Plantar Fasciitis

Overview

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia).

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight.

Symptoms

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or when you get up from sitting.

How is plantar fasciitis treated?

Home treatments like rest, icing, and using braces and anti-inflammatory drugs are often the first ways to treat plantar fasciitis. If those 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 image to help determine the best place for the injection. They 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.

Nonsurgical treatment for plantar fasciitis

Physical therapy

Physical therapy is a key part of treatment for plantar fasciitis. It can help stretch your plantar fascia and Achilles tendons. A physical therapist can show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia.

Shock wave therapy

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. Side effects of this treatment can include:

1.bruises

2.swelling

3.pain

4.numbness

Surgical treatment for plantar fasciitis

Surgery is the most dramatic therapy. This is done only in cases in which pain is severe or lasts more than 6 to 12 months.

Surgery can result in chronic pain and nerve damage, so it should be considered only after trying other treatment options

Gastrocnemius recession

If you have a hard time flexing your feet even after consistent stretching, your doctor may recommend gastrocnemius recession. This surgery involves lengthening the calf muscle to increase ankle motion and flexibility in the foot and release stress on the plantar fascia.

Plantar fascia release

In a plantar fascia release, your surgeon will cut part of your plantar fascia ligament to release some of the tension, which should hopefully relieve the inflammation. This may entail small cuts into the ligament, or it could entail detaching the plantar fascia from the heel bone. The process can be performed endoscopically or via open surgery.

This reduces tension, but weakens the arch of the foot, and full function may be lost.

Home remedies for plantar fasciitis

Reducing pain and irritation or inflammation in the plantar fascia ligament is an important part of treatment, but this doesn’t address the underlying damage to the ligament.

Home treatments for plantar fasciitis

Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, 3 or 4 times per day, to reduce swelling.

You can also try reducing or changing your exercise activities. Using arch supports in your shoes, replacing worn-out athletic footwear, and doing stretching exercises may also help to relieve pain.

Braces and supports for plantar fasciitis

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.

Essential oils for plantar fasciitis

There’s little research on treating plantar fasciitis with essential oils. Still, some studies suggest that using essential oils may reduce pain and inflammation for certain conditions. These oils include:

1.lavender

2.lemongrass

3.eucalyptus

4.rose

Dilute your essential oil with a carrier oil, like coconut oil, before using it for massage. You can also inhale the steam from the essential oil mixed with hot water.

Since it’s unclear whether plantar fasciitis involves irritation or inflammation, using these essential oils may not be much help. However, if you use them correctly, there’s generally no harm in trying them.

Nutrition and supplements for plantar fasciitis

More research is needed on using nutrition to improve or prevent plantar fasciitis. However, taking these supplements may help with tissue repair and healing:

1.vitamin C

2.zinc

3.glucosamine

4.bromelain

5.fish oil

It’s better to get nutrients from eating a balanced diet than from supplements. If you do decide to take supplements, always check with your doctor first.

If weight gain caused your plantar fasciitis, eating a healthy diet can help you lose weight and relieve your heel pain.

Causes

The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking.

Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the facia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.

Complications

Ignoring plantar fasciitis can result in chronic heel pain that hinders your regular activities. You're likely to change your walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems.

Risk factors

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

1.Age. Plantar fasciitis is most common in people between the ages of 40 and 60.

2.Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.

3.Foot mechanics. Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you're standing and can put added stress on the plantar fascia.

4.Obesity. Excess pounds put extra stress on your plantar fascia.

5.Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can be at increased risk of plantar fasciitis.

How do doctors diagnose plantar fasciitis?

Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.

During the evaluation, they 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 swelling.

Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your:

1.reflexes

2.muscle tone

3.sense of touch and sight

4.coordination

5.balance

How can you prevent plantar fasciitis?

Making a few lifestyle changes may help you avoid plantar fasciitis.

Wear supportive shoes with good arch support, and replace your athletic footwear regularly. If you’re a runner, around 400 to 500 miles is the limit for each pair of shoes before you should buy new ones.

Incorporate low-impact exercises into your routine, like swimming or bicycling. Avoid overworking your plantar fascia with very frequent running. Before exercising, be sure to stretch your calves, Achilles tendon, and plantar fascia.

Do your best to stay at a healthy weight. If you’re overweight, try to lose weight to reduce pressure on your plantar fascia

Do children get plantar fasciitis?

Children, like adults, may develop plantar fasciitis from overuse of the ligament or from wearing old or unsupportive shoes. Because the condition can worsen over time, it’s important to see a doctor to properly diagnose and treat it.

Ice your child’s heel to reduce any irritation or inflammation. Massaging the area can also help it heal. Make sure your child rests and avoids running, jumping, and standing for long periods to help their foot heal.

When your child returns to their normal activities, remind them to do warmup exercises and stretches to keep the problem from returning. You should also check that they’re wearing properly fitting, supportive shoes.

Exercises

While sitting, grasp your toes and gently pull them toward you until you feel a stretch in the arch of your foot. Right: Stand as shown, with your back leg straight and heel down. Move your hips forward until you feel a stretch in your calf. Switch legs and repeat.

What not to do with plantar fasciitis

Bad Habits That Are Making Your Plantar Fasciitis Worse

1.Ignoring your weight.

2.Not wearing supportive shoes.

3.Sitting or standing for long periods.

4.Pushing through the pain.

5.Not stretching or using supports.