Plantar Fasciitis

Plantar fasciitis causes the most commonly seen heel pain. It is more common in middle-aged people. It may happen in case of young people who stand a lot.  It is also seen in case of soldiers and athletes.

Plantar fascia is a ligament that joins the toes with your heel bone and is necessary for the support of the arch of the foot. If for any reason, it is stretched, then it may cause swelling, irritation or inflammation.  In such a condition, your heel will hurt while walking or standing.

Causes of plantar fasciitis

The exact causes of plantar fasciitis are not yet known.  Most likely the condition appears when there are repeated small tears in the plantar fascia. If it is stretched by walking or any other activity, the condition may develop.

Some of the important causes of plantar fasciitis

• Abnormal rolling and twisting of foot
• Tight calf muscles
• High arches
• Tight tendons
• Walking or standing for a long time on irregular and hard surfaces
• Overweight
• Age
• Wearing shoes without  the right cushion
• Injury to the foot

Symptoms

The classic symptom that you will see in case of plantar fasciitis is heel pain while taking the first steps after you wake up in the morning.  You may also have heel pain after sitting for a long duration.  There are some other symptoms of plantar fasciitis, which may appear in people suffering from the conditions

• Pain and stiffness of the feet in the morning or after sitting for some time, which gets better after you take a few steps, but the pain gets worse with the progress of the day.
• Pain  in the heel after you stand for long duration
• Pain that gets  worse when you climb stairs
• Pain after you stand on your toes
• Pain when you start exercising, but goes away while exercising and returns when you exercise is completed.

Diagnosis of plantar fasciitis

Diagnosis of plantar fasciitis is done by the doctor by asking the patient about the symptoms.  The doctor may also need to know about the past health of the patient.  A physical exam of the feet may be necessary in which the doctor asks the patient to stand and walk.

Sometimes an x-ray may be necessary to find out stress fracture, other ankle bone problem or bone cyst.  The doctor may advise an x-ray to see if there is a heel spur present. In some rare cases, the doctor may advise MRI, vascular testing, bone scans and blood tests for finding out the flow of blood in the foot.

Treatment

The main objectives of treatment of the condition are-

• Relieving pain and inflammation in the heel
• Healing of  any small tears present in the plantar fascia
• To help you continue with your normal daily activities
• Improving flexibility and strength
• Correcting the foot problems that lead to plantar fasciitis

Initial treatment

There are several methods that you can try to get relief from the heel pain.

• If possible, eliminate the daily activities that causes heel pain.  If eliminating is not possible, you can at least limit those activities.
• Avoid walking or running on hard surfaces.
• For relieving the pain and reducing the inflammation, use ice on your heel.
• You can use a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil or Motrin etc.), naproxen (Aleve etc.), or aspirin to get relief from the pain.  These medicines are available in both cream and pill forms.
• Use shoe inserts in your shoes to get a good cushion for your heel.
• Wearing shoes that have the right arch support and good shock absorption capacity.
• Do a little bit of exercise “ try toe stretches, towel stretches and calf stretches in the morning and several times during the day.

If the condition gets worse, then you need to talk to your doctor again.  He may suggest corticosteroid shots if nonsurgical treatment is not helping you. Even the shots can relieve the pain you have in the heels, the relief will be short-term.  Only 5 people out of 100 need surgery in plantar fasciitis.
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