Plantar fasciitis is a painful condition that affects the bottom of the foot and the heel area, occurring when the band of connective tissue called the plantar fascia becomes irritated and inflamed. The plantar fascia extends from the bottom of the foot from the area beneath the toes to the heel, and it helps to support the arch. The condition most commonly occurs with age, as the connective tissue tightens up and becomes less flexible, but people who spend long periods of time standing and people who are overweight or obese may also develop the condition. Plantar fasciitis can also occur in runners and other athletes whose feet are subjected to repetitive impact. The painful symptoms of plantar fasciitis are usually much worse when waking up in the morning or after a prolonged period of inactivity. Symptoms usually resolve once the foot is flexed and tissues loosen up but recur after another period of sitting or lying down.
Heel spurs are bony projections or calcifications that form along bones and can press into soft tissues, resulting in painful symptoms. Bone spurs can develop on just about any bone. When a heel spur forms, it most commonly forms along the bottom of the heel bone and points toward the arch. People with plantar fasciitis often have heel spurs that press into the plantar fascia, the band of connective tissue that supports the arch, causing irritation and inflammation in the tissue that can make walking very painful.
Most heel spurs can be effectively treated using proper arch support like the support provided by custom orthotics to reduce pain and irritation. Medication, injections of corticosteroids and application of ice can also be used to treat inflammation and reduce pain, and physical therapy and exercise may also help promote healing and flexibility in the area. While the surgery was once commonly performed to remove heel spurs, today surgical removal is reserved as a last resort for patients in whom more conservative options have proven ineffective in relieving pain. When surgery is performed, heel spurs will be removed through tiny incisions made just over the location of the spur as determined by x-ray.
Mild cases of plantar fasciitis typically respond with gentle stretching and special splints to help improve the flexibility of the tissue and to strengthen the foot, so the arch is better supported. Stretching can also stimulate circulation to the tissue to reduce inflammation and promote healing. Oral medication and corticosteroid injections can also be used to relieve inflammation and painful symptoms. Often, custom orthotics are prescribed to provide the arch with additional support and prevent the condition from recurring. Overweight and obese patients may also find relief by losing excess weight. In a few cases when conservative approaches are not effective, surgery may be performed to release the reposition the plantar fascia.
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