Plantar fasciitis is very common.

It causes pain beneath the heel of the foot which is characteristically worse first thing in the morning or when putting the foot to the floor after a period of rest.

It is caused by excessive tension in the thick fibrous band of tissue which runs under the foot. It is commonly associated with a tight calf muscle. People who are overweight or diabetic are more prone to develop plantar fasciitis although it can occur in anyone.

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The condition is self-limiting, meaning that eventually it will burn itself out. There are a number of treatments which may be helpful in reducing the severity and duration of treatment:

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• Physiotherapy is the mainstay of treatment. Stretching exercises aim to release tension in the calf muscle and the plantar fascia.
   

• Shockwave therapy is a non-invasive treatment in which mechanical energy is delivered to the tissue in order to promote healing. When used alongside a structured physiotherapy regime around three-quarters of patients will have significant pain relief. We have a shockwave machine at KIMS Hospital and for patients wishing to fund their own treatment there is a competitively priced physio/shockwave package available.
   

• Steroid injections may temporarily reduce plantar fascia pain. They are very painful if done whilst you are awake so I routinely preform the injection under sedation in the operating theatre. Although an injection is likely to reduce symptoms, it is not permanent and would be administered alongside a physiotherapy programme. There is some risk of tissue damage associated with steroid injections, particularly if someone has had multiple injections in the past.
   

• If the calf muscle remains particularly tight despite a supervised stretching regime, it can be released through a small incision behind the knee. This can usually be done under local anaesthetic and may be helpful in cases which have failed to settle with shockwave and physiotherapy.