Is Plantar Fasciitis?
Plantar fasciitis causes pain in the bottom of the heel. The
plantar fascia is a thin, web-like ligament that connects your heel to the
front of your foot. It supports the arch of your foot and helps you walk.
Plantar fasciitis is one of the most common orthopedic
complaints. 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.
Are the Symptoms of Plantar Fasciitis?
The major complaint of those with plantar fasciitis is pain and
stiffness in the bottom of the heel, although some experience pain at the
bottom mid-foot area. This develops gradually over time. It usually affects
just one foot, but it can affect both feet. Some people describe the pain as
dull, while others experience a sharp pain, and some feel a burning or ache on
the bottom of the foot extending outward from the heel.
The pain is usually worse in the morning when you take your first
steps out of bed, or if you’ve been sitting or lying down for a while. Climbing
stairs can be very difficult due to heel stiffness.
After prolonged activity, the pain can flare up due to increased
inflammation. Pain isn’t usually felt during the activity but rather just after
Causes Plantar Fasciitis?
You’re at a greater risk of developing plantar fasciitis if
you’re overweight or obese. This is due to the increased pressure on your
plantar fascia ligaments, especially if you have sudden weight gain. Women who
are pregnant often experience bouts of plantar fasciitis, particularly during
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 a factory worker or 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.
If you have foot problems, such as very high arches or very flat
feet, you may develop plantar fasciitis. Tight Achilles tendons, which are the
tendons attaching your calf muscles to your heels, may also result in plantar
fascia pain. Simply wearing shoes with soft soles and poor arch support can
also result in plantar fasciitis.
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), one out of every 10 people has a heel spur,
but only one out of 20 people with heel spurs experience pain.
Is Plantar Fasciitis Diagnosed?
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
Your doctor will evaluate the strength of your muscles and the
health of your nerves by checking your:
- muscle tone
- sense of touch and sight
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.
Are the Treatment Options for Plantar Fasciitis?
Reducing inflammation in the plantar fascia ligament is an
important part of treatment, but this doesn’t address the underlying damage to
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
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen
(Motrin or Advil) and naproxen (Aleve), often reduce inflammation in the
If home treatments and over-the-counter, anti-inflammatory drugs
don’t ease the pain, an injection of a corticosteroid directly into the damaged
section of the ligament can help. Your doctor can do this in their office. Your
doctor may use an ultrasound device to help determine the best place for the
injection. Your doctor can also apply corticosteroids to the skin of your heel
or the arch of your foot, and then apply a painless electrical current to let
the steroid pass through your skin and into the muscle.
Physical therapy is an important part of treatment for plantar
fasciitis. It can help stretch your plantar fascia and Achilles tendons. A
physical therapist can also show you exercises to strengthen your lower leg
muscles, helping to stabilize your walk and lessen the workload on your plantar
If pain continues and other methods aren’t working, your doctor
may recommend extracorporeal shock wave therapy. In this therapy, sound waves bombard
your heel to stimulate healing within the ligament. This treatment can result
It hasn’t been proven to be consistently effective in relieving
The most dramatic therapy, used only in cases in which pain is
very severe, is surgery. Your surgeon can partially detach the plantar fascia
from the heel bone, but this weakens the arch of the foot and full function may
be lost. Another surgery involves lengthening the calf muscle. This process is called
Braces and Supports
Night splints are another treatment that can help stretch your
calf and the arch of your foot. Night splints are a type of brace that holds
your foot in a flexed position and lengthens the plantar fascia and Achilles
tendon overnight. This can prevent morning pain and stiffness.
Special orthotics, or arch supports, for your shoes may help
alleviate some of the pain by distributing pressure, and they can prevent
further damage to the plantar fascia. A boot cast may immobilize your foot and
reduce strain while the plantar fascia heals. You can remove the boot cast,
which looks like a ski boot, for bathing.
Are the 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:
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 resection can also cause nerve damage.
Is the Long-Term Outlook for People with Plantar Fasciitis?
Most people don’t need surgery to relieve pain from plantar
fasciitis. Instead, their condition improves through physical therapy, home
treatments, and medical treatments. However, treatment can take several months
to two years to improve your symptoms.