A common complaints I see in our Sports Clinic is foot pain, and probably the most common cause is inflammation of the thick band of fascia along the sole of the foot.

As with all of medical terminology, the suffix “-itis” simply means “inflammation”. 

So this is not a disease that spreads to other parts of the body, just a mechanical “wear and tear” issue from daily use. Walking on hard surfaces is one of the big causes, as any pedestrian in a big city knows. Also excessive pounding from impact sports such as running can also be to blame.

For a more complete understanding of the problem, check out this link:

http://en.wikipedia.org/wiki/Plantar_fasciitis

For treatment options, consider the following:

1. Eschew the (dressy) shoe.  We are built for walking, but not on concrete, and certainly not in dress shoes.  If you do much pedestrian activity, consider a comfortable-if-ugly pair of good walking shoes, then carry or leave your dress shoes at work.  If you are a runner, make sure you replace your shoes long before they start to look old, and, if you are a beginner, make sure you increase your weekly mileage gradually.

2. Try a simple heel lift, such as a thicker walking shoe, or a simple cheap pad for your regular shoes.  Even a half-inch lift can pitch your body weight onto the balls of the feet, instead of the heel.  Usually the worst option is no lift at all, such as a pair of flats or sandals. 

3. See a foot specialist.  If you have poor alignment of your feet and ankles, you may be heel-striking off-center whenever you walk or run.  This is where orthotics can be very useful, but not the cheap squishy ones in the store.  If you actually need an orthotic to correct your foot architecture, get a professional to take a proper imprint of your foot, then make up a hard orthotic that will only fit you.

4. Consider some simple options, like home stretches, massages, and exercises followed by ice packs. Remember to also stretch the calf muscles and Achilles tendons, as they directly pull around the corner of the heel bone, and apply tension to the plantar fascia.  

5. If the above is not working, an excellent option is medical acupuncture, but this works best if one treats the whole calf/Achilles mechanism as well as trigger points into the heel or sole.  Usually just three or four needles will suffice, and a few treatments will bring quick resolution.  For more on how acupuncture works, see our blog on acupuncture. 

If nothing else works, ask your doctor about a cortisone injection.  Not our first choice, but a reasonable option if pains are resisting all other attempts.