Heel spur or Plantar fasciitis

Definition

The medical term ‘Plantar Fasciitis’ means an inflammation of the attachment of the plantar fascia on the heel bone. The plantar fascia is a thick, rather rigid band, which ranges from the bottom of the heel bone to the toes. It is seen as a sort of extension of the Achilles tendon. It is little elastic and plays an important role in creating the foot arch during walking and standing.

Fig-35

Symptoms

The typical complaint is a stabbing and dull pain below the heel, especially in the first steps in the morning or after having been seated for a while. After some time of movement, the pain decreases but re-intensifies as the evening comes.

 

Causes

As possible causes, overweight, an overloading of that particular spot or a stiffness of the Achilles tendon are often indicated.

 

Treatment

The treatment will therefore be focused on multiple factors:

 

  • Local and oral anti-inflammatory drugs
  • Alternating hot and cold baths
  • Vitamin C
  • Wearing shock-absorbing heels (Nike air shoes, Crocs, MBT shoes…)
  • Stretch exercises for the lower limb, particularly of the Achilles tendon
Fig-36

  • Stretch exercises for the lower limb, particularly of the Achilles tendon

 

If this proves insufficient, you can have an electro-shockwave therapy or attempt an infiltration with Cortisone. Provided some patience, 95% of the patients will over a period of several months become painfree.

If ordinary therapy proves unsuccessful, a tarsal tunnel syndrome must be thought of, or, in a few cases, a heel pad syndrome, after which treatment should be adjusted.

Only very rarely, an operation should be proposed. With this, approximately 2/3 of the attachment of the plantar fasciitis is cut loose. This can be either an open or an endoscopic surgery.