Plantar Fasciitis

Plantar fasciitis is a very common injury and the most common cause of pain on the bottom of the heel. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes aggravated or inflamed. The plantar fascia is designed to absorb the high stresses we place on our feet. Chronic stress can damage or tear the tissues resulting in inflammation.

Plantar Fasciitis Symptoms
The most common symptoms of plantar fasciitis include pain on the bottom of the foot near the heel, or after a long period of rest, with the pain subsiding after a few minutes of walking.

Plantar Fasciitis Diagnosis
During a physical examination, the doctors at Gwinnett Medical Center–Duluth will look for an area of tenderness on the bottom of your foot, or for pain that gets worse when you flex your foot. Plantar fasciitis may also be indicated if your pain improves when you point your toes down, or if you have limited "up" motion in your ankle.

Imaging tests, such as MRIs, X-rays and ultrasounds, are not routinely used to diagnose plantar fasciitis. In some instances an MRI may be used if the heel pain is not calmed by initial treatment methods.

Non-surgical Treatment for Plantar Fasciitis
More than 90 percent of patients with plantar fasciitis will improve within 10 months of treatment using methods such as resting and icing the affected area, taking NSAIDs to decrease swelling, light exercise in a pool, getting cortisone injections, wearing supportive shoes or orthotics, using a night splint, undergoing a regimen of physical therapy and even extracorporeal shockwave therapy.

Surgical Treatment of Plantar Fasciitis
Surgery is considered only after 12 months of consistent non-surgical treatment. Two main surgical techniques exist:

1. Gastrocnemius recession—Surgical lengthening of the calf muscles in which one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. This procedure can be performed with an open incision, or with a smaller incision and an endoscope.
2. Plantar fascia release—A better surgical choice if there is normal range of ankle motion and continued heel pain. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision.

Most patients have good results with both of these surgeries. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all non-surgical measures have been exhausted.

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