Description

Plantar fasciitis (PLAN-tur phase-I-tis) is one of the most common causes of heel pain. That involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes, known as the plantar fascia.

Plantar fasciitis commonly causes stabbing pain that often occurs with your first steps in the morning. Like getting up and moving around, the pain is reduced, but it might return after long periods of standing or when you stand up after sitting.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in those who are overweight.

Symptoms

Plantar fasciitis commonly causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or rising from sitting.

Causes

The plantar fascia is a band of tissue, called fascia, which connects the heel bone to the base of the toes. It supports the arch of the foot and absorbs shock as you walk.

The tension and stress in the fascia can cause small tears. Repeat the stretching and tearing in the dashboard can irritate or inflame, although the cause is not clear in many of the cases of plantar fasciitis.

Risk factors

Though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

  • Age. Plantar fasciitis is most common in people between the ages of 40 and 60.
  • Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet and dance aerobic — can contribute to the emergence of plantar fasciitis.
  • The mechanisms of the feet. Flat feet, high arch or even an atypical pattern of walking can affect the way weight is distributed when you're standing and can increase the tension on the plantar fascia.
  • Obesity. Excess pounds put extra stress on the plantar fascia.
  • Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces may be at increased risk of plantar fasciitis.

Complications

Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. It is likely that the change of his foot to try to avoid the pain of plantar fasciitis, which could lead to foot, knee, hip, or back problems.

Diagnosis

The Plantar fasciitis are diagnosed based on the clinical history and physical examination. During the exam, your doctor will check for areas of tenderness in your foot. The location of your pain can help determine its cause.

Imaging tests

Tests are usually not needed. Your health care professional may suggest an x-ray or an mri to make sure that another problem, such as a stress fracture, it is not the cause of your pain.

Sometimes an x-ray shows a piece of bone protruding from the heel bone. This is called a bone spur. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.

Treatment

Most people who have plantar fasciitis recover in several months with conservative treatment, as the ice in the area of the pain, stretching, and the modification or away from the activities that cause the pain.

Medications

Pain medications you can buy without a prescription, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can help relieve the pain and inflammation of plantar fasciitis.

Therapies

Physical therapy or the use of special devices can relieve the symptoms. Treatment may include:

  • The physical therapy. A physical therapist can show you exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist may also teach you to apply athletic taping to support the bottom of your foot.
  • Night splints. Your health care team may recommend that you wear a splint that holds the plantar fascia and the Achilles tendon in a lengthened position overnight, to promote the stretch while you sleep.
  • Orthotics. Your health care professional may prescribe off-the-shelf or custom-made arch supports, called orthotics, to distribute the pressure on your foot more evenly.
  • Walking boot, canes, or crutches. Your health care professional may suggest one of these for a short period, either to avoid the movement of your foot, or keep you from placing your full weight on your foot.

Surgical or other procedures

If the more-conservative measures aren't working after several months, your doctor might recommend:

  • Injections. The injection of steroid medication into the tender area can provide temporary pain relief. The sockets are not recommended because they can weaken your plantar fascia and possibly cause it to rupture. Platelet-rich Plasma derived from your own blood can be injected into the tender of the area to promote healing of the tissues. The ultrasound images during the injections can help in the accurate placement of the needle.
  • Extracorporeal shock wave therapy. The sound waves are directed at the area of heel pain to stimulate healing. This is for chronic plantar fasciitis that hasn't responded to more conservative treatments. Some studies show promising results, despite the fact that this therapy has not been shown to be consistently effective.
  • Ultrasonic tissue repair. This minimally invasive technology uses ultrasound imaging to guide a needlelike probe in the damaged tissue of the plantar fascia. The tip of the probe vibrates rapidly to break down the damaged tissue, which sucks.
  • Surgery. Some people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is severe and other treatments have failed. Can be performed as an open procedure or through a small incision under local anesthesia.

Lifestyle and home remedies

To reduce the pain of plantar fasciitis, try these self-care tips:

  • Maintain a healthy weight. Excess weight can put more tension on the plantar fascia.
  • Choose supportive shoes. Buy shoes with a low to moderate heel, thick sole, good arch support and extra cushioning. Do not use flats or barefoot walking.
  • Do not wear athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet.
  • Change the sport. Try a low-impact sport, such as swimming or cycling instead of walking or jogging.
  • Apply ice. Keep a cloth-covered ice pack over the area of pain for 15 minutes three or four times a day to help reduce pain and swelling. Or try to roll a frozen water bottle under your foot for a massage with ice.
  • Stretching the arches. Simple exercises at home you may stretch the plantar fascia, Achilles tendon and the calf muscles.

Preparing for your appointment

Your health care professional may refer you to someone who specializes in disorders of the foot, or sports medicine.

What you can do

Make a list of:

  • Their symptoms, and when they began.
  • Key personal information, including your and your family's medical history and the activities that you do that may have contributed to your symptoms.
  • The drugs, vitamins, or other supplements you are taking, including dosage.
  • Questions to ask the health care team.

For plantar fasciitis, basic questions to ask your health care team include:

  • What is likely causing my symptoms?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • There are other treatment options that you're suggesting?
  • There are restrictions that must be followed?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your healthcare provider is likely to ask you questions, such as:

  • Did your symptoms tend to occur at a specific time of day?
  • What are the types of shoes you usually wear?
  • Are you a runner, or take part in any of the sports that involve running?
  • Do you have a physically demanding job?
  • Has had problems with his feet before?
  • Do you feel pain in any part, in addition to its feet?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Plantar fasciitis