Plantar fasciitis is the most common cause of walking pain at the point where the plantar fascia attaches to the heel bone on its inner portion, often associated with the presence of a small bony protrusion called a heel spur.
The age at which this inflammation occurs is typically between 40 and 60 years and affects both males and females equally.
Factors contributing to its onset are attributed to certain lifestyles such as:
- Prolonged standing
- Overweight/obesity
- Type of physical activity (running, jumping, soccer)
- Wearing inadequate shoes
- Presence of tight calf muscles.
Which are symtomps and the correct diagnosis?
The possibile treatments: conservative or surgical?
It has been demonstrated that conservative therapy is more effective in the early stages of the disease (before the spur has formed). This consists of:
- Rest from activities that exacerbate the pain (running, long walks).
- Administration of systemic pain-relieving medications.
- Administration of local pain-relieving medications (infiltrative therapy).
- Use of suitable shoes with orthotic insoles (silicone insoles).
- Targeted action to reduce risk factors (e.g., a low-calorie diet for weight loss).
When conservative therapy fails to alleviate the symptoms due to the presence of a heel spur with recurrent pain and continuous irritation of the surrounding soft tissues, surgical removal of the spur with plantar fascia release becomes necessary. Through a microsurgical technique under local or regional anesthesia, a mini skin incision of about 3 mm is made at the level of the heel. Subsequently, under radiographic control, the heel spur is removed using a micro drill.
Thanks to this technique, recovery times are extremely rapid, and the foot can be weight-bearing just after a few days. After approximately one week, normal physical work activities can be resumed using a special heel cushion.
