Plantar fasciitis is a chronic condition caused by inflammation of the plantar fascia at its insertion into the anteromedial calcaneal tuberosity. Occasionally the body of the plantar fascia itself can be inflamed and the pain therefore can extend from the heel towards the mid and forefoot. The condition is generally caused by overuse but can certainly occur in a multitude of situations including athletics, obesity, pregnancy, systemic arthropathy such as Reiter’s disease, initiation of exercise, industrial exposure. The pain can last a long period of time and generally resolves within nine to eighteen months.
Treatment consists of three stages. The first stage includes icing, using ice massage technique, stretching using a technique consisting of toe and heel pointing while still in bed followed by heel cord stretches, Visco elastic heel cups and anti-inflammatory medicine if this is indicated for the particular patient. The second stage consists of Cortisone injection, orthotics, night splints, and other modalities, including the use of physical therapy. Another treatment option of a conservative nature for this patient would be a possible orthopedic lithotripsy (Sonorex) or Platelet Rich Plasma (PRP)treatment to help reduce the pain and discomfort and initiate a healing response. The last stage, which is not commonly needed consists of surgery. Surgery includes the release of the medial 2/3 of the insertion of the plantar fascia through a plantar incision. The indications for surgery are the failure of conservative treatment and prolonged symptoms.