"I thought chiropractors just treated backs and necks?"

Just like your medical doctor has many tools such as a myriad of different drugs and surgery options, so does a chiropractor have many methods of treating conditions. Manipulation is one tool that chiropractors may use; but, not in this particular case. Many of the below therapies, such as custom-fitted orthotics, are provided by doctors of chiropractic.

Plantar fasciitis is an inflammation of the plantar fascia. Some recent reports^1,2 stress that degeneration rather than inflammation of the plantar fascia occurs. "Plantar" refers to the bottom of the foot. "Fascia" is tissue that surrounds muscle and often separates the skin from muscle or other deep tissue. It functions as a bowstring to maintain the arch of the foot by connecting the heel bone to the ball and toes.

Plantar fasciitis is closely related to heel spurs, although the two are not exactly the same. Heel spurs are bony growths that result from too much tension in the plantar fascia. Heel spurs are the common result of repetitive trauma or tension in the plantar fascia for an extended period of time. A heel spur and/or the plantar fascia may "trap" or irritate nerves in the heel area and cause more pain. It is often difficult and usually unnecessary to distinguish between plantar fasciitis and heel spur syndrome. Causes and non-surgical treatments for the two conditions are the same. Many health-care providers use the terms "heel spurs" and "plantar fasciitis" interchangeably.

These conditions are usually caused by a change or increase in activities, no arch support, lack of flexibility in the calf muscles, being overweight, a sudden injury, using bad shoes on hard ground, or spending too much time on the feet. Arthritis can cause similar pain. Those with flat feet or high arches are more likely to get plantar fasciitis (heel spurs). It may run in the family.

Despite the claims of various health-care providers there is no "cure-all". Avoid health professionals that discount other practitioners and push their own treatment methods as the best remedy. Different combinations of treatments help different people. Patients must be active in their treatment. The most successful treatments, done by a co-operative team of chiropractors, physiotherapists, medical doctors, and related providers, may involve:

• ice use

• losing extra weight

• better shoes (with an arch support and/or supportive heel)

• decreasing or changing causative activities

• heel pads, arch supports, shoe inserts, or custom-fitted orthotics

• electro-therapies such as ultrasound or interferential current

• non-aggravating stretching, massage, and exercise for the calf muscles, plantar fascia, and tibialis anterior muscle

• anti-inflammatory medication such as aspirin or Ibuprofen in moderation

• during periods of severe pain keeping the foot raised above the heart and/or compressed by wrapping with ace bandages.

• swimming, pool running, low gear cycling

• night splints and taping

• surgery

Many of the treatments that you see above are done by you. Your active involvement is essential for long term success. Frequent specific exercise and stretching can help prevent the onset of plantar fasciitis and resultant heel spurs.