Plantar fasciitis is a prevalent foot disorder, marked by pain and discomfort in the heel and the bottom of the foot, impacting a broad range of individuals. This condition, often associated with sharp, stabbing pain that is most intense with the first steps in the morning, can significantly affect daily activities and quality of life. Understanding plantar fasciitis, from its causes and symptoms to effective treatment and prevention strategies, is vital for anyone experiencing heel pain or those at risk. This overview aims to provide comprehensive insights into plantar fasciitis, offering guidance on managing this common but often debilitating condition.

Causes of Plantar Fasciitis

Overuse: It often occurs in runners or those who engage in activities that put a lot of stress on the heel and attached tissue.

• Foot Mechanics: Flat feet, high arches, or abnormal walking patterns can adversely affect the way weight is distributed when standing and can add stress to the plantar fascia.
• Age: It’s more common in people between the ages of 40 and 60.
• Obesity: Excess weight can put extra stress on the plantar fascia.
• Occupations: Jobs that keep you on your feet for long periods, like factory work or teaching, can contribute to the condition.
• Tight Achilles Tendons: The Achilles tendon’s tightness can affect calf muscles, which in turn can put strain on the plantar fascia.
• Improper Footwear: Shoes with poor arch support or thin soles can trigger the condition.
• Pregnancy: The added weight and stress on the body during pregnancy can lead to plantar fasciitis, especially during the late stages.

Related: Understanding Your Tarsal Tunnel Syndrome

Symptoms

• Sharp Heel Pain: The most common symptom is a sharp, stabbing pain in the bottom of the foot near the heel. This pain is typically worse with the first steps in the morning or after a period of rest.
• Pain After Prolonged Standing: Pain might develop after prolonged periods of standing or when standing up after sitting for a long time.
• Pain After Exercise, Not During: The pain is usually not felt during exercise but rather just after stopping.
• Pain when Pressing on the Inside of the Heel: There might be tenderness when the inside of the heel and foot is pressed.
• Stiffness: Some people experience stiffness in the bottom of the heel, which can make it difficult to flex the foot and bring the toes up toward the shin.
• Swelling: Mild swelling in the heel area can occur.

These symptoms usually develop gradually and often affect just one foot, though it’s possible to have it in both feet simultaneously. The pain can vary in severity and sometimes might present as a dull ache. If you suspect you have plantar fasciitis, it’s advisable to consult a healthcare professional for a proper diagnosis and treatment plan

Treatment

Treatment for plantar fasciitis includes:

• Rest and Ice: Reducing or stopping activities that cause pain and applying ice to the affected area can help reduce inflammation and pain.
• Pain Relief Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation.
• Physical Therapy: A physical therapist can show you a series of exercises to stretch the plantar fascia and Achilles tendon and strengthen lower leg muscles, which stabilizes your ankle and heel.
• Orthotics: Custom-fitted arch supports (orthotics) can help distribute pressure to your feet more evenly.
• Supportive Shoes: Wear shoes with good arch support and a cushioned sole.
• Night Splints: Wearing a splint at night can stretch your calf and the arch of your foot, holding the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching.
• Corticosteroid Injections: In some cases, injecting corticosteroid into the tender area can provide temporary pain relief. However, too many injections can weaken the plantar fascia and possibly cause it to rupture.
• Extracorporeal Shock Wave Therapy: This procedure uses sound waves to stimulate healing within the ligament. It’s usually considered in chronic cases where other treatments have failed.
• Tenex Procedure: This minimally invasive procedure removes the scar tissue of plantar fasciitis without surgery.
• Surgery: In very rare cases, when the pain is severe and all other treatments have failed, surgery to detach the plantar fascia from the heel bone might be considered.

Prevention

• Maintain a Healthy Weight: Keeping your weight in a healthy range minimizes the stress on your plantar fascia.
• Choose Supportive Shoes: Avoid high heels, and wear shoes with good arch support and a cushioned sole. Replace your athletic shoes regularly.
• Avoid Barefoot Walking: Walking barefoot on hard surfaces can increase the strain on your plantar fascia.
• Stretch Regularly: Regular stretching of your Achilles tendon and plantar fascia can increase their flexibility and reduce the chance of injury. This is especially important for athletes and people who spend a lot of time on their feet.
• Strengthen Your Lower Leg Muscles: Strengthening exercises can help stabilize your ankle and heel, reducing the load on your plantar fascia.
• Avoid Repetitive Impact Activities: Modify your exercise routine to include a mix of activities, avoiding repetitive impact on hard surfaces.
• Start Slowly When Exercising: Gradually increase the intensity and duration of your workouts to avoid overloading the plantar fascia.
• Pay Attention to Foot Pain: Address any foot pain promptly rather than pushing through the pain, as this can lead to more severe problems.
• Use Orthotics if Needed: People with foot issues such as flat feet or high arches may benefit from custom orthotics.
• Maintain a Healthy Diet: A well-balanced diet can help maintain a healthy weight and reduce inflammation in the body.

Conclusion

Prevention of plantar fasciitis revolves around maintaining a healthy weight, choosing supportive footwear, regular stretching and strengthening exercises for the foot and leg muscles, avoiding excessive stress on the feet, and addressing foot pain promptly. These measures are particularly crucial for individuals at higher risk, such as athletes, people who are overweight, and those who stand for extended periods.

Understanding the causes, symptoms, treatments, and preventive measures of plantar fasciitis is essential for both managing existing conditions and preventing future occurrences. As always, if symptoms persist or worsen, it’s important to seek professional medical advice for a tailored treatment plan.

Please see Foot Pain for treatment options.