Definition & Overview
Plantar fasciitis is a foot problem commonly known for causing pain in the heel. The term plantar fasciitis is taken from the plantar fascia, a ligament connecting the heel to the toes. Since it runs through the entire length of a foot, it also supports the arch. Thus, it can be very vulnerable to strain. If this occurs, you may experience weakness, pain, and inflammation in the area. If the plantar fascia is strained repeatedly, there is a risk of tearing it completely.
Since the plantar fascia can get worn over time, this foot condition most commonly strikes during old age. It is most common among middle-aged individuals, although it can also affect younger people, especially those who often stay on their feet for extended periods of time.
Cause of Condition
Your risk of straining or tearing the ligament supporting your foot’s arch is affected by the following factors:
- Excess pronation, or when your feet abnormally roll inward when you walk
- Having flat feet
- Having high arched feet
- Staying on your feet a lot
- Standing on hard surfaces a lot
- Being overweight
- Wearing ill-fitting shoes
- Wearing old, worn out shoes that no longer sufficiently protect the feet
- Tight Achilles tendons
- Tight calf muscles
- An injury that gets worse over time
- Natural aging process
To determine whether your plantar fascia is experiencing some strain, here are the key symptoms of plantar fasciitis:
- Pain in the heel that gets worse when you are standing or walking
- Pain in one heel or both
- Painful first step after sleeping or sitting for a long period; the pain may lessen the more steps you take
- Pain that gets worse gradually as the day progresses
- Pain when climbing the stairs
- Stiffness that gets worse in the morning
It is important to begin the treatment for plantar fasciitis as soon as the condition is diagnosed. Otherwise, the condition may make it impossible for you to walk normally, forcing you to change your manner of walking to avoid the pain.
Seek immediate medical attention, however, if you experience these more severe symptoms:
- Painful heel
- Redness in the heel
- Warmth in the heel
- A tingling sensation
Who to See & Types of Treatments Available
If you experience the symptoms discussed above, especially in the arch area of your feet, consult a doctor to determine whether you are suffering from plantar fasciitis. Correct diagnosis and early detection of the disease can help relieve your symptoms to allow you to perform your regular activities with ease. Beginning treatment as soon as symptoms are first noticed will improve your prognosis.
It is, however, important to accurately diagnose plantar fasciitis since there are other health problems that may cause a similar set of symptoms. These have to be ruled out before plantar fasciitis can be diagnosed and treated.
For an initial checkup, you may approach your family physician, a sports medicine specialist, a podiatrist, and an orthopedist. To determine whether the problem is caused by a strained or torn plantar fasciitis, your doctor will watch you walk and stand, analyze your medical history and current state of health, and evaluate your symptoms. He will specifically ask you about the exact location or origin of the pain. He will also evaluate your risk factor for getting plantar fasciitis by considering your level of physical activity. If needed, he may request for a foot x-ray, which helps determine whether a strain, tear, or fracture is present. If your primary care provider, however, is having difficulty diagnosing your condition, he may ask for more tests, such as blood tests, bone scans, MRI, and vascular testing. If your doctor thinks that a nerve is compressed or trapped, you may be referred to a neurologist for testing.
There is a wide range of possible treatment solutions that can help relieve the symptoms of plantar fasciitis. These can be incorporated into a whole treatment plan that the patient has to follow strictly. This treatment plan will be designed especially for your needs. The main goals of plantar fasciitis treatment are:
- To reduce inflammation and relieve heel pain
- To promote healing in the damaged ligament
- Strengthen the foot
- Correct foot problems
- Enable the patient to return to normal daily activities
Here are the treatment options available to those seeking relief from plantar fasciitis:
Allowing your feet to rest – Since plantar fasciitis is caused by a ligament worn out by stress, the most important factor in treating this foot problem is to give the feet enough time to rest. This may require changing one’s lifestyle or giving up certain activities that affect the feet. This rest period will allow the ligament to heal itself, so it is important to get off your feet for a while.
Pain medications – Doctors often prescribe over-the-counter pain relievers as well as prescription pain medications to help relieve the pain and discomfort caused by plantar fasciitis. Some examples of pain relievers prescribed for sufferers of this foot condition include nonsteroidal anti-inflammatory drugs or NSAIDs, such as ibuprofen or naproxen. Aside from oral pain medications, these drugs also come in a cream form that can be applied topically to the painful area.
Stretching exercises – Doing special stretching exercises, such as toe stretches and calf stretches, can help relieve symptoms. Towel stretches have also been found helpful; to do these exercises, place a rolled towel under the ball of your foot and pull the edges.
Improving footwear – If you are suffering from plantar fasciitis, it is important to use a healthy, protective pair of shoes that fits your foot type. For example, those with high arches need shoes that provide arch support, while those who experience overpronation should use shoes that provide additional cushioning. For those with normal gait, shoes that provide a balance between cushioning and support come highly recommended.
Orthotics - If only one foot experiences symptoms, you can also opt for foot insoles, heel cups, walking casts, and splints.
Steroid shots in the heel – When used properly and injected into the correct part of the foot, steroid injections can be helpful in the treatment of plantar fasciitis.
Weight loss program – This is only applicable for those who has plantar fasciitis caused by obesity. In order to reduce the stress on the feet, the patient may be asked to join a weight loss program.
Corticosteroid injections – If non-surgical treatment methods do not show any improvement after several weeks of treatment, your doctor may make adjustments to your treatment plan. One common addition to the treatment plan is a corticosteroid injection, which is added only when other treatment options are not working. This is because these injections come with certain risks; repeated use can cause some damage to the heel pad and even the plantar fascia.
Surgery – Surgery is only advised by doctors in the most severe cases, such as those wherein pain has been bothering the patient for 6 to 12 months. The main surgical procedure used to treat plantar fasciitis is plantar fascia release, wherein a part of the ligament is cut in order to release tension and calm the inflammation. However, surgical cases are very rare; studies show that only 5 out of every 100 plantar fasciitis patients require surgery.
If the treatment plan advised by a primary care physician is followed to the letter, you may feel an improvement in your symptoms after just a few weeks.The pain, however, may take some months before it disappears completely. Up to 95% of patients are able to recover completely from plantar fasciitis with non-surgical treatment methods.
- Al-Khateeb H, Dega R. (2008). “Planter Fasciitis.” Annals, the Royal College of Surgeons of England.
- Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. (2012). Journal of Research in Medical Sciences.
- Cole C, Seto C, Gazewood J. (2005). “Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy.” American Family Physician.