Heel Pain: Plantar Fasciitis


Pain on the bottom of your heel experienced when you first step out of bed is the classic sign of Plantar Fasciitis (inflammation of the Plantar Fascia). The pain also occurs commonly once you get up from sitting for an extended period of time during the day. The pain can be initiated from a variety of factors including trauma, excessive walking (overuse), poor shoe gear, increased weight gain and age.

On x-rays a bone spur can be seen a majority of the time, however, this is not causing the pain that patients experience. This spur develops from the constant pull of the plantar fascia. The plantar fascia can be thought of as a rubber band on the bottom of your foot that is important in maintaining the integrity of your arch. As patients sleep at night and are off of their feet during the day, the fascia contracts like a rubber band. When you step down first thing in the morning and after sitting for a period of time, the plantar fascia is quickly stretched out. Over time, as this band of tissue pulls on the heel bone where it is attached, small fibers of the tissue are pulled off of the bone. These small micro tears occur causing the fascia to become inflamed and very painful.


Treatment for Plantar Fasciitis heel pain is 90% conservative and 10% surgical. Once x-rays have ruled out any type of fracture or bone abnormality, stretching exercises, anti-inflammatories, cortisone injections, and shoe inserts (orthotics) are initiated. From here, physical therapy, night splints, walking cast boots, and total non-weight bearing are additional options if needed. For those individuals not responding to conservative treatment, surgery is an option, which involves releasing a portion of the plantar fascia. Two new alternative options to the surgery is a new laser technique using MLS Laser Therapy. Additionally, stem cell injections can also provide a safe and less invasive alternative to heel surgery.

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