Plantar Fasciitis (Heel Spur Syndrome)

Plantar fasciitis, also known as heel spur syndrome, is a disabling problem affecting many individuals at one or more points in their lives. Heel spur syndrome can be very difficult to cure and will often get worse if not treated. Many people feel that this pain is "just normal" and will go away on its own. However, the condition may become disabling if it is not properly treated.

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

Plantar fasciitis is caused by inflammation of the plantar fascia, a thick band of tissue found on the underside of the foot. The plantar fascia spans the arch of the foot, from the base of the toes to the heel bone. When too much stress is applied to the plantar fascia, it creates tension around the heel bone. When this happens repeatedly, the area becomes inflamed, which can cause pain in the heel.

A heel spur is a hook-shaped piece of bone that forms on the heel bone. It is common to see heel spurs in people with heel spur syndrome. Heel spurs are considered a symptom of heel spur syndrome. They are generally not the cause of the condition.

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

Plantar fasciitis occurs when too much stress is put on the plantar fascia and results in inflammation of the tissue. This inflammation can be very painful.

Stress on the foot and plantar fascia can be caused by:

• Poor arch support. This is often the main culprit leading to heel spur syndrome. Poor arch support can be caused by flat-footedness (pes planus), shoes with improper shoes arch support and walking barefoot
• Sustained increase in physical activity
• Short-term, unusual physical activity
• Being overweight or experiencing a sudden weight increase
• Tight calf muscles
• Arthritis

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

Symptoms of plantar fasciitis include:

• Heel and/or arch pain with the first few steps after getting out of bed in the morning or after sitting for a long period of time
• Heel and/or arch pain when standing or walking for a long period of time
• Heel and/or arch pain when climbing stairs or on tip-toes
• Pain that goes away after walking for 10 to 15 minutes, but may get worse and last longer over the course of the day

The pain from plantar fasciitis can be dull or sharp, can occur in one or both feet, and may worsen with time.

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

A foot and ankle specialist (podiatrist) can diagnose plantar fasciitis. When a foot and ankle specialist is seen for evaluation, he/she will test for pain by putting direct pressure on the center of the bottom of the heel and along the plantar fascia. For people who have had the condition for a long time, side to side squeezing of the heel will also be painful. X-rays will often show a bone spur, a small hook-shaped bone growth, on the underside of the heel bone. Many people think bone spurs are the reason for the pain, however, they are actually a symptom of the problem.

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

Non-surgical treatments for plantar fasciitis begin and end with arch support. The types of interventions are typically very successful.

Non-surgical treatments for heel spur syndrome include:

• Wearing shoes with stable arch support, a wide shock absorbing heel base, and cushioning in the front part
  of the foot
• Shoes with cushioning insoles
• Use of heel cups
• Arch binders and straps for increased arch support
• Wearing ankle braces to add support to the foot
• Stretching
• Wearing night splints
• Use of over-the counter or custom shoe inserts (orthotics)
• Steroid injections

Stretching the foot can be a very successful way to relieve tension on the plantar fascia. It can be done either by hand or by using specific stretching devices. One study found that stretching improved symptoms of heel spur syndrome after eight weeks and at a two-year follow-up.

Night splints provide a consistent, automatic stretching of the plantar fascia over the course of the night. Using a splint can make those first steps in the morning much less painful.

In cases where over-the-counter, flexible insoles do not help relieve pain, rigid, custom inserts (orthotics) are recommended. Rigid orthotics can realign the foot and provide long-term arch support.

If the above treatments do not sufficiently stop heel pain, a foot and ankle specialist can administer steroid injections. These injections help the healing process by reducing overall inflammation of the area.

Heel pain from plantar fasciitis can flare up when the plantar fascia, the band of connective tissue that stretches from the heel to the ball of the foot – which also supports the arch – becomes inflamed.. Calcium deposits may eventually form on the heel bone, resulting in mild to serious heel pain when applying pressure on the foot.

Sometimes, nonsurgical treatments do not help with the pain and inflammation of plantar fasciitis. This occurs in less than 10% of individuals with the condition. If this happens, the foot and ankle specialist may suggest surgical options

Although not truly surgical a surgical treatment, extra-corporeal shock wave therapy (ESWT) can help with plantar fasciitis. ESWT is performed with or without anesthesia and can help minimize the inflammation associated with plantar fasciitis.

Actual surgical treatment of heel spur syndrome is meant to reduce the tension on the plantar fascia by lengthening the tissue. During the surgery, the plantar fascia is cut close to its attachment at the heel bone. The tissue is then stretched so that a small gap is created. Over time, this area fills with scar tissue, ultimately lengthen the plantar fascia. Heel spurs are not usually removed during surgery, unless they are in a place that directly affects how a person can walk and stand.

After surgery, recovery time varies from patient to patient. Most patients need at least 6 weeks to make a full recovery. Patients will sometimes need casting or splinting, which will lengthen the time it takes until they are back to their normal activities.

This information on foot, leg and lower body health conditions is provided by The Podiatry Institute, dedicated to advancing the standard of care in podiatric medicine and its effects on musculoskeletal health. The Podiatry Institute does not endorse a specific treatment, product, or therapy. This information is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider on all matters relating to this or any other condition that may affect your health.