Gastric Ulcer: Causes, Symptoms, Diagnosis, and Treatment
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Plantar fasciitis is a prevalent foot disorder that involves inflammation and pain in the plantar fascia—the thick, web-like ligament that connects your heel to the front of your foot. This band acts as a shock absorber and supports the arch of your foot, helping you walk.
The primary symptom of plantar fasciitis is a sharp, stabbing pain in the bottom of the heel. This pain is typically worse with the first steps after awakening, although it can also be triggered by long periods of standing or when standing up after sitting.
The exact causes of plantar fasciitis are not entirely understood, but the condition is often linked to repetitive strain injury to the ligament of the sole of the foot. Such strain injury can arise from excessive running or walking, inadequate foot gear, or a heavy body weight.
Additionally, the degeneration of the plantar fascia itself might occur independently of inflammation. This degenerative process is often attributed to repeated microtrauma and can be compounded by factors such as muscular atrophy or tendinopathy in the muscles that facilitate toe movement.
Several risk factors are associated with plantar fasciitis. These include a sedentary lifestyle, having a very high or flat arch (cavus or flat feet), calf muscle contracture, obesity, and wearing shoes with excessively high heels.
The condition often affects individuals whose activities require standing or walking for extended periods on hard surfaces, particularly if they are overweight. Moreover, plantar fasciitis can be associated with other pathological conditions, such as rheumatoid, reactive, and psoriatic arthritis.
Plantar fasciitis is primarily characterized by pain in the heel, specifically at the site where the plantar fascia attaches to the heel bone. This pain is typically most severe with the first steps taken in the morning or after a period of rest, and it may worsen when the heel is subjected to increased pressure.
Patients may also experience a burning or tingling sensation along the inner edge of the foot during activities such as walking. These sensations are indicative of irritation or inflammation of the plantar fascia.
A particularly sharp and intense heel pain can suggest an acute tear in the fascia. This condition may be accompanied by mild to moderate swelling in the heel area. Over time, if plantar fasciitis remains untreated, it can lead to the degeneration of the plantar fascia at its insertion point. This degeneration might manifest as either acute or chronic stretching of the fascia, potentially affecting mobility and quality of life.
The diagnosis of plantar fasciitis is primarily clinical, based on the patient's symptoms and the physical examination findings. During the examination, the clinician may apply forceful pressure to the heel while the foot is in dorsiflexion (upward bending of the foot). This maneuver often triggers the characteristic sharp pain associated with plantar fasciitis.
If the clinician suspects an acute tear of the plantar fascia, an MRI (Magnetic Resonance Imaging) may be ordered. This imaging test provides detailed images of soft tissues and can help confirm the diagnosis by revealing any tears or inflammation in the fascia.
It's important to distinguish plantar fasciitis from other conditions that can cause heel pain. Similar symptoms may be caused by calcaneal bursitis, gout, and radiculopathy.
The treatment of plantar fasciitis aims to alleviate pain and inflammation in the thick band of tissue that runs across the bottom of your foot, known as the plantar fascia. Here is a refined approach to managing this condition: