Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy.
Common symptoms of plantar fasciitis:
- Sharp or dull pain felt at the bottom of the foot directly on or near the heel
- Pain that is most severe in the morning, especially when first standing
- Pain that worsens after prolonged weight-bearing
- Pain that is relieved with rest
- Heel swelling and/or stiffness
When a person has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed. As the stress placed on the inflamed plantar fascia continues, micro tears develop, which may cause the development of a bony growth called a heel spur.
Factors that may increase your risk for developing plantar fasciitis:
- Excessive training, especially long-distance walking or running
- Rapid weight gain
- Prolonged standing
- Recent change in activity
- Tight calf muscles or a tight Achilles tendon
- Improper footwear
- Flat feet
- Very high foot arches
Proper diagnosis of plantar fasciitis requires a medical history and physical exam. During the medical history, your doctor will ask you where your pain is located, and whether it’s worse in the morning and/or with prolonged standing.
Your doctor will look for plantar fascia tenderness. While holding your foot, he will bend your toes toward your shin and then press along your plantar fascia from your heel to forefoot.
Blood and imaging tests are not used to diagnose plantar fasciitis, but they may be helpful for ruling out other potential heel pain diagnoses.
The treatment of plantar fasciitis begins with these simple, self-care steps:
Resting your foot is perhaps the most important step you can take to ease your plantar fasciitis-related pain. Avoid irritating activities, like those that place unnecessary strain on your foot (e.g., running, jumping, dancing, or walking barefoot).
Applying a cold compress or ice pack to the back of your foot for 15-minute sessions, several times a day, can ease pain and swelling. Wrap the ice pack in a thin towel, so it’s not in direct contact with your skin.
Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.