Plantar Fasciitis

What Are the Symptoms of Plantar Fasciitis?

The main symptom of plantar fasciitis is sharp pain near the heel of your foot. Typically, this pain is more intense when you first put weight on your foot in the morning or after sitting for long periods. When you walk around for a bit, the pain usually dissipates. Although you may experience heel pain during exercise, it’s actually more common afterward.

What Causes Plantar Fasciitis?

Plantar fasciitis is caused by inflammation of the plantar fascia. The plantar fascia is a thick band of tissue that supports your arch, connecting the heel bone and toes. It sometimes occurs due to overuse and is fairly common in runners. However, it’s also common in people whose footwear provides inadequate support and those who are overweight.

Risk of developing plantar fasciitis is greater for people who:

• Are aged 40 to 60
• Weigh too much
• Spend most of their working hours walking or standing
• Have gait abnormalities
• Have flat feet or high arches
• Frequently engage in high-impact activities, such as running, jumping, and dancing

Even if you fit all of these demographics, you can help prevent plantar fasciitis by maintaining a healthy weight and wearing high-quality shoes that offer ample support.

Conservative Treatment Options for Plantar Fasciitis

Conservative treatment (i.e. non-surgical) works well for around 95 percent of plantar fasciitis patients. Options include:

• Exercises that stretch and strengthen the plantar fascia as well as the tendons and muscles that support the feet and ankles
• Night splints to hold the plantar fascia and Achilles tendon (it connects the calf to the heel) in a stretched position while you sleep
• Orthotics (i.e. shoe inserts) that help support the arch and distribute weight across the foot
• Over-the-counter medications to manage pain and inflammation, such as ibuprofen and naproxen

Your doctor may also demonstrate stretches you can perform after exercising, such as rolling a ball along the arch of the foot. These therapies help relieve pain and inflammation.

How Is Plantar Fasciitis Diagnosed?

If your podiatrist suspects you have plantar fasciitis, he or she begins by taking your medical history and conducting a physical exam. They should ask you to describe when your heel pain began as well as when it’s worse. In addition, expect to demonstrate where the pain occurs. In some situations, your podiatrist may order diagnostic exams, particularly X-ray and MRI. If your doctor orders these tests, he or she is probably trying to rule out other causes of your pain, such as a stress fracture.

Surgery and Other Procedures to Treat Plantar Fasciitis

Most podiatrists pursue conservative treatment options for at least 6 to 12 months before considering surgery. Plantar fascia surgery is relatively rare and typically only ordered when pain is severe and conservative treatment provides no relief.

Other alternative treatment options include:

• Steroid injections provide pain relief, but it isn't permanent
• Regenerative therapies, particularly platelet-rich plasma (PRP) injections, promote faster healing and even offer pain relief
• Sound wave therapy isn't common but it's an option for patients who aren't responding to conservative treatments
• Tenex is a minimally invasive procedure that uses ultrasound technology and microscopic incisions to remove damaged tissue from the plantar fascia

Again, these options – particularly surgery – are reserved for when your plantar fasciitis just isn’t responding to conservative treatments.

Tricks to Relieve Plantar Fasciitis Pain at Home

In addition to the conservative treatment options listed above, the following help relieve the pain and discomfort of plantar fasciitis:

• Don't walk around barefoot, even at home. Invest in slippers or house shoes that offer excellent arch support. These are especially valuable in the morning, when you first put weight on your feet.
• Replace sneakers even if they aren't visibly damaged. Athletic shoes stop supporting your feet after they log a certain number of miles – just like your car tires. Typically, you want to replace tennis shoes after around 400 to 500 miles.
• Stretch your arches and Achilles tendon after exercising.
• Consider taking a break from the sport causing your pain. You don't have to stop exercising altogether, just look for something low impact to give your feet a rest. Good aerobic options include cycling and swimming.
• Apply ice for 15 to 20 minutes after activity and up to four times a day. One way to ice and stretch the arch at the same time is to freeze a bottle of water. You can then "roll" it under your foot. Simply sit in a chair and lay the bottle on the floor in front of you. Rest your foot on top of it. Then, just roll it back and forth, applying slight pressure.