There is no doubt that the most common cause of heel pain in adults is a condition known as plantar fasciitis. The most common symptom of plantar fasciitis is that it is much more painful when getting up from rest, especially getting out of bed in the morning. Invariable, if anyone has these symptoms, then the diagnosis is almost always plantar fasciitis. The pain of plantar fasciitis after rest can be excruciating. The pain will usually subside after a few steps, but get worse as the day goes on. There is some discussion as to if this is really plantar fasciitis (an inflamation) or plantar fasciosis (a degeneration).
The main risk factors for plantar fasciitis are excessive use, such as sport; being overweight; and having tight calf muscles. The main treatment for plantar fasciitis is usually the use of foot orthotics to reduce the load on the tissues and stretching exercises for the plantar fascia and the calf muscles. There are many other treatments advocated for plantar fasciitis, but all they do is facilitate the healing of the tissues. Unless the load in the tissues that caused the problem is reduced, then it is less likely that plantar fasciitis will get better. Most cases of plantar fasciitis are managed successfully this way and only a very small percent need to go on to surgical management.
There is a lot of confusion between plantar fasciitis and heel spurs or heel spur syndrome. As 20% of the population have heel spurs and have no problem, its just a conincidental finding and the pain assumed to be associated with heel spurs is really plantar fasciitis.
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