Plantar Fasciitis

• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that is worse in the morning or after sitting/standing for a long time
• Heel swelling
• A tight Achilles tendon

Plantar fasciitis can be caused by

• engaging in activities like running, dancing, and aerobics that strain the heel bone;
• Having flat feet or high arches
• being older
• being overweight
• pregnancy
• standing for long periods of time
• wearing shoes with stiff soles or inadequate arch support

• Weight-bearing X-rays
• Ultrasound or MRI scans may be required

The vast majority of patients will improve with non-surgical measures.

• Topical pain creams e.g. NSAIDS
• Pain medications e.g. NSAIDS such as Mobic or Panadol Osteo
• Shoe wear modification
  • athletic shoes
  • stiffer soled shoe with rocker bottom modification
• Physiotherapy:
  • plantar fascia and achilles tendon stretches
• Plantar fascia exercises:
  • rolling the foot on a frozen water bottle
  • rolling the foot on a tennis ball

• Activity modification:
  • improve fitness and strength via non axial loading exercises e.g. cycling, swimming
  • avoid axial loading exercises e.g. running
• Off the shelf or custom orthotics
• Night splints
• Silicone heel pads
• CAM boots may be required to rest the fascia
• Weight loss management
• Shockwave therapy

Surgery for plantar fasciitis is considered if symptoms don't improve for over 6-12 months.

All surgery has risks involved, however every effort is made to reduce these risks. Risks include but are not limited to:

• Infection: superficial wounds or deep infections
• Clots: DVT (deep venous thrombosis) or PE (pulmonary embolus)
• Nerve damage: tingling, numbness or burning
• Ongoing pain
• Stiffness of the ankle joint
• General or anaesthetic risks including to the heart and lung
• Drug reactions/allergy
• Scarring or tethering of the skin
• Rupture
• Calf weakness
• Revision surgery

There are increased risks of surgery in diabetics, smokers, significant peripheral vascular disease, severe neuropathy, previous or current infection which may preclude a patient from surgery.

View FootForward for Diabetes (run by Diabetes Australia) for more information on foot care.