Plantar fasciitis is a common cause of heel pain that involves inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes. It typically causes stabbing pain that usually occurs with the first steps in the morning.

Common Symptoms

• Heel Pain: Sharp, stabbing pain in the bottom of the heel.
• Morning Pain: Pain is often worse with the first steps after waking up but improves with movement.
• Pain After Rest: Pain may return after long periods of standing or after getting up from sitting.
• Stiffness and Tenderness: Stiffness and tenderness in the heel and along the arch of the foot.

Cause & Anatomy

• Overuse: Activities that put a lot of stress on the heel and attached tissue, such as running, dancing, and standing for long periods.
• Foot Structure: Flat feet, high arches, or abnormal walking patterns that affect the way weight is distributed can put extra stress on the plantar fascia.
• Age: Plantar fasciitis is most common between the ages of 40 and 60.
• Obesity: Excess weight increases the stress on the plantar fascia.
• Improper Footwear: Wearing shoes with poor arch support or soft soles.

Diagnosis

• Medical History and Physical Examination: Assessment of symptoms and physical examination of the foot.
• X-rays: To rule out other conditions like fractures.
• MRI: Rarely needed but can show the extent of inflammation and rule out other issues.

Prevention

Proper Footwear:

• Choose shoes with good arch support and cushioning, especially for activities that put stress on the feet.

Maintain a Healthy Weight:

• Reducing weight can decrease the stress on the plantar fascia.

Foot Care:

• Regularly stretch the plantar fascia and Achilles tendon. Avoid walking barefoot on hard surfaces.

Home Care Treatment

Rest:

• Reduce or modify activities that cause pain to allow the inflammation to decrease.

Ice:

• Apply ice to the painful area for 15-20 minutes several times a day to reduce inflammation.

Stretching:

• Regularly stretch the plantar fascia, Achilles tendon, and calf muscles.

Proper Footwear:

• Wear shoes with good arch support and cushioning.
• Avoid walking barefoot on hard surfaces.

Orthotic Devices:

• Use over-the-counter or custom-made orthotics to provide extra support to the arch.

Medical Treatment

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

• Medications like ibuprofen or naproxen to reduce pain and inflammation.

Physical Therapy:

• Specific exercises and manual therapy to stretch the plantar fascia and Achilles tendon, strengthen lower leg muscles, and improve gait mechanics.

Night Splints:

• Wearing a splint that stretches the calf and arch of the foot overnight.

Corticosteroid Injections:

• Steroid injections into the tender area to reduce inflammation.

Extracorporeal Shock Wave Therapy (ESWT):

• A non-invasive procedure that uses sound waves to stimulate healing in the plantar fascia.

Surgery

Considered only if conservative treatments fail after 6-12 months. Procedures may involve partially cutting the plantar fascia to relieve tension.

Rehabilitation

Gradual Return to Activity:

• Slowly resume activities to avoid re-injury. Follow a physical therapy plan to ensure proper healing.

Continued Stretching and Strengthening:

• Maintain flexibility and strength in the foot and lower leg to prevent recurrence.

FAQ’s

How long does it take to recover from plantar fasciitis?
Recovery time varies, but with consistent treatment, most people improve within several months. Some may take longer if the condition is severe.

Can plantar fasciitis become chronic?
Yes, if not treated properly, plantar fasciitis can become a long-term condition. Early and consistent treatment is crucial.

Is it okay to exercise with plantar fasciitis?
Low-impact activities like swimming and cycling are generally safe. Avoid high-impact activities like running until symptoms improve.

Can plantar fasciitis recur?
Yes, recurrence is possible, especially if the underlying causes such as poor footwear or excessive weight are not addressed.

Are there any home remedies for plantar fasciitis?
Yes, home remedies include rest, ice, stretching exercises, proper footwear, and over-the-counter pain relievers.