Symptoms:

• • Pain upon waking with the first few steps or after prolonged sitting.
  • Inability to tolerate flat shoes or walking barefoot
  • A sharp trigger point pain in one or both heels, may cause limping

Causes:

• • Flat or high arched foot structure
  • Prolonged standing
  • Working on very hard surfaces
  • Very common among runners
  • Associated heel spurs

Differentials:

• • Calcaneal (heel bone) stress fracture
  • Plantar Fascia partial tear or rupture
  • Plantar Fibromas
  • Bone cysts
  • Foot strain

Evaluation  – At your appointment, your doctor will perform a history and physical, take x-rays to rule out causes for your heel or arch  pain, beside plantar fasciitis. Be prepared to ask questions about your condition and give details about your habits including work conditions, exercise activities and typical choices for shoe gear. Be prepared to discuss when the pain occurs and what makes it worse or feel better, this will help make an accurate diagnosis.

Treatment – There are many treatment options available, but it is important to remember that this tends to be a chronic foot structure related condition. A person once prone to this condition can see a return of the pain if activities that trigger it are prolonged. Treatment options include:

• • Physical therapy, stretching and icing
  • Orthotics
  • Cortisone injections
  • Shoe gear modification to supportive shoes

Most cases will respond to conservative care, but there are surgical options available for those cases that do not respond. This includes resection of associated heel spurs and shock wave therapy.