Caring & Treating Since 2005
What is Plantar Fasciitis?
If you have ever experienced intense pain over the bottom of your heel whenever you wake up in the morning and take your first few steps, chances are that you have had plantar fasciitis.
Plantar fasciitis is the most common cause of heel pain and affects approximately 1 in 10 people at some point during their lifetime. The pain is typically sharp and sudden and usually happens in only one foot, although both feet can be affected at the same time.
Anatomy and Cause
The plantar fascia is a thick, fibrous band of ligament that lies directly beneath the skin on the bottom of the foot.
It connects the heel to the front of the foot and helps to support the arch of the foot.
The plantar fascia is essentially like a bowstring, designed to absorb the high stresses and strains placed on the foot. If the tension becomes too great, micro-tears can arise in the fascia, causing inflammation.
The plantar fascia stretches whenever during walking, which leads to repeated micro-tearing of the fascia, which is the reason why this condition can last for many months without improvement.
Symptoms of Plantar Fasciitis
- Pain over the bottom of the foot near the heel
- Pain with the first few steps after getting out of bed in the morning, or after a long period of rest. The pain gradually subsides after a few minutes of walking
- Increased pain after a period of exercise or activity
What are the Risk Factors of Plantar Fasciitis?
The factors that may lead to an increased risk of plantar fasciitis include:
- Tends to occur between the ages of 40 to 60
- Obesity leads to excess stress on the plantar fascia
- Repetitive impact activity such as long-distance running
- Abnormal foot mechanics such as flat feet, a high foot arch or an altered walking pattern can lead to increased stress on the plantar fascia
- Occupations that require long hours of standing or walking
- New or increased physical activity that the body is not conditioned for
How to Diagnose Plantar Fasciitis?
A diagnosis of plantar fasciitis is usually made after a detailed history and physical examination of the affected foot.
Usually, no investigations are required, but your doctor might suggest an X-ray or magnetic resonance imaging (MRI) scan to ensure that the pain is not due to another problem, such as a stress fracture or nerve impingement.
How to Treat Plantar Fasciitis?
The treatment for plantar fasciitis depends on the severity and include:
- Avoidance of any strenuous activities for several months
- Painkillers such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Gentle exercises to stretch the plantar fascia and Achilles tendon, and to strengthen the lower leg muscles.
- Wearing a splint at night to stretch the calf muscle and arch of the foot while sleeping.
- Wearing arch supports can help to distribute weight in the foot more evenly.
- Corticosteroid (H&L) injection. This is injected into and around the area of tenderness and reduces the inflammation. The effect may be temporary, usually around 3 months, but may sometimes last a year or longer.
- Extracorporeal shock wave therapy (ESWT). This painless procedure employs sound waves directed at the area of tenderness and stimulates healing.
- If all else fails, surgery can be considered. The procedure involves detaching the plantar fascia from the heel bone.