Plantar Fasciitis Treatment, Causes & Symptoms

Plantar Fasciitis Treatment, Causes & Symptoms

Plantar Fasciitis Treatment, Causes & Symptoms

Plantar Fasciitis Treatment, Causes & Symptoms. Plantar fasciitis is one of the most common orthopedic complaints.

If you observed your steps you take in the are painful, you might be experiencing plantar fasciitis. Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, weblike ligament that connects your heel to the front of your foot. It supports the arch of your foot and helps you walk.

It’s one of the most common causes of foot pain, with 2 million to 3 million patients seeking medical treatment each year, said Dr. Michael Greaser, an orthopedic surgeon and assistant professor at McGovern Medical School at The University of Texas Health Science Center at Houston. Many of the patients typically seek treatment after having months or years of heel pain. There are most likely many others who have plantar fasciitis that never seek treatment.

Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Normally, these ligaments act as shock absorbers, supporting the arch of the foot. Too much pressure on your feet can damage or tear the ligaments; the plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness. The pain is normally localized near the heel but can be felt anywhere along the plantar fascia ligament, according to Dr. Dominic Catanese, professor and chief of podiatric surgery at Montefiore Medical Center at Albert Einstein College of Medicine in New York.

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The pain tends to be worse first thing in the morning and after long periods of sitting or standing. When there is no weight put on the foot, the ligament shortens and tightens, Catanese said. Then when the patient stands, the sudden stretching of the plantar fascia with the added weight may result in pain. Usually the pain subsides after a few minutes of walking and stretching.

What causes Plantar Fasciitis?

You’re at a greater risk of developing plantar fasciitis if you’re overweight or obese. There are many reasons why one might develop plantar fasciitis, according to the American Orthopedic Foot & Ankle Society. Some of these factors include being overweight, being on your feet for extended periods and wearing shoes with inadequate support. In addition, impact exercises such as running, tight calf muscles that limit ankle mobility, flat feet or high arches, excessive pronation (when the foot rolls severely inward when walking) or wearing high heels on a regular basis can be aggravating factors. And women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy.

If you’re a long-distance runner, you may be more likely to develop plantar fascia problems. You’re also at risk if you have a very active job that involves being on your feet often, such as working in a factory or being a restaurant server. Active men and women between the ages of 40 and 70 are at the highest risk for developing plantar fasciitis. It’s also slightly more common in women than men.

Plantar fasciitis isn’t typically the result of heel spurs. A heel spur is a hook of bone that can form on the heel bone, or calcaneus, of the foot. According to the American Association of Orthopaedic Surgeons (AAOS), 1 in 10 people has a heel spur, but only 1 in 20 people with heel spurs experiences pain.

Plantar Fasciitis Diagnose

Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain to make sure that it’s not the result of a different foot problem. Your doctor may ask you to flex your foot while they push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. They’ll also note if you have mild redness or swelling. Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your:

  • Reflexes.
  • Muscle Tone.
  • Sense Of Touch And Sight.
  • Coordination.
  • Balance.
  • An X-ray or an MRI scan may be necessary to check that nothing else is causing your heel pain, such as a bone fracture.

Treatment options for Plantar Fasciitis?

According to Catanese, there are three main ways to treat plantar fasciitis: stretching the plantar fascia and the muscle group in the back of the leg, using good quality and supportive shoes or orthotics, and reducing inflammation.

Stretching is the single most important thing to do to eliminate and prevent pain. According to AAOS, two of the most important stretches are for the calves (place one leg in front of the other with the front leg bent, both heels on the ground, and lean into the wall) and the plantar fascia (from a seated positing, cross the foot with plantar fasciitis over the knee of your opposite leg and carefully stretch the toes towards your body). Doctors recommend taking a break from high-impact exercises like running and switching to low-impact exercises like swimming or yoga.

Over-the-counter anti-inflammatory medications such as ibuprofen or a steroid injection are other ways to reduce the inflammation and associated pain. Ice and massage are also used to reduce inflammation. Another option is to use splints at night to stretch the plantar fascia while sleeping. Physical therapy and extracorporeal shock wave therapy, which sends high-energy pulses to stimulate the plantar fascia, may also promote healing.

If none of those options improve plantar fasciitis, more invasive options are available. Common surgical options include removing scar tissue around the plantar fascia, partially removing the plantar fascia from the heel, or surgically lengthening the calf muscles.

Home treatments for Plantar Fasciitis?

1. Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, three or four times per day to reduce swelling. You can also try reducing or changing your exercise activities. Using arch supports in your shoes and doing stretching exercises may also help to relieve pain.
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin or Advil) and naproxen (Aleve), often reduce inflammation in the ligament.

2. Wear supportive shoes

Try to wear shoes that provide good arch support and have a low heal, especially if you’re going to be on your feet a lot. This helps to support your plantar fascia and prevent them from becoming inflamed.

3. Use orthotics

Your doctor may recommend orthotic shoe inserts or foot pads to help distribute your weight more evenly, especially if you have high arches. You can get them ready-made at most pharmacies, or your doctor can have some made custom for your feet. After a few months, you should be able to stop wearing them.

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4. Replace old athletic shoes

If you regularly wear the same shoes to exercise, make sure to replace them regularly. Signs that you need a new pair include:

  • Wear on the outsoles.
  • Stretching of the heels.
  • Molding of the insoles to the shape of your foot.
  • Breakdown of shoe interior.
  • New blisters forming on your feet.
  • New pain in your feet, legs, or back.

5. Stretch

To soothe the pain caused by plantar fasciitis, try gently stretching the arch of your foot and your calf. For example, try lunging forward with one leg and trying to get the foot on your other leg as close to the ground as you can.

6. Massage

You can perform simple massage techniques to soothe the pain in your heels. Use your thumbs to massage your arches and heels, working from the balls of your feet up to your heel. You can also use a golf ball to massage your arches. Put your foot on the golf ball, hang on to a stable item, and roll the golf ball under your arches.

7. Lose weight

Carrying extra weight puts more pressure on your plantar fascia. If you’re overweight, losing a few pounds can help to alleviate some of that pressure. Work with your doctor to come up with a long-term plan that focuses on a balanced diet and regular exercise.

8. Rest

Sometimes, plantar fasciitis is a sign that your feet simply need to rest, especially if you regularly do high-impact sports. Giving your feet a break for a few days can help to reduce inflammation and let your plantar fascia heal. While you heal, try a low-impact activity, such as swimming.

Complications associated with Plantar Fasciitis?

You can develop chronic heel pain if you ignore the condition. This can change the way you walk and cause injury to your:

  • Legs
  • Knees
  • Hips
  • Back

Steroid injections and some other treatments can weaken the plantar fascia ligament and cause potential rupture of the ligament.

Surgery carries the risks of bleeding, infection, and reactions to anesthesia. Plantar fascia detachment can also cause changes in your foot and nerve damage. Gastrocnemius recession can also cause nerve damage.

Some cases of chronic heel pain have also been found to develop into distal tarsal tunnel syndrome, similar to carpal tunnel syndrome in the wrists, where the nerves running along the bottom of the foot can become entrapped.

The feet are relatively small body parts that experience significant pressure and stress on a daily basis for most people, according to the Institute for Preventive Foot Health. For that reason, it’s important to make sure your feet stay healthy and be aware of the symptoms of foot conditions such as plantar fasciitis.

Additional resources for Plantar Fasciitis:

The Mayo Clinic’s guide to plantar fasciitis
U.S. National Library of Medicine guide to plantar fasciitis
The Plantar Fasciitis Organization