What on earth is Plantar (sole) Fasciitis (inflammation) and why should we be worried? It is a common problem of pain on the heel pad as shown in the picture. The plantar fascia is a band of tissue that runs from the heel and supports the arch of the foot. A story will help illustrate the problem. Forty-five year old Ram Bahadur was a surgeon in a local hospital who started experiencing pain in his right heel even as he was operating on his patients. He would typically feel better for a short period of time when he soaked his feet in hot water. The pain was worse in the morning after he woke up and walked around. There was increased pain and tenderness when he pressed his finger on the soft pad of his heel (picture). Other than this bothersome, dull ache in his right heel, he felt completely normal with no other complaints. There was no history of trauma or any neurological diseases. He took ordinary pain medicines which gave him some relief.

Individuals who spend a significant amount of time on their feet either walking, standing or running may be more predisposed as in the case of the surgeon who spent many hours standing and operating on patients. Athletes who are constantly pounding their feet on a hard surface are also liable to suffer from plantar fasciitis. Obese people and people above 40 also may suffer from this problem due to the excessive weight bearing and pressure on the heels for many years. The most experienced clinicians will make the diagnosis without doing any tests, just based on the history and the tenderness on the heel after careful examination.

Unfortunately there is no single, effective treatment for plantar fasciitis. Educating patients about their condition can be an integral part of therapy. Athletes with plantar fasciitis may need to modify their activity and opt for relative rest for a temporary period of time. Obese people will need to lose weight. Not walking bare feet and using shoes with good arch support and cushioned heels may help. Massaging and stretching the fascia in the morning, for example, by rolling the foot over a can may be beneficial. Besides taking ordinary pain medicines, using ice on the heel pad after exercise or just soaking the feet in warm water can provide temporary relief. Some doctors will inject steroidslocally into the fascia, but this is more of a drastic measure for pain control. In most instances the pain will improve within a year even without any therapy.