Dear all,
Plantar fasciitis is caused by microtearing of this thick non-elastic band of tissue (planar fascia) from its origin on the Os calcis (heel bone). The symptoms include pain under the heel. The pain is often worst first thing in the morning because the foot has been in a relaxed position and the tear has been healing in a shortened position. Walking on it in the morning streatches it back up pulling on the inflammed torn bit.
There is often the development of an associated bony spur from the Os calcis above where the tear has occured. It is not the cause of the problem or the origin of it but an associated phenomenon where the periosteum (skin surrounding the bone) of the Os Calcis has lifted and bone has formed beneath it.
The diagnosis is made from the history and examination. If a differential diagnosis is considered then useful investigations include x-ray or MRI scan.
In the vast majority of cases the condition can be treated conservatively with a good physiotherapist advising on stretching exercises, non-steroidal anti-inflammatories, heel cups, medial arch supports, Dorsiwedge night splints and occasionally the Aircast Air Heel.
Resistent cases can try Dolorclast (lithotripsy) or injection of local anaesthetic and cortisone.
I hope this advice helps.
John Hardy
