Plantar fascitiis is a common condition affecting mainly those around middle age. It is characterized by pain under the heel and is often of insidious onset. It is aggravated by excessive walking or standing. Hence the term “Policemans Heel” referring to the officers who had to walk long distances while on patrol. Paradoxically, many patients will complain of having symptoms on waking up in the morning and putting their feet down with the pain going away after walking a few steps.
Diagnosis of Plantar Fascitis is made on clinical grounds but XRs may sometimes be obtained to exclude occult fractures of the calcaneum in active individuals.
Heel spurs are occasionally seen on XRs. These are commonly thought by laymen to be the cause of their pain. In fact the spur has nothing to do with Plantar fascitis and is present in 20% of patients who have no symptoms at all. Instead chronic tears or inflammation of the origin of the plantar fascia is thought to be the cause of the pain.
X-Ray showing a typical “heel spur” (Figure 1)