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Plantar fasciitis

Plantar fasciitis is a common condition that causes pain under the heel of the foot. It is known also as 'policeman's heel'. The painful area is usually situated about 5 cm (2 inches) from the back of the heel on the sole of the foot.

What is the cause?

It is an inflammation of the site where a long ligament called the plantar fascia attaches to the main heel bone (the calcaneus). It is a condition similar to tennis elbow. One known cause is a tear of this tissue, which can happen, for example, when a runner takes off quickly. Sometimes a spur of bone develops at this spot, but the spur is not a serious problem.

The problem is not thought to be caused by faulty footwear.

Who gets it?

It occurs typically in people over the age of 40, especially if they start a running activity. It occurs in both sexes. It is common in people who have to stand or walk for long periods in their job, such as policemen on a beat.

It is seen sometimes in young sports people.

What are the symptoms?

The pain under the heel is worse when the person first steps out of bed or gets up to walk after sitting for a long time. It is relieved after walking about, but then returns towards the end of the day after a lot of walking. Resting will always ease the pain until you get up and walk. Climbing stairs also hurts.

The painful area on the heel is tender to touch, but not unbearably so.

X-rays may show a small spur on the bone.

What is the outcome?

The pain will usually go away by itself in about 12 months, sometimes as early as 6 months. It is not a serious problem.

What is the treatment?

Rest from long walks and from running is important.

Heel pads

The standard treatment is to wear a pad at all times inside the shoe or slipper to cushion the heel. The pad is made from sponge or sorbo rubber and should raise the heel about 1 cm. A hole corresponding to the tender area should be cut out of the pad so that this area does not make direct contact with the shoe. Suitable shapes. The best pad is a special inner sole (called an orthotic aid) that is moulded for your foot to include the arch as well as the heel.

Injections

If the pain is really bothersome (it is often bad for 2 months), an injection given by your doctor can give relief for a few weeks. It is uncomfortable to have but generally well worthwhile.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia

North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
Please note: NEVDGP does not provide an on-line consultation

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