Plantar fasciitis is the leading cause of heel pain. The term "plantar fasciitis" means an inflammation of the plantar fascia which is a long, flat band of ligament that connects the toes to the heel. It also supports the arch of the foot. When the plantar fascia is strained, small tears can develop resulting in weakness, pain and inflammation. Plantar fasciitis is caused by straining the ligament. This is more likely if your feet roll inward too much when you walk, called "excessive pronation." Having high arches or flat feet can increase the risk of plantar fasciitis. Other circumstances that can increase the risk of this condition include being overweight, walking, standing or running for long periods of time on hard surfaces, wearing improperly fitting shoes, and having tight Achilles tendons or calf muscles. Women are more likely to develop the condition. Plantar fasciitis can become a chronic condition if not treated, which can limit physical activities and lead to ankle, knee, and back problems because of changes in the way you walk. Prolonged inflammation of the plantar fascia may cause the deposit of calcium in the heel area resulting in heel spurs. The most common symptoms include heel pain with the first few steps in the morning or after sitting for long periods. Pain may subside after the first few steps but may return later in the day after standing or walking for long periods.

Rest is the first treatment for plantar fasciitis. Weight should be kept off the feet until inflammation subsides. Ice should be applied to the painful area for 20 minutes at a time 3 or 4 times daily until pain subsides. Non-steroidal anti-inflammatory medications can help control pain and inflammation. Stretching the Achilles tendons and calf muscles are the mainstay of treatment and preventing recurrences of the pain. Stretches should be held to the count of 10, relaxed, and repeated 20 times for each heel. An easy way to stretch the Achilles tendon and calf muscles is to sit on the floor with legs straight out in front. Grasp a towel in both hands, loop the towel around the ball of the foot and pull lightly toward you till you feel the stretch.

About 90% of cases improve after 2 months of such treatment. Other treatments include shock-absorbing and arch-supporting insoles. Taping the foot can also help relieve tension on the plantar fascia. Pain that does not respond to initial therapy may be relieved by corticosteroid injections. A walking cast or positional splint for 2 to 3 weeks may help more serious cases that do not respond to other treatments. Rarely, surgery is used to release the tension in the tendon.

References: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=144; http://www.webmd.com/hw/foot_problems/hw114460.asp

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