• Plantar fasciitis is inflammation of the fascia on the sole of the foot.
• The main symptom is pain along the inside of the foot which extends into the sole.
• The pain is worse on standing or walking and is most severe when getting out of bed.
• Treatment is rest and anti-inflammatory drugs.

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What is plantar fasciitis?
Fascia is connective tissue which forms membranous layers of varying thickness in all regions of the body. Plantar fasciitis occurs when this layer in the sole of the foot becomes inflamed.

It shows itself by pain along the inner border of the sole of the foot.

What causes plantar fasciitis?
The cause is thought to be inflammation possibly due to excessive stretching of the plantar fascia between the two areas of the foot to which it is attached.

It may be associated with heel spurs, but this is not certain and the finding of a heel spur on X-ray may be purely coincidental, since many people have bony spurs with no problems with plantar fasciitis. A heel spur is a bony outgrowth from the weight bearing part of the heel.

The inflammation can be part of a wider condition such as rheumatoid arthritis.

What are the symptoms and signs of plantar fasciitis?
The main problem is pain beneath the heel on standing or walking. The pain extends towards the inside of the foot and into the sole. This can be crippling in some people and make walking almost impossible.

When the inflammation is part of something like rheumatoid arthritis, both feet can be affected.

When the foot is examined, there is marked tenderness over the inner side of the foot and particularly over the weight-bearing part of the heel.

X-rays usually do not show any abnormality, although a heel spur may be seen in some people.

How is plantar fasciitis treated?
Rest is the mainstay of treatment, but recovery may be slow and it may be difficult for the affected person to stay off their feet for long enough.

Physiotherapy techniques such as ultrasound will help, but rest is still required.

Stretching the sole of the foot before going to bed helps to relieve pain as do nightsplints (keeps feet in stretched position).

Non-steroidal anti-inflammatory drugs are usually used, with some success. These must always be taken with food, since they can cause stomach ulceration if taken on an empty stomach.

The heel should be protected with a resilient cushion in the insole of the shoes. If these measures do not help, then a course of cortisone injections into the tender area may be tried.

If the fasciitis is part of a widespread inflammatory condition such as rheumatoid arthritis then treating the arthritis will help the fasciitis.

When to see your doctor
If you have pain in the sole of your foot which is not getting better, then see your doctor.

Reviewed by Dr Sirk Loots, orthopaedic surgeon.

Other related articles:
Painkillers (Paracetamol)
Non-steroidal anti-inflammatory drugs (NSAIDs)
COX-2 specific inhibitors
Different Steroids
Cortisone injections

South African Podiatry Association (SAPA)
 

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