Plantar fasciitis is one of the most commont causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of your foot -- connecting your heel bone to your toes. Plantar fasciitis causes stabbing pain that usually occurs with your very first steps in the morning, or after you have been resting for extended periods of time. Once your foot "limbers up," the pain of plantar fasciitis normally decresases, but it may return after long periods of being on your feet.
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If the tension on that bowstring becomes too great, it can creat small tears in the fascia.
Factors that may increase your risk of developing plantar fasciitis include:
Age: Plantar fasciitis is most common between the ages of 40 and 60.
Sex: Women are more likely than men to develop plantar fasciitis.
Faulty Foot Mechanics: Arches that are too flat or too high can adversely affect the way weight is distributed when you're standing and walking, putting added stress on the plantar fascia.
Obesity: Excess pounds put extra stress on your plantar fascia.
Occupations that keep you on your feet for extended periods.
Improper shoes: Shoes that are thin soled, loose, or lack arch support or the ability to absorb shock do not provide adequate protection for the plantar fascia.
Your doctor may suggest an x-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a stress fracture or pinched nerve.
Ultrasound is becoming an increasingly popular way to diagnose and monitor treatment of plantar fasciitis. Ultrasound allows a physician to see and measure the plantar fascia, checking for inflammation and other abnormalities.
Sometimes an x-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically, but research has shown that this is not the true cause of the pain and usually do not need to be removed.
About 90 percent of the people who have plantar fasciitis recover with conservative treatments in just a few months.
Stretching is a mianstay of treatment; it is critical in regaining flexibility within the plantar fascia and avoiding further injury.
Medications including non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Motrin, etc) and naproxen (Aleve) may ease the pain and inflammation, although they do not treat the underlying problem.
Corticosteroids can reduce the inflammation and ease the pain associated with plantar fasciitis. This is usually administered through an injection of cortisone into the heel.
Orthotics are very important in relieving plantar fasciitis pain and keeping it away. A stiff over-the-counter insole such as Powerstep, or even a custom orthotic made by your podiatrist are best.
Night Splints are worn at night to maintain a stretch on the plantar fascia while you sleep. While difficult to become accustomed to, these are known to greatly relieve morning pain associated with plantar fasciitis.
Physical Therapy may be ordered by your doctor to employ other methods of stretching, and to reduce inflammation and internal scar tissue. PT is also excellent for strengthening foot and leg muscles.
Surgery is very rarely needed in plantar fasciitis. There are multiple procedures that your podiatrist will discuss with you if you are one of the small percentage of people that cannot get relief through conservative measures.