Plantar fasciitis is an inflammation of the plantar fascia, and it is the most common diagnosis given to patients with medial heel pain. The plantar fascia originates on the calcaneus (heel bone) and plays an important role in stabilizing the foot during walking.
Factors that can increase tension on the fascia and lead to symptoms include:
- Acute trauma or strain to the fascia
- Excessive or prolonged pronation
- A high-arched foot
Chronic tension to the fascia where it inserts on the heel can lead to a heel spur, which is a buildup of calcium. Risk factors for heel spurs include:
- Age: generally over 40, but as early as the 20s for athletes
- Excessive weight
- Hard surfaces
- Inadequate footwear
- Calf tightness
Common symptoms include:
- Pain in the heels that is worst when first getting out of bed in the morning, and that eases gradually with walking
- Pain upon standing after sitting five minutes or more
- Pain that is worse with activity or increased weight-bearing and is usually relieved with rest
Cortisone injections can give temporary relief, but finding the cause and eliminating it is more effective. Physical therapy can help. Treatment may include:
- Stretches for calf muscles while maintaining an arch in the foot
- Use of a night splint to maintain calf muscles on stretch during sleep
- Providing support and control by taping the bottom of the foot or using an orthotic
- Increasing the strength of stabilizing muscle groups.