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Plantar fasciitis

Plantar fascia

Plantar fasciitis is a painful inflammatory process of the connective tissue on the sole of the foot. It is often caused by overuse of the plantar fascia or arch tendon of the foot. It is a very common condition and can be difficult to treat if not looked after properly. Another common term for the affliction is "policeman's heel".

Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis.

Who it affects: 
Two million Americans a year and in 10% of the U.S. population over a lifetime. It is commonly associated with long periods of weight bearing. Among non-athletic populations, it is associated with a high body mass index.
Symptoms: 

The pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Another symptom is that the sufferer has difficulty bending the foot so that the toes are brought toward the shin. A symptom commonly recognized among sufferers of plantar fasciitis is an increased probability of knee pains, especially among runners.

An incidental finding associated with this condition is a heel spur, a small bony calcification on the heel bone, in which case it is the underlying plantar fasciitis that produces the pain, and not the spur itself. The condition is responsible for the creation of the spur; the plantar fasciitis is not caused by the spur.

Treatment: 
Based on current research, recommendations for immediate relief and reduction of inflammation include heel and foot stretching exercises as can be tolerated, rest, and wearing shoes with good support and cushions. Other steps to relieve pain include: Applying ice or ice-heat-ice, and using night splints to stretch the injured fascia. Customized functional foot orthotics can offer a decrease in the pain associated with plantar fasciitis and may provide an additional benefit in terms of increased functional ability in patients with plantar fasciitis.