Foot & Ankle Associates

WHAT IS PLANTAR FASCIITIS?

Sharp pain, aching or stiffness in one or both heels is a very common ailment. The pain is often at its worst upon awakening in the morning (or after sitting down for an extended period and then resuming activity), causing hobbling or limping for a few minutes before a comfortable stride can be resumed. Several layers of fatty tissue surround the heel bone, softening the impact while walking or running. Beneath this padding, a fibrous band of connective tissue (the fascia) extends from the heel bone, supports the arch and reaches across the bottom of the foot to the toes. Pain results when these tissues become irritated or inflamed. Most cases of heel pain are characterized by inflammation. The fascia pulls on the heel bone at its attachment. The tissues become irritated and inflamed, a condition called fasciitis. Sometimes a bony spur may also be present, but spurs are not truly the cause of the heel pain. Spurs are secondary to the chronic inflammation in the heel.

	Treatment for Heel Pain

	•	NSAIDs: nonsteroidal anti-inflammatory medications are often used to help reduce tissue inflammation and pain.
	•	Stretching exercises for the calf mucles are very important (see diagrams on next page).
	•	Ice the sore heel and arch at the end of the day. This can be done in a number of ways. Place a styrofoam cup full of water in the freezer. When the water is frozen, peel the outer rim of the cup off and massage the heel and arch with the ice block. You can also place your foot on top of a bag of frozen peas or use a commercially available ice pack. CAUTION: people with diabetes or poor circulation should not use ice packs.
	•	Massage the heel and arch by rolling your foot over a golf ball.
	•	Wear shoes with a cushioned outersole and good arch support in the innersole. Running shoes are highly recommended (see our running shoe guide for more information).
	•	Your doctor may also administer a cortisone injection in the inflamed area, apply a foot strapping or prescribe custom-made insoles (called orthoses or orthotic devices).
	•	In approximately 5% of cases surgical intervention may be necessary to alleviate pain.