bone, joint, and muscle disorders
Plantar Fasciitis
Introduction
Plantar fasciitis is pain originating from the dense band of tissue called the plantar fascia that extends from the bottom of the heel bone to the base of the toes (ball of the foot). The connective tissue between the heel and ball of the foot may become damaged and painful. Pain, which is often worse when first bearing weight in the morning and after periods of rest, is felt at the bottom of the heel. The diagnosis is based on an examination of the foot and imaging tests. Stretches, applying ice, changing footwear, wearing devices inside the shoe that cushion, support, and elevate the heel, and sometimes corticosteroid injections can help. (See also Overview of Foot and Ankle Problems .) The plantar fascia connects the bottom of the heel bone to the ball of the foot and is essential to walking, running, and giving spring to the step. Other terms used to describe plantar fasciitis include plantar fasciosis, calcaneal enthesopathy, and calcaneal spur syndrome ( What Is a Heel Spur? ). A heel spur is a pointed growth of extra bone on the heel bone. It is caused over time by a combination of increased pull on the fascia and foot dysfunction. However, a heel spur may or may not be present. Often a small tear results from excessive strain placed on the plantar fascia. Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis can develop in people who have a sedentary lifestyle, wear high-heeled shoes, have unusually high or low arches in the feet, or have tight calf muscles or a tight Achilles tendon (the tendon that attaches the calf muscles to the heel bone). Sedentary people are usually affected when they suddenly increase their level of activity or wear less supportive shoes such as sandals or flip-flops. Plantar fasciitis is also common among runners and dancers because of increased stress on the fascia, especially if the person also has poor foot posture. The development of this painful disorder occurs more often in people whose occupations involve standing or walking on hard surfaces for prolonged periods. Disorders that may cause or aggravate plantar fasciitis are obesity, Rheumatoid Arthritis (RA) , and other types of arthritis. Too many corticosteroid injections may contribute to the development of plantar fasciitis by damaging the fascia or the fat pad under the heel. 