The bones in the midsection of the foot are supported by a strong band of connective tissue called the plantar fascia. Sometimes, this band of tissue becomes irritated, inflamed or injured, resulting in painful symptoms that can occur across the bottom of the foot, all the way from the base of the toes to the heel. This painful condition is called plantar fasciitis, and it occurs more commonly as people get older and the band of tissue becomes stiffer and less flexible, or simply becomes more prone to irritation and inflammation after years of wear and tear. People who spend long periods of time on their feet and those who place repeated pressure on the bottom of their feet, such as competitive runners and other athletes, are more likely to develop plantar fasciitis. Being overweight or obese can also increase the risk for plantar fasciitis as the foot is tasked with supporting more weight day in and day out. Wearing shoes that don't provide enough arch support can also contribute to plantar fasciitis and its symptoms.
Usually, plantar fasciitis can be diagnosed with an office exam and evaluation of the foot, combined with a review of symptoms. In a few cases, diagnostic imaging may be ordered to rule out other possible causes of symptoms.
Most people with plantar fasciitis benefit from stretching exercises and special splints to help gently stretch the plantar fascia, improving flexibility and reducing painful stiffness. Custom orthotics can be very helpful in providing additional support that can result in long-term relief. Injections or oral medications may be used initially to resolve inflammation and pain. In a very few cases, surgery may be needed to reposition the plantar fascia or to remove heel spurs, bony projections that firm on the bottom of the heel and which can irritate the plantar fascia.
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