The plantar fascia is a thick band of tissue in the sole that helps to support the arch of the foot. When it gets irritated and inflamed, this is known as plantar fasciitis. It is often associated with a bone spur on the heel; but the bone spur is not the cause of the problem.

It is an awful condition causing pain in the sole of the foot, mostly around the heel. It is often worse first thing in the morning when you first attempt to weight-bear (stretching the plantar fascia), and gets worse when standing on flat hard ground. It is often associated with occupations with prolonged standing or walking.

Treatment is somewhat problematic; surgery should be the last resort. Most of the time it will settle in 6-12 months; the mainstay of treatment is physiotherapy with stretching; and orthotics. There is some success overseas with ultrasound treatment; but in Australia there is no equivalent Medicare number, and hence the majority of private insurance companies won’t cover it.

If there is no improvement after six months, surgery can be an option. In modern medicine, an operation with only 65-70% success rate is not terribly good; surgery should really be the last resort.