Make an Appointment
Talk to DoctorOverview
Plantar fasciitis is a condition characterized by inflammation in the plantar fascia, a thick band of tissue that connects the heel bone to the toes and runs along the bottom of each foot. It is the leading cause of heel pain and is usually a result of overuse or excessive stress on the feet.
Inflammation caused by plantar fasciitis can make walking painful. Stabbing pain is a common symptom that is typically felt during the first steps in the morning. After movement, the pain usually subsides, but it may reappear after prolonged periods of standing or when transitioning from a seated position to standing. Plantar fasciitis typically affects one foot at a time, although it can affect both feet simultaneously.
It’s unclear what causes plantar fasciitis. It occurs more frequently in overweight and people who run. In most cases, surgery is not necessary for treating plantar fasciitis.
Symptoms
Typically, plantar fasciitis creates a stabbing pain near the heel on the bottom of the foot. Though it can also be brought on by prolonged standing or getting up from a chair, the discomfort is typically at its greatest when taking the first few steps after waking up.
- Painful arch of the foot
- Stiffness
- Swelling of the heel
- Tightness of Achilles tendon
Causes
The plantar fascia is a band of tissue that connect the heel bone to the toes’ base and provides support to the foot arch while walking by absorbing shock. However, the fascia can develop small tears due to tension and stress, which may cause inflammation or irritation. Despite this, the exact cause of plantar fasciitis remains unknown in many cases.
Risk factors
The exact risk factors for developing plantar fasciitis are still unclear, but there are some factors that can increase the likelihood of its development. These factors may include:
- Age: People between the ages of 40 and 60 are most likely to develop plantar fasciitis.
- Exercise: Long-distance jogging, ballet, and aerobic dancing are examples of activities that put a lot of strain on the heel and connected tissue and may accelerate the development of plantar fasciitis.
- Foot mechanics: The distribution of weight while standing can be affected by flat feet, high arches, or even unusual walking patterns, which can put additional strain on the plantar fascia.
- Weight: Obesity increases the pressure on the plantar fascia.
- Occupations: Plantar fasciitis can be more common in those who spend the majority of their working hours walking or standing on hard surfaces, such as factory employees, teachers, and others.
Diagnosis
The following procedure will assist the healthcare provider in diagnosing plantar fasciitis.
- Physical examination: A healthcare provider will examine the foot for painful location. The location of the pain might be used to identify the cause. Healthcare provider will examine the foot and inquire about the symptoms. The plantar fascia may be lightly pressed to assess for inflammation and check the level of pain.
- Imaging tests: Typically, tests are not required. If the patient is experiencing pain, healthcare provider may advise getting an X-ray or magnetic resonance imaging (MRI) to rule out other issues like a stress fracture.
An X-ray may occasionally reveal a spur-shaped fragment of bone protruding from the heel bone. These bone spurs were once frequently held responsible for heel pain and surgically removed. However, many individuals with heel bone spurs do not have heel pain.
Treatment
Typically, individuals suffering from plantar fasciitis experience relief within a few months through non-invasive treatments, including targeted icing of the affected area, gentle stretching exercises, and adjustments to or avoidance of activities that trigger pain:
Non-surgical treatment
- Medications: Plantar fasciitis pain and inflammation can be reduced with the help of medicines like NSAIDS, naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, among others). Avoid taking NSAIDs for more than 10 days straight without consulting a healthcare provider.
- Self–care: For at least a week (if possible), patient is advised in refraining from any activities that triggered the plantar fasciitis or playing sports. Patient may use cold compression and apply 10 to 15 minutes of cold compress to the foot twice day. This will reduce inflammation, roll a frozen water bottle over the bottom of the foot while covering it with a thin cloth to protect the skin.
- Physical therapy: A physical therapist can demonstrate the stretching and strengthening exercises for the lower leg muscles as well as for the plantar fascia and Achilles tendon. The patient may be shown how to use athletic taping to support the bottom of the foot by the therapist.
- Night splints: Wearing a splint that keeps the plantar fascia and Achilles tendon in a lengthened posture overnight to facilitate stretching while the patient sleep may be advised by a physical therapist or other healthcare professional.
- Orthotics: This arch supports that are either off-the-shelf or specially made to match the wearer’s arch, can help to evenly distribute pressure on the feet. Healthcare provider may advise either ready-made insoles that may be purchased over-the-counter or specially manufactured orthotics that are shaped precisely to the patient’s foo.
- Walking boot, canes or crutches: In order to prevent them from shifting their foot or from putting their entire weight on the foot, a healthcare provider can advise using one of these for a brief duration.
- Surgical or other procedures
Healthcare provider might advise the following if alternative methods are unsuccessful after several months:
- Injections: Temporary pain relief may be obtained by injecting steroid medicine into the painful area. It is not advised to take multiple doses because doing so could weaken the plantar fascia and even cause it to burst. To help with tissue repair, healthcare provider can inject platelet-rich plasma made from their own blood into the sore area. Precision needle placement during injections can be helped by ultrasound imaging.
- Extracorporeal shock wave therapy: In order to promote healing, sound waves are directed at the painful heel area. This is used to treat chronic plantar fasciitis when more conservative measures haven’t worked. Although this therapy hasn’t been proven to be consistently successful, several trials have showed encouraging results.
- Ultrasonic tissue repair: Using ultrasonic imaging, this minimally invasive technique directs a needle-like probe into the injured plantar fascia tissue. The injured tissue is subsequently broken up by the probe tip’s fast vibrations before being suctioned out.
- Percutaneous needle tenotomy: Healthcare provider will insert a needle into the plantar fascia via skin during a percutaneous tenotomy. The area receives more blood than usual from the body, which encourages the plantar fascia’s natural ability to heal.
- Surgery: Surgery is rarely necessary to separate the plantar fascia from the heel bone. It is typically only a choice in cases of extreme pain where all other options have failed. With local anesthetic, it can be carried out as an open surgery or by a little incision. The two most typical surgical procedures are:
- Gastrocnemius recession: To relieve strain on the plantar fascia, healthcare provider will stretch the calf muscles.
- Plantar fascia release: To release some of the additional tension, healthcare provider will make a few very small incisions (cuts) in the plantar fascia.
Healthcare provider or surgeon will specify the kind of surgery that the patient require to address the plantar fasciitis.
