What is Plantar Fasciitis and How to Treat it?

Dr. Igor Smelyansky Pain Management Specialist Knoxville, TN

Dr. Igor Smelyansky is the owner of Omega Pain Management in Knoxville, TN. He graduated NYU Medical Center (New York, NY) Neurology residency, followed by a prestigious ACGME-accredited Pain Management Fellowship at Virginia Commonwealth University in Richmond, VA. He is the only physician in the entire East Tennessee... more

What is plantar fasciitis?

Plantar fasciitis is a painful condition that causes heel pain. Plantar fasciitis, also known as plantar fasciopathy or plantar fascia pain, occurs when the plantar fascia ligament becomes stretched and inflamed. The plantar fascia ligament is a thick band of tissue on the bottom of your foot which supports the arch and provides stability. If you are experiencing this problem it can be very frustrating to walk around because it will cause intense heel pain.

What causes plantar fasciitis?

Several things can cause plantar fasciitis. One of the most common causes is wearing shoes that do not fit well or are worn out. This can cause your foot to move around in the shoe and put excessive strain on the plantar fascia ligament. Another common cause is obesity, which can put extra strain on your feet. Activities that involve a lot of running or jumping can also cause plantar fasciitis, as can flat feet or high arches. Genetics and age can also be causes of plantar fasciitis. It is a fairly common problem in people who are on their feet all day, but it can also be caused by flat feet or an imbalance of your foot muscles.

How common is plantar fasciitis?

This condition is quite commonly found common in the general population. As reported by specialists at American Family Physician Journal: "Plantar fasciitis (also called plantar fasciopathy, reflecting the absence of inflammation) is a common problem accounting for approximately 1 million patient visits per year, with about 60% of these to primary care physicians. It is the most common cause of heel pain in adults, with a lifetime incidence of about 10% and an increased incidence in women 40 to 60 years of age. Plantar fasciitis is associated with a variety of sports but is mostly reported in recreational and elite runners (incidence of 5% to 10%)."

Plantar fasciitis affects more than 4 million Americans every year and it usually occurs in adults between 40 and 60 years old, though this condition can appear at any age.

What are common symptoms of plantar fasciitis?

Plantar fasciitis appears when your plantar fascia ligament becomes inflamed. This causes heel pain that increases upon standing or taking the first few steps after sitting down for long periods of time. The beginning of plantar fasciitis often presents itself as morning heel pain which quickly goes away as you move around throughout the day.

How to diagnose plantar fasciitis?

X-rays can be utilized as an initial screening tool to rule out any spurs or bone overgrowth in the feet when one is trying to diagnose plantar fasciitis. X-rays are cheap, quick but do expose the patient to a certain amount of radiation.

MRI can be used to diagnose plantar fasciitis. MRI is safer and gives a better picture of the soft tissue. MRI is used to evaluate the potential tear in the plantar fascia. MRI does not require general anesthesia nor does MRI expose patients to any radiation. MRI is more expensive than X-rays and is more time-consuming. MRI uses a strong magnetic field and radiofrequency pulses to produce detailed images of the foot, its bones, and ligaments. MRI provides better resolution than x-rays.

How to treat plantar fasciitis?

There are several ways that you can treat plantar fasciitis. Medications, such as ibuprofen or other pain relievers (so-called NSAIDs), may help to reduce inflammation and pain. Corticosteroid foot injections can be performed by your local podiatrist or a neurologist may reduce inflammation and pain, but they have serious side effects if used too often. To treat plantar fasciitis, doctors usually recommend resting and avoiding activities that involve walking or standing for a long time.

Physical therapy treatments can also help to stretch the fascia and muscles around the heel bone. Physical therapy can also help to improve balance and muscle strength around the ankle and the foot in general. Physical therapy treatments are usually completed by a physical therapist, a person who has completed a rigorous and lengthy training process. Physical therapy may also include range-of-motion exercises, ultrasound to loosen the tissue around the heel or other stretching exercises. Physical therapy treatments are usually completed several times a week over several weeks.

Wearing shoes that are supportive and have a good arch can also help with the pain. The shoes that are well-ventilated or airy may make walking more comfortable. You should be able to wiggle your toes, allowing enough room for them to move around. The shoe should have plenty of cushioning for shock absorbency and support on both the heel and under the arch.

You may also wear a supportive night splint. A night splint is an elastic band that goes around the foot and is worn overnight. It gently stretches the plantar fascia ligament to help reduce pain in the morning. You should wear a night splint every night until your pain is gone, and then continue to wear it for a few nights a week to reduce the risk of experiencing pain again.

A few studies have looked at the effectiveness of heel lifts, but the evidence is mixed. Some studies have shown that heel lifts may be effective in the short term. However, other studies have shown no benefit from wearing heel lifts. Because plantar fasciitis is caused by inflammation, it is important to rest. It may take several months for the pain to completely go away. Also, weight loss is extremely important in treating this painful condition.

Conclusion

Plantar fasciitis can become serious if it is left untreated because it causes your plantar fascia ligament to break down over time which will lead to long-term heel pain. This can cause inflammation of other tendons, arches, or tissue in your feet which will make plantar fasciitis even more painful.

Plantar fasciitis is a common condition that can be diagnosed and treated with relative ease. If you think you might have plantar fasciitis, the first step to take is an appointment with a local podiatrist for diagnosis and treatment options. From stretching exercises to orthotics, there are many ways of getting rid of this debilitating pain in your feet! You don’t want to waste time suffering from plantar fasciitis when it could be fixed quickly by visiting your podiatrist today.

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References

Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019 Jun 15;99(12):744-750. PMID: 31194492.