
pain
to
improve.
Prevention
Maintaining
good
flexibility
around
the
ankle
is
probably
the
best
way
to
prevent
plantar
fasciitis.
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Silicone
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content
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substitute
for
professional
medical
advice,
diagnosis,
or
treatment.
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