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Dr. Daniel C. Eby

Orthopedic Surgery & Sports Medicine

Are your first few steps in the morning severely painful over the bottom of your heel?

Plantar fasciitis is most often a result of overuse including excessive standing, walking, or even athletics.

The plantar fascia is a fibrous tissue that becomes inflamed and irritated. Over time the disease can progress to the reformation of the fibers.

The reforming of the fibers can develop into knots and scar tissue, which can further your pain.

Causes and Risk Factors

Anyone can develop plantar fasciitis. However, females, people with obesity, or those whose work requires excessive standing or walking on a hard surface are at a higher risk. Some exercises including running or walking on pavement and other hard surfaces can cause damage to the plantar fascia. Having high arches in your foot or being flat-footed can contribute to symptoms as well.

Symptoms

Pain is often worse when first arising after a break or after sleeping. The pain does not always worsen with activity and can even feel better with walking. The disease process can progress to a chronic condition and require more aggressive treatment modalities if left untreated. If the disease is allowed to continue over years, abnormally walking on your foot to compensate for the pain can lead to leg, hip, and even back pain.

Diagnosis

Often imaging is necessary to diagnose plantar fasciitis. Our office provides X-ray and ultrasound imaging to accurately assess and treat the disease.

Treatments and Recommended Imaging

The good news is, there are a lot of ways to treat the pain and symptoms. Typically, the best first step is stretching and strengthening your feet and surrounding structures. A quick trick is to freeze a water bottle and roll it under your foot to massage out the pain.

We advise trying to balance yourself with your hands on a wall. Then lean forward into your foot and place your weight into the arch of your foot. This stretch and others can also be taught at a formal physical therapy session.

There are braces, orthotics, and medications that can be offered depending upon the case of plantar fasciitis. Dr. Eby and staff may offer an anti-inflammatory medication including meloxicam, or ibuprofen. These are a great choice for this condition as the basis of the pain comes from inflammation.

With regular stretching, application of ice, and anti-inflammatory medication, most patients recover in a few months. Although, not everyone recovers with these measures and needs more help.

Cortisone injections, platelet-rich plasma injections, and surgery may be necessary with persistent plantar fasciitis. If the need for surgery arises, we can offer a minimally invasive endoscopic TENEX procedure.


REFERENCES

McMahon, Patrick J., and Harry B. Skinner. Current Diagnosis & Treatment in Orthopedics. 6th ed., McGraw-Hill Medical, 2021.
“Conditions & Treatments.” FootCareMD, American Orthopedic Ankle and Foot Society, 2021, https://www.footcaremd.org/conditions-treatments.