Plantar Fasciitis

         

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It is an inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia). 

Plantar fasciitis often causes a throbbing pain that usually occurs with the first steps in the morning. When you get up and move, the pain usually subsides, but it may return after standing for a long time or when getting up from a sitting position. 

The cause of plantar fasciitis is poorly understood. It is more common in runners and people who are overweight. It is common to see this in patients who suddenly started running or playing and putting extra demands on their feet.

Plantar Fasciitis

Symptoms

Plantar fasciitis usually causes throbbing pain in the sole of the foot near the heel. The pain  usually gets worse with the first  steps after waking up, but it can also be triggered by standing for a long time or getting up from a seated position.

Causes  

The plantar fascia is a band of tissue (fascia) that connects the heel bone to the base of the toes. Supports the arch of the foot and absorbs shock when walking.   Tension and strain on the fascia can cause small tears. Repeated stretching and tearing of the fascia can irritate or inflame it, although the cause  in many cases of plantar fasciitis remains unclear.

Risk Factors  

Although plantar fasciitis can develop with no apparent cause, some factors may increase your risk of developing the condition. 

These include:   

  • age. Plantar fasciitis is most common in people between the ages of 40 and 60.  
  • Certain kinds of exercises. Activities that put a lot of pressure on the heel and adjacent tissues, such as walking. Physical activities such as long-distance running, ballet, and aerobic dance can contribute to the development of plantar fasciitis.
  • Foot biomechanics. Flat feet, a high arch, or even an atypical walking pattern can affect weight distribution when standing and put extra pressure on your plantar fascia. 
  • obesity. Extra pounds put extra pressure on the plantar fascia.  
  • professions that keep you busy. Factory workers, teachers, and others who spend most of their working hours walking or standing on hard surfaces may be at higher risk for plantar fasciitis.

Complications

Ignoring plantar fasciitis can lead to chronic heel pain that makes it difficult for you to do your normal activities. You’ll likely change the way you walk to avoid pain from plantar fasciitis, which can lead to problems with your feet, knees, hips, or back.

Diagnosis  

Plantar Fasciitis is diagnosed based on your medical history and physical exam. During the exam, your doctor will examine your foot for tender spots. The location of your pain can help determine its cause.   

Imaging tests  

No tests are usually required. Your doctor may suggest an X-ray or MRI to make sure there isn’t another problem, such as a stress fracture, that is causing your pain. Sometimes an X-ray will show a protruding piece of bone  (spur) from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed

Treatment  

Most people with plantar fasciitis recover within a few months with conservative treatment, such as B. Cooling the sore area, stretching, and modifying or avoiding activities that cause pain.   

medications  

pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can reduce the pain and inflammation of plantar fasciitis.  

 Therapies  

  • Physiotherapy. A physical therapist can show you exercises to stretch your plantar fascia and Achilles tendon and strengthen your lower leg muscles. A therapist can also show you how to put on an athletic bandage to support the sole of your foot. 
  • Night splints. Your physical therapist or healthcare provider may recommend wearing a splint that holds the plantar fascia and Achilles tendon in an extended position at night to encourage stretching while you sleep.  
  • Orthoses. Your healthcare provider may prescribe ready-made or custom-made arch supports (orthoses) to help distribute pressure more evenly across your feet.
  • Hiking shoes, walking sticks or crutches. Your healthcare provider may recommend one of these for a short time, either to keep you from moving your foot or to keep you from putting all your  weight on your foot.  
  • Surgical or other  procedures  

If more conservative measures have not worked after several months, your doctor may recommend:   

  • injections. A steroid injection into the sensitive area can provide temporary pain relief. Multiple injections are not recommended as they can weaken the plantar fascia and potentially lead to tearing. Platelet-rich plasma from your own blood can be injected into the sensitive area to encourage tissue healing. Ultrasound imaging during the injection can help with precise needle placement.  
    • Extracorporeal shock wave therapy. Sound waves are directed at the heel pain area to stimulate healing. This applies to chronic plantar fasciitis that has not responded to more conservative treatments. Some studies show promising results, although this therapy has not been shown to be consistently effective. 
    • Ultrasonic Tissue Repair. This minimally invasive technology uses ultrasound images to guide a needle-like probe into damaged plantar fascial tissue. The tip of the probe then vibrates rapidly to break up damaged tissue, which is aspirated.  
    • Surgery. Few people need surgery to separate the plantar fascia from the heel bone. It’s usually only an option when the pain is severe and other treatments have failed. It can be performed as an open procedure or through a small incision under local anesthesia.

Lifestyle and Home Remedies  

To relieve pain from plantar fasciitis, try these self-care tips:   

  • Maintain a healthy weight. The extra weight can put extra pressure on the plantar fascia.  
  • Choose shoes that give you support. Buy shoes with low to medium heels, thick soles, good arch support and extra cushioning. 
  • Don’t wear loafers and don’t go barefoot. Do not wear worn-out athletic shoes. Replace your old running shoes before they no longer support and cushion your feet.  \
  • Switch sports. Instead of walking or jogging, try a gentle exercise like swimming or cycling. 
  • Apply  ice cream. Hold a cloth-covered ice pack over the painful area for 15 minutes three or four times a day to reduce pain and swelling. Or try rolling a frozen water bottle under your foot for an ice massage.  
  • Stretching your arches. Simple home exercises can stretch the plantar fascia, Achilles tendon, and calf muscles.