Bony avulsions are treated in essentially the same way. Plantar faciitis can commonly be diagnosed with the history and physical exam alone. This heel pain can also occur with the first step after sitting for a prolonged period of time. Conservative treatment is the cornerstone of treatments for this problem and surgery is almost never indicated. Other causes of heel pain include compression of the first branch of the lateral plantar nerve, fat pad atrophy and pain associated with a seronegative spondyloarthropathy.
Some specialists advocate stretching exercises.
Deeper ulcerations may require surgical debridement and meticulous wound care. Broad spectrum antibiotics are indicated for infected ulcers. It is important to select antibiotics that cover gram positive and negative organisms, as well as anaerobes, as these infections tend to be polymicrobial. Lesions discovered radiographically often require biopsy for confirmation. Home maintenance programs have shown benefit in terms of decreasing joint bleeds and damage.