A tight band of connective tissue called the plantar fascia runs from the heel to the ball of your foot. If the plantar fascia becomes over-stressed, it becomes inflamed, can tear, and can cause the irritation of bone on the bottom of the heel. The pain is typically in the bottom of the heel and often the first steps in the morning are the most painful.
The principle first cause of plantar fasciitis is excessive “pronation” or flattening of the arch of the foot, due in large part to gravity and secondarily to the pull of the Achilles’ tendon.
To receive a diagnosis, a qualified healthcare professional in musculoskeletal disorders will examine your feet and ask questions about your symptoms. They will look at your muscles and bones to see the shape of your foot and assess pain. They will examine the alignment of your foot and ankle while standing and walking. Your footwear must also be examined as this alone can be the major cause of plantar fasciitis.
This condition is usually treated non-surgically. The first order of treatment is to accommodate for the pull of the Achilles’ tendon by having patients wear shoes with at least a one inch heel, at all times, even at home. The inflammation is treated with medications such as NSAIDS, short term oral steroids, or an injection of local anesthetic mixed with steroid. If after six months of conservative treatment the patient is still in pain, the endoscopic plantar fasciotomy is a good option.