Overview

What is plantar fasciitis?

It is a condition characterized by pain on the bottom side of the heel. The plantar fascia is a thick, weblike ligament connecting the heel to the front of the foot. It is meant to act like a shock absorber and support the arches while walking.

Plantar fasciitis is considered to be one of the most frequent orthopedic issues. The plantar fascia ligaments undergo considerable stress during normal indoor activities. Excessive weight bearing on the feet can rupture or injure the ligaments. In such cases, the plantar fascia becomes inflamed, which triggers heel pain together with pain and stiffness in the affected area.

What are the symptoms of plantar fasciitis?

Some of the common symptoms evident with plantar fasciitis are as follows;

• Heel pain
• Arch of foot pain in it
• Stiffness.
• Heels swollen
• Achilles tendon tightening

What causes plantar fasciitis?

Anything can irritate or damage your plantar fascia, including:

• Constantly standing on your feet for work.
• Engage in sports.
• Working or exercising on a hard surface (such as the floor of a warehouse or sidewalk).
• Engage in any type of exercise without stretching or warming up.
• Wear shoes that don't adequately support your feet, such as flip-flops or flexible sneakers.
• Walking or standing barefoot while you are at home.

Some health issues may lead to plantar fasciitis, such as:

• High arched foot
• A flat foot
• Pregnancy or gaining more than 15 pounds in a few months.

How is plantar fasciitis diagnosed?

A medical professional diagnoses plantar fasciitis through a physical exam. The doctor will ask you questions about your symptoms and examine your foot. The doctor may also press lightly on your plantar fascia to feel for inflammation and check your pain tolerance.

Discuss with your provider the pain you are experiencing in your daily routine. Discuss where on your foot it hurts and when it is the most painful at your part of the day.

What diagnostic tests do doctors give to diagnose plantar fasciitis?

In most cases, a doctor does not require any kind of tests to determine plantar fasciitis. They might carry out some imaging tests where pictures are taken of your foot when they suspect other conditions or issues are causing the pain. Some of the imaging tests that you might require include:

• X-rays.
• An ultrasound.
• An MRI scan.

How is plantar fasciitis treated?

You can often treat plantar fasciitis with self-care remedies and OTC medication.

Your doctor will suggest ways to alleviate your symptoms and support your feet so that you have fewer chances of developing this condition again.

Common treatments for plantar fasciitis include:

• Over-the-counter NSAIDs: NSAIDs (such as aspirin, ibuprofen, and naproxen) reduce pain and inflammation. Do not take any NSAIDs for more than 10 days in a row unless speaking with a health care provider.
• Rest: Avoid playing sports or doing activities that aggravate plantar fasciitis for at least one week (if possible).
• Applying an ice pack: Apply an ice pack to the bottom of your foot 10 to 15 minutes, twice a day. To avoid the freezing temperature coming in contact with the skin, cover a frozen water bottle in a thin towel and roll it on the bottom of your foot, massaging the inflammation.
• Wearing supportive shoes: Wear sturdy, well-cushioned shoes. Avoid sandals, flip-flops or other flat shoes without built-in arch support. Avoid walking barefoot.
• Orthotics or shoe inserts: Inserts can be placed inside your shoes. These will provide further support to your feet's arches. Your doctor may prescribe over-the-counter pre-made inserts or custom orthotics, which are molded to the specific shape of your foot.
• Immobilization: For some, the use of a walking cast or a pneumatic cam walker for several weeks can be the wearing of a walking boot. This keeps your foot in position and shifts pressure off your plantar fascia. Your provider will let you know how long you'll have to wear a boot.
• Massaging and stretching: Your provider or physical therapist will demonstrate stretches and massage techniques you may do on your foot and calf muscles.
• Corticosteroids: Corticosteroids are anti-inflammatory drugs. Your doctor can inject a corticosteroid such as prednisone directly into your plantar fascia.
• Platelet-rich plasma (PRP): PRP is usually used in the treatment and healing of injuries.
• Extracorporeal pulse activation technology (EPAT): EPAT is a form of shockwave treatment. Your doctor will apply focused acoustic waves, or sound waves, to stimulate the blood flow to your plantar fascia, which will allow it to heal more efficiently.
• Percutaneous needle tenotomy: Your provider will insert a needle through your skin into your plantar fascia during a percutaneous tenotomy. The area gets more blood than normal, which boosts your plantar fascia's repair mechanisms.

Surgical procedure for plantar fasciitis

As a general rule, you will need all of the above treatments to gain relief from your symptoms and to treat the condition known as plantar fasciitis. However, surgery is rarely needed. The two most common types of surgery are:

• Gastrocnemius recession: Your surgeon will tighten your calf muscles by adding length to reduce tension on your plantar fascia.
• Plantar fascial release: Your surgeon will make several small cuts (incisions) in your plantar fascia to release some of the extra tension.

Your surgeon or healthcare provider will advise you on which type of surgical intervention you will undergo in order to treat plantar fasciitis.

How to prevent plantar fasciitis?

The best prevention for plantar fasciitis is avoidance of the overuse of your feet. You should typically:

• Stretch before and after exercise let your feet.
• Let your feet rest and recover following strenuous activity or exercise.
• Wear shoes that have supportive qualities.
• Avoid walking barefoot on hard surfaces.
• Replace your sneakers every six to nine months (or after you've walked or run between 250 and 500 miles in them).
• If you have any medical condition that exposes you to plantar fasciitis, there is not much that can be done.

How long does plantar fasciitis take to cure?

You should find that the symptoms of plantar fasciitis start to abate a few weeks or months after you begin treatment. However, it is going to take anywhere from a few weeks to a few months to fully recover your plantar fascia.

Are you starting to feel better but reverting back to pre-treatment status? Try the same over-the-counter remedies that helped you initially. Consult with your provider if your symptoms are different and/or worse than they were when you first began treatment.

When to seek medical care?

Consult a healthcare professional if:

• After one week, heel or foot pain does not subside with home remedies.
• The condition does not have an improvement after two weeks of medication.

To seek an expert consultation for any orthopedic condition.

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