Foot pain affects nearly all people at one time or another. It can also lead to other musculoskeletal problems such as ankle, knee and back pain (Hill et al., 2008). This pain negatively affects
oneâs quality of life and ability to enjoy workouts and/or maintain a regular program of exercise. One of the most common sources of foot pain is plantar fasciitis, a condition where the connective
tissue on the underside of the foot becomes irritated and painful as a result of an injury, overuse or misuse. The plantar fascia is a system of connective tissue that runs from your heel to just
behind your toes. During weightbearing activities, such as walking or running, your body weight is transferred onto your foot from your heel to your toes (which results in your toes moving away from
your heel). This spreading out of the foot places tension on the plantar fascia because it connects those two parts. If the tension on this structure is too great or is not dispersed evenly, the
plantar fascia can develop microtears and become irritated and painful, resulting in a condition called plantar fasciitis.
The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is
inflammation, which results in the heel pain and stiffness of plantar fasciitis.
Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by
long periods of standing or getting up from a seated position.
Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past.
The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to
use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.
Non Surgical Treatment
Over-the-counter arch supports may be useful in patients with acute plantar fasciitis and mild pes planus. The support provided by over-the-counter arch supports is highly variable and depends on the
material used to make the support. In general, patients should try to find the most dense material that is soft enough to be comfortable to walk on. Over-the-counter arch supports are especially
useful in the treatment of adolescents whose rapid foot growth may require a new pair of arch supports once or more per season. Custom orthotics are usually made by taking a plaster cast or an
impression of the individual's foot and then constructing an insert specifically designed to control biomechanical risk factors such as pes planus, valgus heel alignment and discrepancies in leg
length. For patients with plantar fasciitis, the most common prescription is for semi-rigid, three-quarters to full-length orthotics with longitudinal arch support. Two important characteristics for
successful treatment of plantar fasciitis with orthotics are the need to control over-pronation and metatarsal head motion, especially of the first metatarsal head. In one study, orthotics were cited
by 27 percent of patients as the best treatment. The main disadvantage of orthotics is the cost, which may range from $75 to $300 or more and which is frequently not covered by health
Surgery may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar
fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can
cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.