Here is a good medical article on Plantar Fascitis

I have been working with over 5 different chronic cases of foot pain which include plantar fascitis. This condition can go on for years and years without the correct soft flexible orthotics, good quality lace up shoes. Osteopathic treatment should include electrotherapy and strapping while the microtears in the collagen fibres recover and heal. Without such treatment, the condition will continue.

Plantar fasciitis is a common, painful foot condition. Patients, and sometimes doctors often confuse the terms plantar fasciitis and heel spurs. Plantar fasciitis refers to the syndrome of inflammation of the band of tissue that runs from the heel along the arch of the foot; a heel spur is a hook of bone that can form on the heel bone (calcaneus). About 70% of patients with plantar fasciitis have been noted to have a heel spur that can be seen on X-Ray.

Who gets plantar fasciitis?
Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. Plantar fasciitis is diagnosed with the classic symptoms of pain well localized over the heel area of the bottom of the foot. Often the pain from plantar fasciitis is mostsevere when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking.

Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. Plantar fasciitis is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the fibrous tissue that forms the arch of the foot.

Could something other than plantar fasciitis cause this pain?
Plantar fasciitis can be confused with a condition called tarsal tunnel syndrome. In tarsal tunnel syndrome, an important nerve in the foot, the tibial nerve, is trapped and pinched as it passes through the tarsal tunnel, a condition analogous to carpal tunnel syndrome in the wrist. This may cause symptoms similar to the pain of a plantar fasciitis.

There are also other less common problems such as nerve entrapments, stress fractures, and fat pad necrosis, all of which can cause foot pain. Finally, several rheumatologic conditions can cause heel pain. These syndromes such as Reiter’s syndrome and ankylosing spondylitis can cause heel pain similar to plantar fasciitis. If your symptoms are not typical for plantar fasciitis, or if your symptoms do not resolve with treatment, your doctor will consider these possible diagnoses.

Why did I get plantar fasciitis?
Plantar fasciitis occurs because of irritation to the thick ligamentous connective tissue that runs from the heel bone to the ball of the foot. This strong and tight tissue contributes to maintaining the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. Therefore, the stress placed on the this tissue is tremendous.

When a patient has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed (tendonitis) and degenerative (tendinosis)–these abnormalities cause plantar fasciitis and can make normal activities quite painful.

Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.

Helen How
Registered Osteopath
14 Craighall Gardens
Edinburgh EH6 4RJ
0131 551 1044

£35 for one hour session
£20 for 30 minutes simple easy to treatment follow ups

see reviews on Helen on Edinburghonline

I am seeing an increased number of cases of painful feet in people under the age of 40.

Foot pain can be a tricky problem to treat, especially heel pain and pain caused by inflammation of the plantar fascia, the thick connective tissue which supports the arch of the foot. One of the probable causes is that our shoes nowadays offer less protection to the different parts of the foot.

Many of the modern inserts in our shoes, and some of the orthopaedic devices designed to support or correct the way we walk, instead of providing comfort, are rather hard and uncomfortable. This can mean our heels slipping around on the hard surface, resulting in a deep and long lasting pain around the base of the heel or along the sole of the foot. The more flimsy forms of flat shoes, for example pumps, in particular can cause these problems.

Recovery from and treatment of this very painful condition is complicated. It involves finding good quality lace up shoes with soft non slippy surfaces which can grip the heel to avoid irritation from it constantly moving.

Osteopathic treatment for this condition involves ultra sound, stretching and soft tissue support. Sometimes it is necessary to strap and tape the feet initially, when the foot is very sore.

More on this next week.

Helen How
Registered Osteopath
14 Craighall Garden
Edinburgh EH6 4RJ

0131 551 1044