Related articles: Plantar fasciitis
Definition
Plantar fasciitis is a disease that affects the plantar fascia (a thick band of fibrous connective tissue that starts from the heel and spreads over the entire sole of the foot). Pain under the heel is the characteristic symptom of this annoying condition.
The possible causes of plantar fasciitis have not yet been clarified; according to recent studies, the degeneration of the fascia would be independent of inflammatory processes (for this reason the term plantar fascicosis was introduced) and could depend on repeated microtraumas or problems of muscular atrophy or tendinopathy on some muscles responsible for the movement of the toes
Degenerative changes in the plantar fascia and atrophy of the subcalcaneal fat pad (usually responsible for absorbing pressure stresses on the heel) can also be the consequence of repeated corticosteroid infiltrations.
Risk factors include a sedentary lifestyle, a very hollow or flat arch (hollow or flat feet), the contraction of the calf muscles, obesity and the use of shoes with excessively high heels.
Plantar fasciitis very often affects people engaged in activities that require standing or walking for a long time on hard surfaces (eg, runners, athletes and dancers), especially if overweight.
Moreover, plantar fasciitis can manifest itself in association with other pathological conditions, such as rheumatoid, reactive and psoriatic arthritis.
Most common symptoms and signs *
- Foot pain
- Heel pain
- Swollen and tired feet
Further indications
Plantar fasciitis is characterized by heel pain at the point of insertion of the plantar fascia on the heel. Often, this symptom gets worse when the heel is pushed forward (propulsive phase of the step). During walking, some patients experience burning or stinging pain along the medial (inner) edge of the foot.
If the heel pain is acute and particularly intense, it may indicate an acute laceration of the fascia. In this case, it may be associated with a slight local swelling (swelling).
Plantar fasciitis can cause degeneration of the plantar fascia in its insertion site (where it may occur that a prominent bone called calcaneal spur forms) and its acute or chronic stretching.
The diagnosis is essentially clinical; during the visit, an energetic pressure on the heel with the dorsiflexion foot triggers the pain. If an acute laceration of the fascia is suspected, an MRI is performed.
Other diseases that cause heel pain can simulate plantar fasciitis. Among these are calcaneal bursitis (manifested by a throbbing pain in the heel, mild heat or swelling), gout (retrocalcanary pain is acute and intense, with local redness and heat) and radiculopathy from a herniated disc (pain occurs radiates from the lumbar region).
The treatment of plantar fasciitis involves stretching exercises of the calf muscles and the soft parts of the foot. Other measures may include the use of braces and orthoses, the use of NSAIDs and weight loss in overweight patients.
