Plantar fasciitis is sometimes mixed up with a heel spur although they are not the same. A heel spur is a calcium deposit that occurs where the plantar fascia is attached to the heel bone
(calcaneus). In many cases a heel spur is found on a foot with no pain or other symptoms at all. And in many painful heels there is no sign for a heel spur. Heel spur and painful heal does not
necessarily go together. For many years plantar fasciitis was believed to be an inflammatory condition. It is thought now to be inaccurate because there were many cases of the disorder with no
inflammatory signs observed within the fascia. The heel pain cause is now believed to be damage to the collagen fibers of the fascia. This damage, caused by stress injury, sometimes may include
Although plantar fasciitis may result from a variety of factors, such as repeat hill workouts and/or tight calves, many sports specialists claim the most common cause for plantar fasciitis is fallen
arches. The theory is that excessive lowering of the arch in flat-footed runners inÂcreases tension in the plantar fascia and overloadÂs the attachment of the plantar fascia on the heel bone (i.e.,
the calcaneus). Over time, the repeated pulling of the plantar fascia associated with excessive arch lowering is thought to lead to chronic pain and inflammation at the plantar fasciaâs attachment
to the heel. In fact, the increased tension on the heel was believed to be so great that it was thought to eventually result in the formation of a heel spur.
When a patient has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed (tendonitis) and degenerative (tendinosis)--these abnormalities cause plantar fasciitis
and can make normal activities quite painful. Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements
stretch the contracted tissue. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.
A physical exam performed in the office along with the diagnostic studies as an x-ray. An MRI may also be required to rule out a stress fracture, or a tear of the plantar fascia. These are conditions
that do not normally respond to common plantar fasciitis treatment.
Non Surgical Treatment
A doctor may prescribe anti-inflammatory medication such as ibuprofen to help reduce pain and inflammation. Electrotherapy such as ultrasound or laser may also help with symptoms. An X-ray may be
taken to see if there is any bone growth or calcification, known as a heel spur but this is not necessarily a cause of pain. Deep tissue sports massage techniques can reduce the tension in and
stretch the plantar fascia and the calf muscles. Extracorporeal shock wave therapy has been known to be successful and a corticosteroid injection is also an option.
In cases that do not respond to any conservative treatment, surgical release of the plantar fascia may be considered. Plantar fasciotomy may be performed using open, endoscopic or radiofrequency
lesioning techniques. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. Potential risk factors include flattening of the longitudinal arch and heel
hypoesthesia as well as the potential complications associated with rupture of the plantar fascia and complications related to anesthesia.