Plantar Fasciitis

Heel pain is oftentimes (but not always) caused by plantar fasciitis, which is the swelling of the tissue that connects the heel bone to the toes at the bottom part of the foot, also known as the plantar fascia.

Plantar fasciitis is often described as burning or stabbing ache at the heel, which is typically worse after rest when fascia contracts. The pain usually becomes more bearable as the muscles loosen up during low-impact walking, but can return even worse after extended periods of walking or standing.

The plantar fascia is a very important tissue. It serves as a shock absorber and supports the foot’s arch. Too much tension on the plantar fascia can become irritate it and eventually cause it to swell.

Fortunately in most cases, plantar fasciitis treatment is fairly conservative. Plantar fasciitis exercise, some medications and orthotics are usually all that’s needed to manage the pain. More severe cases may require plantar fasciitis surgery, though.

Plantar Fasciitis Signs and Symptoms

Plantar fasciitis, which usually occurs on one foot at a time, typically develops slowly. Some cases can be sudden and severe, though. If you suspect that you have plantar fasciitis, you should feel a sharp, stabbing heel pain, usually in the inside bottom part of the heel.

The pain will likely be worse when you take the first few steps after long periods of rest (especially after sleep). The pain may also worsen as you stand, climb stairs, or tiptoe. You typically will not feel a lot of pain during exercise, but will feel the ache after. In some cases, the affected heel may swell up.

Causes and Risk Factors

Plantar fasciitis can be caused by one or a combination of foot activity overloads. Jogging, climbing, or walking for extended periods, for example, puts too much stress on the plantar fascia, But even routine, non-athletic activities such as moving heavy furniture can set off pain.

Some kinds of arthritis are also attributed to plantar fasciitis. Certain arthritic conditions cause the tendons of the heel to swell. Diabetes is also a culprit – there is still no explanation why, but studies have repeatedly shown that diabetics are more prone to developing plantar fasciitis.

n some cases, plantar fasciitis is triggered by shoes of poor quality or shoes that do not fit. Those with thin soles, no arch support, and no shock-absorbing properties, for example, do not give feet enough protection. Shoes that are too tight and those with very high heels can also cause the Achilles tendon to tighten straining the tissue surrounding the heels.

Tests and Diagnosis

To check for plantar fasciitis, a doctor usually looks tenderness in some area of the foot to rule out other conditions that also cause heel pain, such as foot arthritis , tendonitis , cysts , or nerve irritations . An X-ray or an MRI may also be required to rule out stress fractures.

Plantar Fasciitis Treatment

Plantar fasciitis treatment can be conservative (non-surgical) or invasive (surgical).

Among the non-surgical ways to manage plantar fasciitis involves wearing night splints, which help stretch the Achilles tendon and plantar fascia overnight, so that they can be more easily stretched during the morning. Orthotics that can be custom-made for the feet can also distribute tension on the feet more consistently.

Plantar fasciitis exercise may also help. Your doctor may design a series of exercises to help you gently stretch your Achilles tendon and plantar fascia while strengthening the muscles on your lower legs, helping your heel and ankle become stable.

Plantar fasciitis surgery is only usually required when other treatments do not work. The doctor may prescribe corticosteroids before considering surgery. Corticosteroid is injected into the affected area to relieve pain, at least temporarily. Remember that multiple injections can only do more harm than good, though.

Some doctors may also use extracorporeal shockwave therapy before considering plantar fasciitis surgery. During the therapy, sound waves are used to stimulate the affected area and eventually heal it. There is still no consensus on whether or not extracorporeal shockwave therapy is effective or not. The doctor may refuse to perform this procedure because of some side effects such as bruising, inflammation, numbness, and sometimes even pain. Extracorporeal shockwave therapy is also not used to treat kids and pregnant women.

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