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Plantar Fasciitis (heel spur)



Plantar Fascitis is one of the most common reasons for heel pain. It is also sometimes referred to as heel spur syndrome. We at the OC Foot and Ankle Associates are strong advocates of aggressive conservative treatment for heel pain. However, heel pain that persists longer than 6 months, despite conservative treatment, should be evaluated closely and we are committed to providing you with all available options including Extracorporeal Shockwave therapy, a noninvasive treatment for persistent heel pain and Endoscopic Plantar Fasciotomy when all other measures have failed. We are one of the few physicians in Southern California certified in performing revolutionary nonsurgical Shockwave Therapy.


Plantar fascia is a ligament on the bottom part of your foot that runs from the ball of your foot to the heel. Some of the fibers of the Achilles tendon in the back of your leg continue on to the form the plantar fascia on the bottom of the foot. Plantar fascitis refers to an inflammation of this ligament at the point where it attaches into the heel. This condition is sometimes referred to as heel spur syndrome because occasionally on x-ray, you may see a bone spur at the area where this plantar fascia attaches. Numerous studies have shown that the bone spur itself does not cause the pain but is just an indication that the plantar fascia has probably been tight over numerous years and is constantly pulling on the bone. People can have absolutely no heel spur and have tremendous pain or vice-versa, have very large spurs on x-ray but no symptoms at all.


Most common complaint with this condition is a deep, achiness feeling, esp. with first steps in the morning or with first steps after a period of sitting. The reason for this is that while sleeping or sitting, the plantar fascia tightens up and thus when you stand, the ligament pulls on the heel, and this stretching is what causes the pain. It usually begins to feel better after several steps but may return again after being on it for a prolonged amount of time.


After complete evaluation of your foot including clinical and radiographic (x-ray) exam, conservative treatment may include stretching, cortisone injections, orthotics, night splints, immobilization, and possible restrictions on weight-bearing. We ensure each treatment program to be individualized based on your needs.


Once conservative measures have failed, and heel pain still persists after 6 months, the OC Foot and Ankle Associates are dedicated to ensuring that all available options are discussed and that the best option is recommended. This may include a revolutionary noninvasive shockwave therapy (please refer to section on ESWT) that allows immediate ambulation with no incisions or down time. Other options may also include Endoscopic Plantar Fasciotomy, a minimal incision, endoscopically guided surgical treatment that involves resecting the plantar fascia so that it does not pull on the heel anymore. Please contact us to see if this is an option for you.

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