Plantar Fasciitis & Bone Spurs

The plantar fascia is a tissue at the bottom of the foot that connects the heel to the fore-foot and supports the arch. Plantar fasciitis is an inflammation of this tissue.

Causes & Symptoms

Plantar fasciitis typically develops without any specific cause and develops slowly over time. Risk factors include tight calf muscles, obesity, high foot arch, repetitive impact activity, and new or increased activity level.

Heel spurs are not necessarily a cause of pain. One out of 10 people has heel spurs, but only 1 out of 20 people with heel spurs has foot pain. Since the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.

Symptoms of plantar fasciitis include most notably pain with the first few steps in the morning, pain on the bottom of the foot near the heel, and pain after but not during exercise.

Evaluation & Treatment

Evaluation includes a detailed medical history and physical examination. X-rays may be done to rule out other conditions.

Initial treatment includes rest, ice, anti-inflammatory medications, and stretching of the calf and plantar fascia. Occasionally soft heel pads, night splints, extracorporeal shockwave therapy, and rarely corticosteroid injections may be suggested. Greater 90% of patients with plantar fasciitis will improve within 10 months of this treatment.

Surgery should only be considered after 12 months of aggressive nonsurgical treatment. If surgical treatment is recommended it can be done through a small incision as an outpatient procedure. As surgery for plantar fasciitis can result in chronic pain and dissatisfaction, it should only be considered after exhaustive nonsurgical treatment.