Causes and risk factors
Plantar fasciitis can affect any individual, whether he leads an active or sedentary lifestyle. People who are obese or are involved in excessive physical activity like running or dancing are at a higher risk of developing plantar fasciitis. Presence of structural abnormalities of the foot such as flat foot (pes planus) or high arches (pes cavus) predisposes to plantar fasciitis. Occupations involving prolonged standing (cooks, teachers etc.) are associated with a higher risk of plantar fasciitis. Wearing improper shoes is also a risk factor.
Clinical presentation
Plantar fasciitis is unilateral in most cases and bilateral in some. Plantar fasciitis produces a sharp pain in the inner aspect of the heel and arch of the foot. This pain worsens with the first few steps after prolonged rest or on first waking up in the morning. After walking a few steps, the pain diminishes. The affected foot may feel fatigued after long periods of standing.
As plantar fasciitis worsens, the patient will experience pain with any weight bearing activity. The plantar fascia continuously pulls on the heel bone. An associated calcaneal spur may get formed.
Investigations
Diagnosis is made on the basis of the patient’s symptoms. X-rays may be used to eliminate other conditions that may be responsible for the pain.
Treatment
Many cases of plantar fasciitis get better on their own within a year. Conservative mode of treatment is tried first. Rest and ice application are advised. Supportive measures such as orthotic shoes, heel cups, foot arches and night splints are recommended. Physiotherapy exercises are advised to the patient. Anti-inflammatory drugs and cortisone injections are given to relieve the pain.
If non-surgical methods do not work, surgery is advised. Surgery can involve either recession of the gastrocnemius muscle or release of the plantar fascia.
Recent update
A recent study has stated that patients with plantar fasciitis who receive Botox injections have better relief compared to those who receive steroid injections.
