Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot.
Causes, incidence, and risk factors:
Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult.
You are more likely to get plantar fasciitis if you have:
• Foot arch problems (both flat feet and high arches)
• Long-distance running, especially running downhill or on uneven surfaces
• Sudden weight gain or obesity
• Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
• Shoes with poor arch support or soft soles
Plantar fasciitis is seen in both men and women. However, it most often affects active men ages 40 - 70. It is one of the most common orthopedic complaints relating to the foot.
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.
The pain is usually worse:
• In the morning when you take your first steps
• After standing or sitting for a while
• When climbing stairs
• After intense activity
The pain may develop slowly over time, or suddenly after intense activity.
Signs and tests
The health care provider will perform a physical exam. This may show:
• Tenderness on the bottom of your foot
• Flat feet or high arches
• Mild foot swelling or redness
• Stiffness or tightness of the arch in the bottom of your foot.
1. Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section F.
2. Abu-Laban RV, Ho K. Ankle and foot. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 55.
3. Silverstein JA, Moeller JL, Hutchinson MR.Common issues in orthopedics. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 30.
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