foot arch pain not plantar fasciitis treatment

This creates tension/stretch in the arch of the foot/plantar fascia.

Using the hand on your affected side, take hold of your affected foot and pull your toes back towards your shin (Figure 3). This is done in a seated position, and includes crossing the affected leg over the other leg. Plantar fascia specific stretching has been found to provide symptomatic relief for the majority of patients. Plantar Fascia Specific Stretch (Figure 3): Equally good results can be obtained with a formal plantar fascia stretch.It is important that the stretch be done daily.įigure 2: Calf stretch with back leg straight Six sets of 30 seconds per side is one method of achieving this. It should be done with the knee straight so that the gastrocnemius is stretched, as this is the muscle that is tight. The stretching should be performed for a total of 3 minutes per day. Calf Stretching (Figure 2): Regular daily calf stretching performed over a 6 to 8-week period will alleviate plantar fasciitis in almost 90% of patients.The main elements of non-operative treatment are as follows:

The vast majority of patients will have their symptoms resolve with non-operative treatment. There is excellent non-operative treatment available for plantar fasciitis. However, if symptoms fail to resolve after a concerted treatment effort, an MRI may be ordered to rule out other causes of heel pain, such as a calcaneal stress fracture. MRI is initially not indicated for patients with heel pain that is believed to be secondary to plantar fasciitis. Many patients have heel spurs on x-rays and are asymptomatic, whereas, many patients have significant plantar fasciitis and do not demonstrate a heel spur on plain x-ray. However, the presence of a heel spur does NOT directly correlate with symptoms. Essentially, the same traction phenomena that causes overloading of the plantar fascia and its origin may cause excessive bone formation, in the form of a calcaneal heel spur. However, when ordered, a lateral, weight-bearing view of the foot will often demonstrate a calcaneal heel spur. Plantar fasciitis is typically diagnosed based on the patient’s history and on physical examination. Plain x-rays are not routinely indicated.

Seronegative arthritis-induced inflammation.

Entrapment of the first branch of the lateral plantar nerve (Baxter’s nerve).

However, there are other less common causes including:

Plantar fasciitis is by far the most common cause of heel pain. However, any foot type can develop this condition. There is an association between flatfeet and the development of plantar fasciitis. Symptoms may also be exacerbated by placing the toes in a dorsiflexed position, thereby stretching the plantar fascia (See Figure 3). There is often an associated stiffness ( equinus contracture) of the calf demonstrated with the knee straight. Pain can also occur with direct pressure (palpation). new running program)Ĭlinical examination will often localize the pain to the plantar medial heel region.

A recent increase in activity level (ex.

However, it will tend to recur as the day progresses, particularly if the patient has been doing significant weight-bearing activities, such as walking or standing. Burning pain is not typical of plantar fasciitis, and may suggest nerve irritation as a source of the pain (ex. It will often improve after some movement or stretching. This pain is located in the heel and can be sharp (Figure 1). Pain is often also associated with first steps after periods of inactivity, such as sitting for lunch, or after getting out of a car. Patients with plantar fasciitis almost universally give a history of pain with the first few steps in the morning. Figure 1: Common location of plantar fascia pain The main components of an effective non-operative treatment program are: calf stretching with the knee straight, plantar fascia stretching, activity modification (to avoid precipitating activities), and comfort shoe wear. Plantar fasciitis can be managed non-operatively in the vast majority of patients. Risk factors for plantar fasciitis include: excessive standing, increased body weight, increasing age, a change in activity level, and a stiff calf muscle. This microtearing leads to an inflammatory response (healing response) which produces the pain. Microtearing at the origin of the plantar fascia on the heel bone (calcaneus) can occur with repetitive loading.

The plantar fascia is a thick band of tissue in the sole of the foot. Pain from plantar fasciitis is often most noticeable during the first few steps after getting out of bed in the morning. Plantar fasciitis is the most common cause of heel pain. Summary Patient Handout: Plantar Fasciitis

Foot arch pain not plantar fasciitis treatment