Plantar Fasciitis
What is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia. It is the most common cause of heel pain. The plantar fascia is a strong, fibrous attachment (similar to a ligament) that extends from the heel all the way down to the ball of the foot and toes. It stretches like a thick rubber band. The plantar fascia connects the bones of the foot together to form the arch of the foot. Plantar fasciitis occurs when the plantar fascia is overused or stretched too far. Any damage to the plantar fascia causes it to swell. This inflammation can cause pain when you walk or use your foot. Most people get plantar fasciitis in one foot at a time, but it can affect both feet. If you have heel or foot pain for more than a week, go to the hospital.
What are the symptoms of plantar fasciitis?
The most common symptoms of plantar fasciitis include:
● Heel pain.
● Pain in the arch of your foot.
● Stiffness.
● Swelling around your heel.
● A tight Achilles tendon.
How is plantar fasciitis diagnosed?
Your doctor may prescribe an X-ray, which produces images of your bones, to rule out other causes of foot pain, such as a stress fracture. He may prescribe an ultrasound or an MRI that produces images of soft tissues. These imaging exams can reveal whether an irritated or inflamed nerve, rather than an inflammatory fascia, is the source of the pain, which is particularly true when nonsurgical treatments haven’t previously made the discomfort less severe.
Innovative devices such as
Footwork Lab foot pressure scanner offer valuable data that aids specialists in precisely identifying plantar issues, including plantar fasciitis.
Plantar fasciitis typically resolves within a few months through conservative approaches like icing, stretching, and activity modification. However, there are additional methods available:
Orthotics or Shoe Inserts: Inserts that offer extra arch support can be added to your shoes. These may include over-the-counter pre-made inserts or custom orthotics tailored to the contours of your foot.
Immobilization: Wearing a walking boot, also known as a walking cast or pneumatic cam walker, for several weeks can provide relief by reducing pressure on the plantar fascia. The duration of boot usage will be determined by your healthcare provider.
Shock Wave Therapy: This treatment involves delivering low- or high-energy shock waves to the affected area. These waves induce microscopic trauma, triggering the body’s healing response. This process is believed to aid in healing the plantar fascia.
Steroid Injections: While most cases of plantar fasciitis improve with stretching over a few months, persistent symptoms may warrant steroid injections to reduce inflammation, particularly if symptoms persist beyond two months of treatment.
It’s essential to consult a medical professional to determine the most suitable treatment strategy for your individual condition.
What are the causes of plantar fasciitis?
Any factor that irritates or damages the plantar fascia can lead to plantar fasciitis, including
● Working on your feet all day.
● Playing sports.
● Exercising or working on hard surfaces such as warehouse floors or sidewalks.
● Exercising without stretching or warming up.
● Wearing shoes that don't support your feet well enough (such as flip-flops or flat, flexible sneakers).
● Walking or standing barefoot at home.
● Certain health conditions can lead to plantar fasciitis, including
● Highly arched feet.
● Flat feet.
● Obesity (or gaining more than 15 pounds in a few months).
How is plantar fasciitis treated?
The most common treatments for plantar fasciitis include:
● Over-the-counter NSAIDs: NSAIDs (like aspirin, ibuprofen and naproxen) reduce pain and inflammation. Don’t take NSAIDs for more than 10 days in a row without talking to a healthcare provider.
● Rest: Take a break from playing sports or participating in the activity that caused the plantar fasciitis for at least a week (if possible).
● Icing your foot: Ice your foot for 10 to 15 minutes, twice a day. Cover a frozen water bottle in a thin towel to protect your skin, then roll it along the bottom of your foot to massage the inflammation.
● Wearing supportive shoes: Wear sturdy, well-cushioned shoes. Don’t wear sandals, flip-flops or other flat shoes without built-in arch support. Don’t walk with bare feet.
● Orthotics or shoe inserts: You can add inserts into your shoes that add extra arch support. Your provider will suggest either pre-made inserts you can buy over-the-counter or custom-made orthotics that are molded to the exact shape of your foot.
● Immobilization: Wearing a walking boot (sometimes called a walking cast or a pneumatic cam walker) for a few weeks will hold your foot in place and take pressure off your plantar fascia. Your provider will tell you how long you’ll need to wear a boot.
● Massaging and stretching: Your provider or a physical therapist will show you stretches and massage techniques you can perform on your foot and calf muscles.
● Corticosteroids: Corticosteroids are anti-inflammatory medicines. Your provider might inject a corticosteroid (like prednisone) into your plantar fascia.
● Platelet rich plasma (PRP): PRP is usually injected to heal and repair injuries.
● Extracorporeal pulse activation technology (EPAT): EPAT is a form of shockwave therapy. Your provider will apply concentrated acoustic waves (sound waves) to increase blood flow to your plantar fascia. This encourages it to heal faster.
● Percutaneous needle tenotomy: During a percutaneous tenotomy, your provider will poke a needle through your skin into your plantar fascia. Your body sends more blood than usual to the area, which will stimulate your plantar fascia’s ability to repair itself.
How can I prevent plantar fasciitis?
The best way to prevent plantar fasciitis is to avoid overusing your feet. In general:
● Stretch before and after exercise.
● Give your feet time to rest and recover after strenuous activity or exercise.
● Wear supportive shoes.
● Don't walk barefoot on hard surfaces.
● Replace your athletic shoes every six to nine months (or after walking or running 250 to 500 miles in them).
● If you have a health condition that makes you more likely to develop plantar fasciitis, you may not be able to prevent it.