Plantar fasciitis, also called âheel pain syndrome,â affects approximately 2 million people in the United States each year. Plantar fasciitis can come on gradually as the result of a degenerative
process or sudden foot trauma. It can appear in one heel or both. It is generally worse on taking the first few steps in the morning or after prolonged sitting or non-weight-bearing movement.
Symptoms can be aggravated by activity and prolonged weight bearing. Obesity, too, is hard on the feet-it can cause plantar pain or it can make that pain worse. The plantar fascia connects the
calcaneal tubercle to the forefoot with five slips directed to each toe respectively. Other conditions, such as calcaneal fat pad atrophy, calcaneal stress fracture, nerve entrapment, and rheumatoid
arthritis may also cause foot pain. These conditions may be found in combination with plantar fasciitis, or separate from it. A blood test can help pinpoint the cause(s).
Because the plantar fascia supports your foot and gets used every time you take a step, it has to absorb a large amount of stress and weight. If too much pressure is put on the plantar fascia, the
fibers can become damaged or start to tear. The body responds by causing inflammation in the affected area. This is what causes the pain and stiffness of plantar fasciitis. Things that can increase
the risk of plantar fasciitis include tight calf muscles. Tight calves make it harder to flex your foot, and this puts more stress on the plantar fascia. Weight. Carrying a few extra pounds puts
added pressure on your feet every time you take a step. Activities that put a lot of stress on the feet. This includes things like running, hiking, dancing, and aerobics. Bad shoes. Footwear that
doesn't give your foot the support it needs increases your risk of plantar fasciitis. You'll want to ditch any shoes that have thin soles or inadequate arch support, or ones that don't fit your feet
properly. Routinely wearing high heels can also cause your Achilles tendon to contract over time, making it harder to flex your foot. Jobs that involve a lot of standing or walking on hard surfaces.
Jobs that keep you on your feet all day, like waiting tables or working in a store, can cause damage to your plantar fascia. High arches, flat feet, or other foot problems. The shape of your foot can
affect the way your weight is distributed on your feet when you stand. If weight distribution is a bit off, it can add to a person's risk of plantar fasciitis. How someone walks can increase the
stress on certain parts of the foot too.
A very common complaint of plantar fasciitis is pain in the bottom of the heel. Plantar fasciitis is usually worse in the morning and may improve throughout the day. By the end of the day the pain
may be replaced by a dull aching that improves with rest. Most people suffering from plantar fasciitis also complain of increased heel pain after walking for a long period of time.
A health care professional will ask you whether you have the classic symptoms of first-step pain and about your activities, including whether you recently have intensified your training or changed
your exercise pattern. Your doctor often can diagnose plantar fasciitis based on your history and symptoms, together with a physical examination. If the diagnosis is in doubt, your doctor may order a
foot X-ray, bone scan or nerve conduction studies to rule out another condition, such as a stress fracture or nerve problem.
Non Surgical Treatment
Many types of treatment have been used to combat plantar fasciitis, including injections, anti-inflammatory medications, orthotics, taping, manipulation, night splinting, and instrument-assisted
soft-tissue manipulation (IASTM). IASTM begins with heat, followed by stretching. Stretching may be enhanced by applying ice to the plantar fascia. These stretches should be performed several times
per day, with the calf in the stretched position. IASTM uses stainless-steel instruments to effectively access small areas of the foot. IASTM is believed to cause a secondary trauma to injured soft
tissues as part of the healing process. Therapeutic modalities such as low-level laser, ultrasound, and electrical muscular stimulation may be effective in the reduction of pain and inflammation. Low
Dye strapping or taping of the foot is an essential part of successful treatment of plantar fasciitis. Extracorporeal shock-wave therapy (ESWT) was introduced with great promise at one time. Recent
studies have reported less favorable results. Some report no effect. Previous local steroid injection may actually have a negative effect on results from ESWT.
Most practitioners agree that treatment for plantar fasciitis is a slow process. Most cases resolve within a year. If these more conservative measures don't provide relief after this time, your
doctor may suggest other treatment. In such cases, or if your heel pain is truly debilitating and interfering with normal activity, your doctor may discuss surgical options with you. The most common
surgery for plantar fasciitis is called a plantar fascia release and involves releasing a portion of the plantar fascia from the heel bone. A plantar fascia release can be performed through a regular
incision or as endoscopic surgery, where a tiny incision allows a miniature scope to be inserted and surgery to be performed. About one in 20 patients with plantar fasciitis will need surgery. As
with any surgery, there is still some chance that you will continue to have pain afterwards.