Plantar Fasciitis is the leading cause of heel pain. In medicine, the suffix itis refers to irritation or inflammation of an organ, and in this case, to the plantar fascia, a band of tissue which connects your heel bone (calcaneus) to the ball of your foot. Pain can be felt anywhere along this path.
The classic sign of plantar fasciitis comes in the morning, when you step out of bed – a sharp pain in your heel. Gradually, as the tissue warms up and becomes flexible, the pain fades – maybe not completely, but substantially. It may then return if you stand on your feet all day or exercise, especially if you run or exercise strenuously.
What causes the heel pain of plantar fasciitis? When the plantar fascia is constantly stressed, small tears occur in the tissue. The tears make the plantar fascia weaker, less able to do its job of support and shock absorption. This offloading of the work causes stress on the surrounding tissues, which is the actual cause of the pain.
Plantar fasciitis also makes itself known to those who are carrying more body weight than normal, like pregnant women or obese individuals. You might also develop plantar fasciitis if you made a poor choice in shoes and wear a style which doesn’t support your feet correctly. People with flat feet also frequently suffer from plantar fasciitis, as do long distance runners .
Symptoms of Plantar Fasciitis
- A sharp pain at the back of your heel, sometimes described as “knife-like”
- Pain is most common with your first few steps in the morning, but may also occur after physical activity, or climbing stairs
- In most cases, pain increases gradually
- Usually appears in one foot, but occasionally both
- Foot may be stiff and difficult to bend
The Plantar Fascia acts like a shock absorber for your foot, and also supports your arch. If the plantar fascia receives repetitive stress, such as from exercising on hard surfaces, unsupportive footwear, or too much pressure from weight, small tears form in the tissue. These tears cause irritation in the surrounding tissue, which triggers pain.
If plantar fasciitis is left untreated, the condition may get substantially worse. Knee pain is also frequently reported in patients with plantar fasciitis, due to their change in gait to compensate for the heel pain.
Treatment for Plantar Fasciitis
- Custom orthotics (not off the shelf) prescribed by your podiatrist
- Physical therapy
- Rest, elevate, and ice the heel
- Over the counter anti inflammatory pain medicine such as Ibuprofen (Advil) or Naproxen (Aleve)
- Athletic shoes which provide excellent arch support and padding at the heel
- If exercising, train on soft surfaces instead of hard surfaces
- If overweight, start a weight management program
If these methods aren’t successful in relieving your pain, your podiatrist may recommend steroid injections, PRP injections, EPAT (shockwave) therapy, Radiofrequency Ablation (RFA), or in extreme cases, surgery.