Plantar Fasciitis

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.

Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.

Causes

Too much of pressure over the fascia may damage or tear away the tissue 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 and high arch, activities such as long-distance running, ballet dancing and dance aerobics, occupations that necessitate walking or standing on hard surfaces for long period of time and wearing shoes with poor arch support or thin-soled shoes.

Symptoms

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 may aggravate after standing up for a long time.

Diagnosis

Your doctor will examine your foot and will check for the signs of flat feet or high arches, tenderness, swelling and 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.

Treatment

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 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.
• Physical therapy: Your physical therapist may suggest you an exercise program that focuses on stretching your plantar fascia and achilles tendon. These exercises may help to strengthen the muscles of lower leg. In addition to exercises application of athletic taping to support the bottom of your foot is also taught.
• Extracorporeal shock wave therapy: During this procedure, sound waves are targeted to the painful area to stimulate the healing process in the damaged plantar fascia tissue.

Surgery: Rarely, surgery to release the tight plantar fascia may be needed. However it is recommended only after all nonsurgical measures have failed.

Preventive measures such as stretching exercise programs and footwear modifications can help prevent plantar fasciitis. But if it occurs proper treatment is essential as otherwise it can become a long-term problem.