Plantar fasciitis is one of the most common explanations of heel pain. It is caused by inflammation to the thick band that connects the toes to the heel bone, called the plantar fascia, which runs
across the bottom of your foot. The condition is most commonly seen in runners, pregnant women, overweight people, and individuals who wear inadequately supporting shoes. Plantar fasciitis typically
affects people between the ages of 40 and 70. Plantar fasciitis commonly causes a stabbing pain in the heel of the foot, which is worse during the first few steps of the day after awakening. As you
continue to walk on the affected foot, the pain gradually lessens. Usually, only one foot is affected, but it can occur in both feet simultaneously. To diagnose plantar fasciitis, your doctor will
physically examine your foot.
There are a number of plantar fasciitis causes. The plantar fascia ligament is like a rubber band and loosens and contracts with movement. It also absorbs significant weight and pressure. Because of
this function, plantar fasciitis can easily occur from a number of reasons. Among the most common is an overload of physical activity or exercise. Athletes are particularly prone to plantar fasciitis
and commonly suffer from it. Excessive running, jumping, or other activities can easily place repetitive or excessive stress on the tissue and lead to tears and inflammation, resulting in moderate to
severe pain. Athletes who change or increase the difficulty of their exercise routines are also prone to overdoing it and causing damage. Another common cause of plantar fasciitis is arthritis.
Certain types of arthritis can cause inflammation to develop in tendons, resulting in plantar fasciitis. This cause is particularly common among elderly patients. Diabetes is also a factor that can
contribute to further heel pain and damage, particularly among the elderly. Among the most popular factors that contribute to plantar fasciitis is wearing incorrect shoes. In many cases, shoes either
do not fit properly, or provide inadequate support or cushioning. While walking or exercising in improper shoes, weight distribution becomes impaired, and significantly stress can be added to the
plantar fascia ligament.
The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs
right after getting up in the morning and after a period of sitting. If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity,
and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
No single treatment works best for everyone with plantar fasciitis. But there are many things you can try to help your foot get better. Give your feet a rest. Cut back on activities that make your
foot hurt. Try not to walk or run on hard surfaces. To reduce pain and swelling, try putting ice on your heel. Or take an over-the-counter pain reliever like ibuprofen (such as Advil or Motrin) or
naproxen (such as Aleve). Do toe stretches , calf stretches and towel stretches several times a day, especially when you first get up in the morning. (For towel stretches, you pull on both ends of a
rolled towel that you place under the ball of your foot.) Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or try heel cups or shoe inserts ( orthotics ). Use them in
both shoes, even if only one foot hurts. If these treatments do not help, your doctor may recommend splints that you wear at night, shots of medicine (such as a steroid ) in your heel, or other
treatments. You probably will not need surgery. Doctors only suggest it for people who still have pain after trying other treatments for 6 to 12 months.
Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if
non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider
surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament
and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release
when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the
cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
More than with most sports injuries, a little bit of prevention can go a long way toward keeping you free from plantar fasciitis. Here are some tips to follow. Wear supportive shoes that fit you
well. When your shoes start to show wear and can no longer give your feet the support they need, it's time to get a new pair. Runners should stop using their old shoes after about 500 miles of use.
Have a trained professional at a specialty running store help you find the right pair for your foot type, and then keep your shoes tied and snug when you wear them. Stay in good shape. By keeping
your weight in check, you'll reduce the amount of stress on your feet. Stretch your calves and feet before you exercise or play a sport. Ask an athletic trainer or sports medicine specialist to show
you some dynamic stretching exercises. Start any new activity or exercise slowly and increase the duration and intensity of the activity gradually. Don't go out and try to run 10 miles the first time
you go for a jog. Build up to that level of exercise gradually. Talk to your doctor about getting heel pads, custom shoe inserts, or orthotics to put in your shoes. Foot supports can help cushion
your feet and distribute your weight more evenly. This is especially true for people with high arches or flat feet. Your doctor will be able to tell you if shoe inserts and supports might lower your
chances of heel injury.