Plantar fasciitis



  • Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot.

    Causes, incidence, and risk factors.

    You are more likely to get plantar fasciitis if you have:
    • Foot arch problems (both flat feet and high arches)
    • Long-distance running, especially running downhill or on uneven surfaces
    • Sudden weight gain or obesity
    • Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
    • Shoes with poor arch support or soft soles

    Plantar fasciitis is seen in both men and women. However, it most often affects active men ages 40 - 70. It is one of the most common orthopedic complaints relating to the foot.

    Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.

    Symptoms.

    The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.

    The pain is usually worse:
    • In the morning when you take your first steps
    • After standing or sitting for a while
    • When climbing stairs
    • After intense activity

    The pain may develop slowly over time, or suddenly after intense activity.

    Signs and tests.

    The health care provider will perform a physical exam. This may show:
    • Tenderness on the bottom of your foot
    • Flat feet or high arches
    • Mild foot swelling or redness
    • Stiffness or tightness of the arch in the bottom of your foot.

    X-rays may be taken to rule out other problems.

    Treatment.

    Your health care provider will usually first recommend:
    • Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
    • Heel and foot stretching exercises
    • Night splints to wear while sleeping to stretch the foot
    • Resting as much as possible for at least a week
    • Wearing shoes with good support and cushions

    Other steps to relieve pain include:
    • Apply ice to the painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days.
    • Try wearing a heel cup, felt pads in the heel area, or shoe inserts.
    • Use night splints to stretch the injured fascia and allow it to heal.

    If these treatments do not work, your health care provider may recommend:
    • Wearing a boot cast, which looks like a ski boot, for 3-6 weeks? It can be removed for bathing.
    • Custom-made shoe inserts (orthotics)
    • Steroid shots or injections into the heel

    Sometimes, foot surgery is needed.