Plantar fascia is the fibrous tissue that runs in the bottom of the foot from the heel bone to the toes. This ligament absorbs shock while walking and supports the arch in your foot. But repeated stress to the heel can cause small tears in the tissue, resulting in inflammation which is called plantar fasciitis. The stress to the heel can be caused due to repeated force from sports that involves running and jumping, wearing high heels, work that requires continuous standing or walking. It is more common in people who are overweight, and people with flat feet.
Plantar fasciitis usually causes stabbing pain as soon as your feet hit the floor in the mornings. The pain reduces ones you start walking, but often returns if you strain your heel a lot.
The symptoms are:
The pain and tenderness are experienced at the sole and heel. The pain is worse in the morning when you stand up after sitting for long, and after exercising. The pain makes it difficult for you to walk or run, and can sometimes make your feet feel warm and swollen.
Overuse of the foot even after developing signs of plantar fasciitis can cause the plantar fascia to rupture, which may result in local swelling, acute sole pain, and clicking or snapping sound.
Repetitive strain injury to the fascia of the sole causes plantar fasciitis. This strain injury can be caused by:
Excessive walking or running.
Walking barefoot on hard surfaces.
Shock from jumping and landing on your feet.
Long periods of standing.
Continuous use of high-heeled shoes.
Inward rolling of the foot while walking or running.
Tight Achilles tendon.
Heel spurs - Bony outgrowth near the heel where the ligament attaches.
Some other conditions that can cause foot and heel pain are osteoarthritis, ankylosing spondylitis, reactive arthritis, and heel pad syndrome.
The possible risk factors for developing this condition are:
Wearing worn-out shoes with thin soles.
Very high-arched feet.
Wearing high-heeled shoes.
Limb length discrepancy.
Achilles tendon tightness.
If left untreated, you might develop chronic heel pain, which can change the way you walk. This may put abnormal loading at the ankle, knee, and hip joint and later on can cause pain in these joints too.
In some cases, the plantar fascia can become irritated and thick and result in chronic foot pain called plantar fasciosis.
After physically examining you, the doctor will make sure that some other foot problem is not the cause of pain. The doctor may press at your heel which may replicate your kind of pain and is diagnostic.
The doctor will then check your reflexes, muscle tone, sense of touch, coordination and balance, to evaluate your muscle strength and nerve health. If needed, the doctor might suggest getting an X-ray or an MRI scan to rule out any fracture or other pathology that might cause heel pain. Perse, to diagnose plantar fasciitis, no investigation is needed. If X-ray of the heel is done, it can show bone spur which is formed as a result of chronic inflammation.
The following are the treatment options:
Painkillers like Ibuprofen and Naproxen sodium.
Steroid or platelet-rich plasma (PRP) injections at the tender point.
Apply ice packs for 15 to 20 minutes, 3 to 4 times a day.
Lose weight to reduce stress on the foot.
Avoid wearing high heels.
Avoid walking barefoot on hard surfaces.
Wear shoes with moderate heels and good shock absorbent properties.
Avoid sports that require walking and jogging and switch to swimming or cycling.
Do plantar fascia stretching exercises.
Physiotherapy - a physiotherapist will teach you strengthening and stretching exercises to stabilize your ankle and heel.
Extracorporeal shock wave therapy or ultrasonic or laser therapy.
Night splints - it is a splint that has to be worn in the night while sleeping. It stretches the calf and arch of the feet and holds the plantar and Achilles tendon in an extended position.
Orthotics - it is the use of shoe inserts to distribute force evenly to your feet.
Surgery is seldom required in this condition.
Plantar fasciotomy - surgery is done to detach the plantar fascia from the bone present in the heel.
Tenex procedure - It is a minimally-invasive procedure that removes scar tissue from the plantar fascia.
This condition usually resolves with the treatment options that are mentioned above, so the prognosis is good. But if the condition causes complication like plantar fasciosis, then it has to be managed differently.
Some of the following lifestyle changes can prevent plantar fasciitis:
Maintain a healthy weight.
Keep replacing your sports shoes and wear shoes with good support.
Wear supportive footwear even at home.
Avoid high-impact activities.
Do leg and foot stretches.
Most cases of plantar fasciitis improve with home remedies and physical therapy, but it might take a few months. If the pain is getting worse even after trying home remedies, consult an orthopedician online.