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Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot.
Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult.
Risk factors for plantar fasciitis include:
Plantar fasciitis most often affects active men ages 40 - 70. It is one of the most common orthopedic complaints relating to the foot.
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.
The pain is usually worse:
The pain may develop slowly over time, or suddenly after intense activity.
The doctor will perform a physical exam. This may show:
X-rays may be taken to rule out other problems, but having a heel spur is not significant.
Your doctor will usually first recommend:
Other steps to relieve pain include:
If these treatments do not work, your doctor may recommend:
In a few patients, nonsurgical treatment does not work. Surgery to release the tight tissue becomes necessary.
Nonsurgical treatments almost always improve the pain. Treatment can last from several months to 2 years before symptoms get better. Most patients feel better in 9 months. Some people need surgery to relieve the pain.
Pain may continue despite treatment. Some people may need surgery. Surgery has its own risks. Talk to your doctor about the risks of surgery.
Contact your health care provider if you have symptoms of plantar fasciitis.
Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis.
Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section F.
Abu-Laban RV, Ho K. Ankle and foot. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 55.