Plantar fasciitis is an inflammation of the plantar fascia, a band of fibrous connective tissue that runs along the bottom of the foot from the heel to the base of the toes. This band normally supports the muscles and the arch of the foot, functioning as a shock absorber, but if, after repeated stretching, it tears, inflammation and severe heel pain, exacerbated by standing or walking, result. Plantar fasciitis is the most frequent cause of heel pain and a common reason for the development of outgrowths of bone, called heel spurs, as well. It is more common in women and tends to occur as people age.
Risk Factors for Plantar Fasciitis
Although plantar fasciitis can occur in any individual, certain risk factors predispose people to developing the condition. Some people are at an anatomical or physical disadvantage because of they have:
- Flat feet and excessive pronation
- Extremely high arches
- Tight Achilles tendons or calf muscles
- Legs of uneven lengths
- An abnormal gait
Some individuals increase their chances of developing plantar fasciitis by:
- Being overweight
- Walking, standing, or running for long periods
- Beginning or intensifying exercise without proper preparation
- Wearing poorly fitted, worn-out, or high-heeled shoes
Plantar fasciitis, while more common as people in patients between 40 and 60 years of age, may occur in younger individuals who spend a great deal of time standing or running, like athletes or soldiers. Arthritis may be a factor in the development of the condition.
Symptoms of Plantar Fasciitis
Patients with plantar fasciitis have sharp pain in the heel which may extend to the arch of the foot or to the back of the leg during walking. The pain is usually worst in the morning when the patient first steps down on the affected foot. It may subside somewhat and then recur when the patient rises to a standing position after sitting or lying down. Stair climbing may be especially difficult. Plantar fasciitis does not usually cause foot pain at night.
Diagnosis of Plantar Fasciitis
In order to diagnose plantar fasciitis, the doctor does a thorough examination of the patient's feet that includes observing the patient stand and walk. A medical history is also taken, including information concerning what time of day the patient's feet hurt most and what types of physical activities elicit pain.
If the doctor suspects an anatomical problem with the bones of the foot, or another type of injury, such as a stress fractures, an X-ray may also be taken.
Treatment of Plantar Fasciitis
As with other medical conditions, the simplest remedies are typically the first treatments tried. These include:
- Application of ice to the heel
- Over-the-counter pain medications and anti-inflammatories
- Exercises that stretch the toes and calves
- Purchase of more supportive shoes
- Wearing orthotics (shoe inserts)
If these preliminary treatments don't work, the doctor may advise the wearing of splints during the night or the administration of corticosteroid injections directly into the site. While most patients find relief within several days or weeks, some will not experience complete recovery for many months. If recovery doesn't occur after 6 to 12 months, surgical intervention may be necessary.