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#03-07 Gleneagles Medical Centre
6 Napier Road, Singapore 258499

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+65 96584362

Plantar Fasciitis and Heel Spurs

Plantar fasciitis is a common, painful foot condition. Patients, and sometime doctors often confuse the terms plantar fasciitis and heel spurs, however they are two different conditions.

Plantar fasciitis refers to the inflammation of the band of tissue that runs from the heel along the arch of the foot, while a heel spur is a hook of bone that can form on the heel bone (calcaneus). About 70 percent of patients with or without plantar fasciitis have been noted to have heel spur that can be seen on X-ray.

The confusion comes when we start thinking the bone spur is causing the heel pain. The bone spur can be innocuous or signs. Once the plantar fasiciitis has healed, the bone spur is still left there without causing any problems.

More About Plantar Fasciitis

Heel Pain

Plantar fasciitis is most often seen in middle-aged men and women,but can be found in all age groups. It is diagnosed with the classic symptoms of pain well-localised over the heel area of the bottom of the foot.

Plantar fasciitis occurs because of irritation to the thick ligamentous connective tissue that runs from the heel bone to the ball of the foot. When a patient has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed (tendonitis) and degenerative (tendinosis). These abnormalities cause plantar fasciitis and can make normal activities such as standing or walking quite painful.

Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. Often the pain from plantar fasciits is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, once you begin to loosen the foot, but then returns after prolonged standing or walking.

Plantar fasciitis is sometimes, but not always, associated with  rapid gain of weight. It is also sometimes seen in recreational runners. In these athletes, it is thought that the sudden stretch or strain on the heel causes the damage to the fibrous tissue that forms the arch of the foot.

Treating Plantar Fasciitis

Many treatments of plantar fasciitis have been unsatisfactory and limited outcome in the overall management of the foot pain. There are many treatments tried for this fairly common condition, such as rest and avoiding precipitating activities, cool and ice, shoe inserts, insoles and splints.

Even anti-inflammatory painkillers may not be effective in this condition, rendering many patients frustrated and upset. TCM acupuncture and blood letting have been tried as alternatives, but there is little evidence to support these approaches.

If the pain does not resolve, an injection of cortisone can decrease the inflammation of plantar fasciitis.

Shockwave therapy like ultrasound using energy pulses to induce microtrauma to the tissue of the plantar fascia has been tried in some cases. This microtrauma is thought to induce a tissue repair process by the body.

Preventing Plantar Fasciitis from Returning

To prevent the recurrence of plantar fasciitis after treatment, it is important to continue the stretching and exercises that are designed to relax the tissues that surround the heel bone. These simple exercises will help maintain the flexibility of the foot and prevent the plantar fasciitis pain from returning.

Last Course of Action – Surgery

In a small number of cases (usually less than 5%), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments be performed for at least a few months before considering surgery (plantar fascia release).

Surgery is rarely needed in the treatment of plantar fasciitis. This is the treatment of plantar fasciitis. This is because the outcome with such surgery is unpredictable and there are many possible complications (such as nerve injury, infection and over-correction of the tendon release of the foot) associated with it. The vast majority of patients diagnosed with plantar fasciitis will recover given ample time. With some basic treatment steps, well over 90% of patients will achieve full recovery from symptoms of plantar fasciitis within one year of the onset of treatment.