Answer: Plantar fasciitis is also called “Painful Heel Syndrome.” This condition and a related disorder called heel spurs are the two most common causes of heel pain.

Before I can talk about your condition, I first need to give you a short anatomy lesson about the foot. The plantar fascia is a long band of tissue that runs from the heel to the base of the toes. This structure helps to support the longitudinal arch of the foot in a manner similar to way the string on a bow keeps the bow bent.

When you place your foot on the ground and put weight on it, a tremendous amount of force is concentrated on the plantar fascia and its attachment points at the base of the toes and the heel. Normally, your plantar fascia can take all of this punishment without causing a problem. However, sometimes people who put excessive stress on their feet -- like athletes or older people who have weakened foot muscles or those with overly tight muscles and tendons -- may develop plantar fasciitis. Some anatomic abnormalities such as flat feet also make you more prone to this disorder.

Classically, plantar fasciitis causes pain in the central heel region. It is usually at its worst upon initial standing in the morning -- or after any rest period -- and then quickly gets better after the first few morning steps. Unfortunately, the pain usually returns after continued standing or walking. Apparently, this is what is happening to you.

When you visited your doctor, he or she probably asked you questions about the severity, location, duration and timing of your pain. This history is usually enough to make the diagnosis. If an X-ray of the foot was taken, it was probably negative.

Now that you have a diagnosis, the treatment should be based on the severity of symptoms. But, please note that recovery can be difficult and prolonged. Among the things your doctor might try -- again depending on your specific symptom pattern -- are non-steroidal anti-inflammatory drugs, a change of activity and recommendation for new, properly fitted shoes for walking or running. Stretching and strengthening exercises can help prevent a recurrence but should not be started until your inflamed foot is starting to feel somewhat better. Your family physician or a physical therapist can structure an exercise program specific to your underlying problem.

If you have a great deal of inflammation and the pain is intense and unrelenting, your doctor may recommend steroid injections in the heel tendon. Sometimes prescription orthotic devices in your shoes are needed or even a walking cast to rest the fascia. This may require a referral to a podiatrist -- a doctor who specializes in the care of the feet.

Finally, if your condition does not improve within six to 18 months, a podiatrist or orthopedist should be consulted about the possible need for surgical intervention.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at http://www.FamilyMedicineNews.org.