Plantar fasciitis is a common problem that causes pain under the heel bone often first thing in the morning and with prolonged standing. It is often seen in middle-aged men and women.
The plantar fascia is a thick band of tissue that lies at the bottom of the foot. It runs from the heel bone to the toes and forms the arch of the foot. The plantar fascia functions as a shock absorber and also supports the arch of the foot.
Too much tension in the fascia may damage or tear away the tissue from the bone and can be a cause of heel pain. It is also possible that when the plantar fascia gets overstretched or overused repeatedly, there may be irritation or inflammation of the fascia. Inflammation of the plantar fascia causes plantar fasciitis.
The risk factors that can make you more prone to develop plantar fasciitis include obesity, foot arch problems such as flat feet, high arch, activities such as long distance running, ballet dancing, dance aerobics, occupations that necessitate walking or standing on hard surfaces for long periods of time and wearing shoes with poor arch support or thin-soled shoes.
The most common symptom of plantar fasciitis is stabbing pain on the bottom of the foot near the heel. The pain develops gradually and may involve either one or both feet at the same time. Pain is usually worse in the morning or after standing up for a long time.
Your doctor will examine your foot and will check for the signs of flat feet or high arches, tenderness, swelling, redness of the foot and stiffness or tightness of the arch in the bottom of your foot.
Your doctor may suggest an x-ray or MRI scan to rule out other causes of heel pain such as a stress fracture or pinched nerve.
Most patients with plantar fasciitis are effectively treated with the following measures:
Medications: Your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) as they can reduce your pain and inflammation. Corticosteroids can be injected directly into the plantar fascia which may offer pain relief and reduce inflammation.
Rest: Decrease or avoid the activities that worsen the pain.
Ice: Apply an ice pack over the painful area for at least twice a day for 10 – 15 minutes, for the first few days.
Night splints: Use of night splints is beneficial as it stretches the plantar fascia and allows it to heal.
Supportive shoes and orthotics: Your doctor may recommend you to wear shoes with good support and cushioning. Custom orthotics (shoe inserts) may also be helpful.
Physiotherapy: Your physiotherapist may suggest an exercise programme that focuses on stretching your plantar fascia and your Achilles tendon. These exercises may help to strengthen the muscles of the lower leg. In addition to exercises the application of taping to support the bottom of your foot can help.
Surgery: Rarely, surgery to release the tight plantar fascia or the tight calf muscle may be needed. However It is recommended only after all non surgical measures have failed.
Preventative measures such as stretching exercise programmes and footwear modifications can help to prevent plantar fasciitis, but if it does occur proper treatment is essential as otherwise it can become a long term problem.