Plantar Fasciitis

Once plantar fasciitis has been identified as the cause of your heel pain, non-invasive treatments include resting and icing the area, along with anti-inflammatory drugs to reduce inflammation. A steroid injection can also relieve inflammation and pain.
Plantar Fasciitis

Plantar Fasciitis

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Table of Contents

Introduction - Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a band of tissue that runs along the bottom of the foot from the heel bone to the toes. This tissue helps to form the foot’s arch.

With overuse such as running or standing for long periods on hard surfaces, or from wearing shoes with little support, tiny tears can develop in the plantar fascia. These can cause inflammation and heel pain.

Causes

Plantar fasciitis is often caused by poor foot mechanics. If your foot flattens too much, the fascia may overstretch and swell. If your foot flattens too little, the fascia may ache from being pulled too tight.

Plantar Fasciitis Symptoms

With plantar fasciitis, the bottom of your foot may hurt when you stand, especially first thing in the morning. Pain usually occurs on the inside of the foot, near the spot where your heel and arch meet. Pain may lessen after a few steps, but it comes back after rest or with prolonged movement.

  • Sharp, burning or throbbing heel pain
  • Pain is worst when arising from bed in the morning because the plantar fascia has contracted during the night
  • The pain eases during the day
  • Pain returns after resting or sitting for a period

Related Problems

A heel spur is extra bone that may grow near the spot where the plantar fascia attaches to the heel. The heel spur may form in response to the plantar fascia’s tug on the heel bone. Bursitis is the swelling of a bursa, a fluid-filled sac that reduces friction between a ligament and a bone. Bursitis may develop if a swollen plantar fascia presses against a plantar bursa.

Treating Plantar Fasciitis - Medical History and Physical Exam

Where and when does your foot hurt? Your podiatrist may first ask about your symptoms. Then he or she may feel for damaged ligaments, inflamed tendons, and displaced bones or joints. Your podiatrist may also watch you walk to see if your symptoms are caused by incorrect foot movement.

Once plantar fasciitis has been identified as the cause of your heel pain, non-invasive treatments include resting and icing the area, along with anti-inflammatory drugs to reduce inflammation. A steroid injection can also relieve inflammation and pain.

Wearing a brace to keep the plantar fascia stretched at night can be very effective.

Physical therapy will help. Strengthening and stretching exercises and massage will restore the plantar fascia’s flexibility.

There are more intense treatments available for persistent pain, and surgery may be recommended in severe cases.

Testing

X-rays of your foot may be taken, or you may have a bone scan to confirm a suspected heel spur or a stress fracture of the heel bone. To check for plantar fasciitis and related problems, your podiatrist may press the bottom of your foot near the heel.

Can My Podiatrist Help? Preventing Plantar Fasciitis

Reducing symptoms is your podiatrist’s first goal. Then he or she works to correct the cause of your problem. If your pain is due to poor foot mechanics, custom-made shoe inserts (orthoses) may help. We also now offer EPAT Treatment.

Reduce Symptoms

To relieve mild symptoms, try aspirin, ibuprofen, or other medications as directed. Rubbing ice on the affected area may also help. To reduce severe pain and swelling, your podiatrist may prescribe pills or injections. Physical therapy, such as ultrasound or stretching exercises, may also be recommended. To reduce symptoms caused by poor foot mechanics, your foot may be taped. This supports the arch and temporarily controls movement. Night splints may also help by stretching the fascia.

Control Movements

If taping helps, your podiatrist may prescribe orthoses. Built from plaster casts of your feet, these inserts control the way your foot moves. As a result, your symptoms should go away.

If Surgery Is Needed

Your podiatrist may consider surgery if other types of treatment don’t control your pain. During surgery, the plantar fascia is partially cut to release tension. As you heal, fibrous tissue fills the space between the heel bone and the plantar fascia.

What Can I Do?

You can’t stay off your feet altogether, but you can reduce overuse and the risks that come with it. Also, be sure to follow your podiatrist’s treatment plan. Take medications as directed, and wear orthosis if you have them, even while at home.

Some lifestyle changes can also help a return of plantar fasciitis:

  • Lose excess pounds if you are overweight.
  • Avoid running on hard or uneven ground
  • Choose sturdy shoes with good support.
  • Avoid wearing high heels.  Wear shoes or house slippers that support your arch.
  • Low-impact exercises such as biking and swimming are better for your heels than running.
  • Stretch your calves regularly during the day and after a workout.
  • Sleep with your bedsheet untucked at the bottom so your feet and legs can stretch out at night.