Plantar Fasciitis
The plantar fascia is tough fibrous tissue across the sole that maintains the arch of the foot.
Repeated micro-tears and repairs replace the injured area with weaker, less elastic scar tissue. Over time it becomes poor-quality degenerative tissue and the condition develops.
Common causes
01
Primary: aging. Left untreated, it affects walking and can cause knee, hip and back problems.
02
Secondary: long-standing lumbar disc or stenosis. Then both the back and the plantar fasciitis must be treated for the pain to improve.
Signs to watch for
- Pain with the first steps in the morning
- More pain when bending the toes upward
- Pain on moving that eases after a period of activity
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
Ultrasound
Examines the joint while it moves, so problems that appear only in certain positions can be found. Inflamed areas can be treated with guided injections at the same time.
MRI
Shows soft tissue that X-ray cannot, such as muscles, ligaments, discs, cartilage, nerves and blood vessels.
How we treat it
Foot problems affect walking and even the knees, hips and back, so early treatment matters. More than 90% of patients recover with conservative treatment, without surgery.
Non-surgical injection therapy
Prolotherapy injects directly into weakened ligaments or tendons to reinforce the fibrous tissue, or a hyaluronic acid injection, a main component of joint fluid, is placed into weakened cartilage.
Manual & exercise therapy
A specialist physical therapist uses hands-on techniques based on anatomy, such as relaxation methods and joint mobilization, to reduce pain and improve function.
Arthroscopy
Through a minimal incision under about 5 mm, an arthroscope with a tiny camera and special instruments is inserted into the joint. It shows areas that are hard to see on X-ray, allowing accurate diagnosis and treatment at the same time.
When surgery is consideredSurgery partially releases the plantar fascia or removes the lesion. Pain can persist afterward and complications such as nerve damage can occur, so it is done only in very limited cases.