The plantar fascia is a very long, thick band of tissue that runs across the bottom of the foot. It supports the bones in the lower part of the foot and stretches with every step taken. Problems occur when part of the plantar fascia over-stretches and tears; which causes pain and inflammation.
Signs and Symptoms
This condition can make walking very difficult and painful, especially upon waking, as the fascia ligament tightens up when we are sleeping but when pressure is put on the ligament the next day, it goes taut and it feels very painful. The pain may improve throughout the day or be increased when walking for extended periods.
Some people complain of a dull ache at the end of the day in the heel, which improves with rest. The pain is felt often most where the plantar fascia connects to the heel bone. Plantar fasciitis causes mild swelling, redness and tenderness on the bottom of the heel. The pain may feel like a stabbing, burning or aching feeling.
Causes
Those most at risk for developing plantar fasciitis are:
- Those that are obese or have a sudden weight gain.
- Runners and other athletes who engage in repetitive activities such as jumping.
- Those with foot problems such as flat feet, high arches or a tight Achilles tendon (which is the tendon that connects the calf muscles to the heel). These conditions may make the fascia ligament over work or stretched abnormally.
- Active adults between the ages of 40-70 years of age, most commonly report this problem.
- Heel spurs do not cause plantar fasciitis, as often thought.
- Some types of arthritis cause inflammation in the tendons, which results in plantar fasciitis, especially in the elderly.
- Those with diabetes, again, especially in the elderly can cause heel pain and damage.
- Wearing ill-fitting athletic shoes may put stress on the fascia ligament causing swelling and pain.
- Pregnant women, due to weight gain and the pregnancy hormones that cause ligaments to loosen and relax.
- Those in occupations that are on their feet all day are at risk.
Treatment
If you suspect plantar fasciitis, contact your health care professional, who will be able to diagnose your symptoms and advise you on the best course of treatment. Treatment is most successful when started as early as possible. In the meantime, try icing the area and use ibuprofen to reduce swelling. Drug stores sell devices that when placed in the shoe may relieve pain.
Changing your exercise routine and resting the foot may help with pain and other symptoms. Initial conservative treatment as directed by your health care professional, may include heel stretching and strengthening exercises.
Night splints or shoe inserts may be recommended, as well as an anti-inflammatory medication. An x-ray may be taken to rule out any other foot issues. For more severe cases, where these treatments do not work, a short leg cast or a cast boot may be necessary for a few weeks to reduce pain and inflammation.
Some patients may require steroid injections or surgery on the plantar fascia to ease very acute symptoms. Treatment can take from a few months to two years to complete but most patients will start to feel better within a year of starting treatment.
References
Mayo Clinic: Plantar fasciitis
Plantar-fasciitis.org: Plantar fasciitis: from causes to treatment
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