Plantar fasciitis, which is common in life, is the most common cause of heel pain.Plantar fascia is a tough fan-shaped fiber band connecting the calcaneal tubercle and the base of the toe on the plantar bottom, which plays important physiological functions such as supporting the arch of the foot and assisting walking.Aseptic inflammation of plantar fascia near calcaneal insertion is more likely to occur when patients are overweight, skip too much walking or running, have difficulty in flexion and extension of ankle joint, or have hard soles or ground. Patients with flat feet and high arch foot are more likely to have symptoms.

The common complaint of plantar fasciitis patients is getting up in the morning or sitting up after walking the first step of obvious pain, relieved after a few steps, and then walking more or exercise and pain.

Plantar fasciitis pain is not necessarily located directly below the heel as is commonly believed. In general, medial and middle heel pain is most common.

Because most people’s arches decrease with age (see “Flat Foot In Depth” above), excessive pronation of the foot exceeds the normal 4-6 degree pronation range. Excessive pronation can lead to stretching of the medial plantar fascia and even tearing of the calcaneal attachment, causing aseptic inflammation and pain symptoms.

In middle-aged and elderly patients, atrophy of the calcaneal fat pad enhances the impact of ground reaction forces on the attachment point of the calcaneal plantar fascia, which is also an important cause of local aseptic inflammation and pain symptoms.

Plantar fasciitis at the beginning of the attack can be relieved by a short rest, if the risk factors are not removed, it will be chronic, repeated plantar pain, gradually appear calcaneal spur, each attack gap shortened, pain time prolonged.

Repeated plantar pain can be very debilitating and severely limit the patient’s ability to move.

Causes of heel pain in addition to plantar fasciitis there are calcaneal stress fracture, foot nerve compression, Achilles tendinitis and so on, the need for experienced specialists through medical history, physical examination and imaging to identify the diagnosis.

Plantar fasciitis is a more stubborn disease, generally speaking, the early curative effect of the disease is better, the longer the duration of symptoms, the longer the treatment time is required.

Basic treatment include weight loss, decrease walk, run and jump, custom insoles correction before reducing membrane injury and switch to loose large base shoe, etc., at the same time to carry on the plantar fascia, Achilles tendon and triceps leg stretch therapy can accelerate rehabilitation, reduce recurrence for moderately severe pain occurs can also add a local ice compress and oral NSAIDS anti-inflammatory painkillers.

For chronic recurrent plantar fasciitis heel pain, shockwave therapy, topical steroid injection, topical application of PRP, or surgery may be performed.

Commonly used surgical methods include gastrocnemius release, plantar fascia release, calcaneal spur resection, etc., with little surgical trauma and rapid recovery.


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