Plantar Fasciitis
What is it: Plantar fasciitis is caused by inflammation of the plantar fascia at its insertion on the calcaneous, often associated with tightness of the gastrocsoleus muscles.
How does it present: Patients usually have heel pain, particularly worse with the first few steps in the morning. Pain may also be exacerbated by excessive walking or walking on hard surfaces.
Common exam findings: The exam may show tenderness at the plantar fascial insertion. Patients may also have a tight gastrocsoleus.
Tests and treatment: Foot x-rays may reveal a calcaneal spur, which is generally an incidental finding and not related to the foot pain. Treatment is generally conservative aimed at stretching of the gastrocsoleus complex and plantar fascia. Tension night splints can be used, as can heel pads. Steroid injections to this area are somewhat controversial, and in rare cases surgical release can be done.