Plantar fasciitis is an inflammation of a thick band of tissue that lies at the bottom of the foot (the plantar fascia). This band runs from the heel bone to the toe and forms the arch of your foot. This is one of the most common causes of heel pain. It is most often seen in middle-aged men and women but may also occur in those who are constantly on their feet.
Causes
The plantar fascia functions as a shock absorber and supports the arch of your foot. Repeated overstretching or overuse causes irritation or inflammation of the fascia. Excessive pressure over the fascia may strain and tear the tissue causing heel pain. Other risk factors may include obesity, foot arch problems such as flat feet or high arches, activities such as long-distance running, ballet and dance aerobics, occupations that necessitate walking or standing on hard surfaces for a long period, and wearing shoes with poor arch support or thin-soled shoes.
Symptoms
The most common symptom is stabbing pain on the bottom of the foot near the heel. Pain may occur with first steps out of bed in the morning and slowly decrease, but may return after standing for a long period.
Diagnosis
The doctor will examine your foot and will check for the signs of flat feet or high arches, tenderness, swelling, redness and stiffness or tightness of your foot arch. An X-ray or MRI scan may be ordered to confirm the diagnosis and rule out other causes of heel pain.
Treatment
Patients with plantar fasciitis are often effectively treated as follows:
- Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce 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 ice pack over the painful area at least twice a day for 10 to 15 minutes, for the first few days.
- Platelet Rich Plasma and Orthobiologics
- Night splints: Use night splints to stretch the plantar fascia and allow it to heal.
- Supportive shoes and orthotics: Your doctor may recommend shoes with good support and cushioning.
- Custom orthotics (shoe inserts) may also be helpful.
- Physical therapy: Your physical therapist may design an exercise program that focuses on stretching your plantar fascia and Achilles tendon and strengthening the muscles of the lower leg. In addition to exercises, application of athletic taping to support the bottom of your foot may also help relieve symptoms.
- Surgery: Occasionally, surgery to release the tight plantar fascia may be needed.