This is a common complaint heard in a doctor’s office. It affects men and women, young and old. But what is it? It is most commonly plantar fasciitis. You may not have heard of this diagnosis. It is more commonly known as a heel spur. This is an older terminology for the same diagnosis. The reason it was called a heel spur was because when the foot is X-rayed, often one sees a spur-like bony projection off of the bottom of the heel bone. For many years, this was thought to be the cause of the pain. Surgery was often performed to remove the spur. But often, even after removing the spur, the pain persists.
As advances in medicine occurred through the years, like examining the tissue in the pathology lab and imaging techniques, it was discovered that the pain was coming from the inflammation of the fascia layer between the layers of muscles and tendons of the foot, not the heel spur itself. Hence the name change to plantar fasciitis, which literally means inflammation of the fascia.
Fascia is a white silvery tissue between the tissues. It is in the entire human body. You may see it on chicken breast, too. It is that white layer you peel off the chicken you get from the grocery store. This tissue has little blood supply, hence it is often very difficult to treat with medicines. Treatment can vary, and usually a multitude of modalities are required to get relief.
Anti-inflammatory medications are used along with heat and ice. But stretching the foot and removing anything that makes the tendons tight are very helpful. Keeping the leg calf muscles warm at night while you sleep can reduce the pain and inflammation. And in most severe cases, a steroid injection to the heel can be useful.
Plantar fasciitis can last a long time and aggravate or cause other lower extremity dysfunction. So if it doesn’t go away, see your doctor for the best attention and relief possible. ••
Jack Tumasz, D.O., practices family medicine with EPIC Physicians, 8019 Frankford Ave.