Plantar Fasciitis

Plantar Fasciitis

What Is Plantar Fasciitis?

• Plantar fasciitis is a condition caused by irritation and inflammation of the plantar fascia—a thick band of connective tissue along the bottom of the foot. This tissue runs from the heel bone to the toes and plays a key role in supporting the arch of the foot and absorbing shock during walking and running.
• Plantar fasciitis is one of the most common causes of heel pain. It most frequently affects middle-aged adults but can occur at any age, especially in individuals who spend long periods standing, walking, or engaging in repetitive impact activities.

What Causes Plantar Fasciitis?

• The plantar fascia is designed to absorb stress and support the foot’s arch. When excessive or repetitive strain is placed on this tissue, small tears can develop. Over time, repeated overstretching or overuse can lead to irritation, inflammation, and pain—most commonly felt near the heel.

Risk factors 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
• Wearing thin-soled shoes or shoes with poor arch support

What are the Symptoms of Plantar Fasciitis?

• The most common symptom is stabbing pain on the bottom of the foot, near the heel. You may experience pain when you take your first steps on awakening and it slowly decreases, but may return after standing for a long period of time.

How is Plantar Fasciitis Diagnosed?

• Your doctor will examine your foot for signs of flatfoot or high arch, tenderness, swelling, redness, stiffness or tightness of your foot arch. 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.

What Are the Treatment Options for Plantar Fasciitis?

• Most cases of plantar fasciitis improve with non-surgical treatment. Your doctor may recommend one or more of the following options based on the severity of your symptoms and how long they have been present.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help reduce pain and inflammation. In some cases, a corticosteroid injection may be considered to decrease inflammation in the plantar fascia.
• Rest and activity modification: Reducing or avoiding activities that worsen heel pain allows the plantar fascia time to heal.
• Ice therapy: Applying ice to the painful area can help control inflammation. Ice packs should be placed over a towel and applied for 10 to 15 minutes at a time, several times a day, especially during the early stages of treatment.
• Night splints: Night splints may be recommended to gently stretch the plantar fascia and Achilles tendon while you sleep, helping reduce morning heel pain.
• Supportive footwear and orthotics: Shoes with good arch support and cushioning are important for symptom relief. Custom orthotics or shoe inserts may also be recommended to provide additional support and reduce strain on the plantar fascia.
• Physical therapy: A structured physical therapy program may focus on stretching the plantar fascia and Achilles tendon, strengthening the lower leg muscles, and improving foot mechanics. Taping techniques may also be used to support the foot and relieve pain.
• Extracorporeal shock wave therapy (ESWT): This non-invasive treatment uses sound waves directed at the painful area to stimulate healing in the plantar fascia. It may be considered for patients whose symptoms do not improve with standard treatment.
• Surgery: Surgery is rarely needed and is reserved for patients with persistent symptoms that do not respond to extended non-surgical care. The procedure typically involves a plantar fascia release, which reduces tension on the fascia to relieve pain.

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