Plantar Fasciitis

Arlington Foot & Ankle Center

Ben Pearl, D.P.M., F.A.C.F.A.S.

N.I.H. Consultant

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PLANTAR FASCIITIS

With the warmer weather upon us and the seasonal ritual of getting back into shape you may develop one of the 2 million cases of heel pain reported annually in the U.S. The most common cause of heel pain is plantar fasciitis. This occurs when to much strain is put on the arch of the foot (plantar fascia). Since the plantar fascia attaches to the heel bone the area on the inside bottom part of the heel becomes inflamed. You may find the area is particularly sore in the morning. This is because at rest the blood is not circulating as much, which gives inflammatory products a chance to build up at the heel.

Plantar Fasciitis can be treated conservatively about 80% of the time. Treatments include stretching, rest, over-the-counter arch supports or custom arch supports (orthotics), anti-inflammatory medications, and physical therapy. Stretching the heel chord or Achilles tendon is particularly important.

For a small percentage of cases that have not responded to conservative treatment, the last resort has been surgery. This involves release of a band of plantar fascia sometimes accompanied by removal of a spur. A recent FDA approved non invasive treatment called extracorporeal shock wave therapy has been utilized. This has demonstrated promise for cases that do not respond to conservative care. The treatment involves directing pulses of high-energy sound waves to the injured are on the bone and soft tissue. In theory there is a controlled re-injury of the area, which allows for regeneration of the new blood vessel and bone to the area. It has also been proposed that the treatment may break down some of the calcified deposits on the bone. This works in a similar fashion to the way that lithrotripsy breaks down kidney stones. The treatment has been formerly available at regional locations across the United States and Canada. There will soon be a facility in the Washington DC area able to perform this procedure.

If you have persistent pain contact a podiatrist or healthcare provider that deals with foot ailments.