Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the flat band of tissue that connects the heel bone to the toes. When strained, the thick band of tissue can cause throbbing pain and inflammation, making it difficult to stand or walk. Once your foot limbers up, the pain of plantar fasciitis usually decreases, but it may return after long periods of standing or after getting up from a seated position.
Plantar fasciitis is most common in individuals who are middle aged, in individuals who are overweight and in runners.
The classic symptom for plantar fasciitis is heel pain. The pain is usually worst with:
- Taking the first few steps after awakening
- Longer periods of standing or standing on toes
- Getting up from a seated position
- Climbing the stairs
- Exercising intensively
Exactly what causes plantar fascia is not well understood. Since the plantar fascia acts as the shock-absorbing bowstring, supporting the arch of the foot, too much pressure can result in repeated tears to the plantar fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed, in turn causing severe pain to the heel.
Factors that may increase the risk of developing plantar fasciitis include the following:
- Age (most common between ages 40 and 60)
- Activities that put stress on the heel (running, ballet and dance aerobics)
- Being overweight
- Being flat-footed
- Longer periods of walking or standing on hard surfaces
Chronic heel pain is a complication that can arise from ignorance of plantar fasciitis. Any changes made in walking to minimize the pain associated with plantar fasciitis can develop into foot, knee, hip or back problems.
Treatment options for plantar fasciitis typically involve the following:
- Pain relievers: medications such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) can be used to help ease the pain and inflammation associated with plantar fasciitis.
- Physical therapy: A series of exercises which can help stretch and strengthen lower leg muscles, which stabilize the ankle and heel.
- Night splints: Wearing a splint that stretches the calf and the arch of the foot while asleep can help provide support to the leg and ease discomfort.
- Orthotics: Wearing off the shelf heel cups, cushions or custom-fitted arch supports (orthotics) can help distribute pressure to the feet more evenly.
A doctor may recommend other possible treatment methods such as:
· Steroid shots: Injection of a type of steroid medication into the tender area. This type of treatment is used to help provide temporary pain relief.
· Extracorporeal shock wave therapy: A procedure that uses sound waves to be distributed to the area of heel pain in order to aspire healing. This method is typically used for chronic plantar fasciitis that hasn't responded to more conservative treatments.
· Surgery: Surgical removal of the plantar fascia from the heel bone. This treatment option is usually used when pain is severe and all else fails. Possible side effects can include a weakening of the arch in the foot.