Footnotes
Plantar Fasciitis
As a podiatric physician, one of the most common foot-related complaints that I see in my practice is plantar fasciitis (a.k.a. heel spur syndrome).
What is the plantar fascia?
The plantar fascia is a thick band of inelastic tissue (kind of like a ligament) that runs along the bottom of the foot from the heel bone to the toes. Acting as a truss mechanism, it helps to lend structural support to the arch of the foot. If you pull up on your big toe, you can actually see and feel your plantar fascia.
1 in 10
Americans have heel pain and/or plantar fasciitis.
Why is it called heel spur syndrome?
It is not uncommon for a spur to develop on the bottom of the heel where the fascia inserts. However, this spur does not actually cause the pain that the patient feels but is actually the result of the fascia pulling on the heel bone and stimulating the spur to develop.
Why does it occur?
There are many reasons that one may develop plantar fasciitis. These include being overweight or obese, wearing unsupportive shoes, standing for extended periods on tile or concrete floors (think hospital employees, teachers and retail employees), having tight calf muscles or Achilles tendons, poor mechanical functioning of the feet, or any combination of the above. There does not appear to be a genetic predisposition to developing plantar fasciitis. (Sorry, you can’t blame your parents for this one!)
I always make sure to let them know that
90-95%
of patients with plantar fasciitis are treated successfully without surgery.
Can it be treated, and will I have to have surgery?
Fortunately, plantar fasciitis is often treated without the need for surgery (like 90-95% of the time). It is also usually self-limited meaning that it will generally resolve on its own, though this may take a year or more. Treatment includes stretches to target the calf muscles and Achilles tendons, good supportive shoes, specialized insoles for your shoes (called orthotics), anti-inflammatory medication such as Ibuprofen, ice massage, physical therapy, shock wave therapy, and cortisone injections.
What should I do if I think I have plantar fasciitis?
If you think you may be suffering from plantar fasciitis, make an appointment with a podiatrist. In my clinic, I will take an x-ray of the foot that is hurting, perform a clinical examination and discuss treatment recommendations for immediate and long-term management of the problem.
Yes, I have had plantar fasciitis
twice myself!
What if it just won’t go away?
If you are one of the 5-10% of patients for whom conservative (non-surgical) care does not resolve their plantar fasciitis, then surgical management may be recommended. This is an outpatient procedure (no hospital stay needed) where the fascia is cut at its insertion at the heel to release it and prevent it from continuing to pull on the heel bone and cause pain. But it is a last resort and should not be offered as a first line treatment option.
Dr. Heather Kaufman is a Board-certified podiatrist and the owner of Anchorage Foot & Ankle Clinic, LLC located at the corner of Dimond Boulevard and Old Seward Highway. She has practiced in Alaska since 2014 and specializes in medical and surgical management of the foot, ankle and lower leg. She has surgical privileges at Providence Alaska Medical Center and Alaska Regional Medical Center, as well as at Alaska Surgery Center and Surgery Center of Anchorage.
