Heel pain: plantar fasciitis or plantar fasciosis?

Plantar fasciitis is a common cause of heel and arch pain, with over 1 million visits annually in the United States to health care providers. Inflammation or thickening of the main supportive band of "celery-like" ligaments connecting the heel bone (calcaneus) to the toes may be related to injury, overuse without adequate conditioning, obesity, improper shoes, inflammatory conditions such as rheumatoid arthritis, tight Achilles tendons, and/or flatfoot or high arches. This pain is often deep "bruising" pain under the heel especially when getting out of bed in the morning. If the inflamed fascia continues for several weeks or a few months, thickening of the fascia may lead to softening of the bands of this ligament. In turn, degeneration of the ligament may cause tears within the fascia, or, plantar fasciosis. Diagnostic ultrasound is useful and sensitive in identifying changes within the plantar fascia. So, is it inflammation or degeneration? Also, Xrays are helpful in studying the heel bone for abnormalities, tumors, spurs, stress fractures and so forth. While other conditions can cause or contribute to heel pain, plantar fasciitis or plantar fasciosis are recognized as the "big players". Dr. Johnson