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Plantar Fasciitis

Questions

WHAT IS PLANTAR FASCIITIS?

Plantar fasciitis is a chronic local inflammation of the "bowstring-like" ligament stretching underneath the sole, also referred to as the plantar fascia that attaches at the heel. The word “fasciitis” means “inflammation of the fascia of a muscle or organ” while “plantar” relates to the sole of the foot. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning.

Two million patients get treatment for plantar fasciitis, annually, that makes it the most common cause of heel pain. 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. Plantar fasciitis is one of the most common orthopedic complaints. Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Too much pressure on your feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness. Plantar fasciitis is more common in runners. People who are overweight and those who wear shoes with inadequate support also have an increased risk of plantar fasciitis. 

WHAT ARE THE SYMPOTMS OF PLANTAR FASCIITIS?

The plantar fascia runs along the sole from the toes to the bottom of the heel. Excessive pressure on this part of the foot can cause small tears in the tissue. This damage leads to inflammation, pain, and stiffness. Both dull pain and stabbing pain have been reported by patients with plantar fasciitis. The symptoms of plantar fasciitis include:

  • Pain on the bottom of the heel, or nearby.
  • Increased pain after exercise (not during).
  • Pain in the arch of the foot.
  • Pain that is worse in the morning or when you stand after sitting for a long time.
  • A swollen heel.
  • Pain that continues for months.

A tight Achilles tendon. (80% of people report this symptom.) Your Achilles tendon connects your calf muscles to your heel

WHAT ARE THE COMMOM CAUSES OF PLANTAR FASCIITIS?

The function of the plantar fascia is to absorb the impact of standing, walking, and running on the foot. This part of the body gets a lot of use, and too much pressure can damage the plantar fascia. Plantar fasciitis will not necessarily have one single cause. Several risk factors can increase a person’s likelihood of developing the condition. These include:

  • Age, as plantar fasciitis is especially common in people between the ages of 40 to 60 years
  • Doing exercise, such as running, that repeatedly impacts the plantar fascia
  • Having Flat feet, high arches, or tight calf muscles
  • Having overweight or obesity or being pregnant, all of which put more pressure on the feet
  • Having certain medical conditions, such as arthritis
  • Frequently standing for extended periods
  • Often wearing high heeled shoes

Women are more likely than men to experience plantar fasciitis. It is not clear why, but it may be because certain risk factors for the condition - such as pregnancy and wearing unsupportive shoes - affect women more than men. The condition usually develops with repeated impact or pressure, which, over time, can cause damage to the tissue in the foot.

DIAGNOSIS

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:

  • Reflexes
  • Muscle tone
  • Sense of touch and sight
  • Coordination
  • Balance

An X- Ray or an MRI scan may be necessary to check that nothing else is causing your heel pain, such as a bone fracture.

TREATMENT OF PLANTAR FASCIITIS?

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 device 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.

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. 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:

  • Bruises
  • Swelling
  • Pain
  • Numbness

Extracorporeal shock wave therapy hasn’t been proven to be consistently effective in relieving symptoms. If the home and medical treatments don’t take care of your plantar fasciitis, the next option to consider is surgery.