Plantar Fasciitis

Plantar fasciitis is one of the commonest causes for heel pain. Plantar fascia is a structure that connects toes and heel bone. If there is wear and tear of the plantar fascia, it will become inflamed and swollen, causing pain.

When heel strikes onto the floor during the first step in the morning, the heel will get severe pain. As walking continues, the pain will gradually improve. Although short period of walking can relieve the heel pain, in prolonged walking/ standing/ running cases, the pain will come back. This condition can be happened in single or both heels.

Plantar fasciitis is due to repeated micro-tear of the plantar fascia, causing inflammation and swelling. Increase load to plantar fascia will also lead to plantar fasciitis

Overweight, wear high heel shoes, too much walking, prolonged standing, foot deformity like flat feet will cause inbalance of the load at the foot during standing or walking.

Orthopaedic surgeons will take a medical history and check the posture and the foot condition during walking or standing. X-ray and MRI is also sometimes required for rule out other causes of heel / foot pain like stress fracture or nerve compression.

Treatment for early cases of plantar fasciitis will be focused on lifestyle modification and self exercise, which include reducing weight, avoid prolonged standing or walking. Stretching the calf muscle and plantar fascia; wearing proper insole; and physiotherapy will also be useful in managing plantar fasciitis. For the inflammation, non-steroidal anti-inflammatory drugs will be used to alleviate the heel pain.

If the above measures are not effective, shockwave therapy will be used. Steroid or PRP (plasma-rich protein) injection may also be used in refractory cases.

If conservative management failed, orthopaedic surgeon will advise patients for operation for releasing the plantar fascia. However, there may be risk of reduce in heel/ arch power.