Did you know that heel pain – that horrible, makes you want to walk on the sides of your feet kind of pain – is most often caused by plantar fasciitis? It should be noted that heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst; however, plantar fasciitis is by far the most common.
What Is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. It should be noted that, since there are several potential causes for heel pain, it’s important to have the condition properly diagnosed. A foot and ankle surgeon is the most qualified medical professional to diagnose the cause of your heel pain.
What Causes Plantar Fasciitis?
The most common cause of plantar fasciitis is the structure of the foot itself. For example, people who have problems with their arches – such as flat feet or highly-arched feet – are more prone to developing plantar fasciitis. Wearing shoes with no support – or going barefoot – on hard, flat surfaces also puts an abnormal amount of strain on the fascia.
What are the Symptoms of Plantar Fasciitis?
The symptoms of plantar fasciitis can vary from person to person, but the most commonly reported symptoms are: pain on the bottom of the heel; pain in the arch of the foot; pain that is substantially worse after a period of inactivity; and pain that increases over the course of several months. Individuals that are afflicted with plantar fasciitis will often describe their pain as being substantially worse first thing in the morning or after they’ve been sedentary for a long period of time, with the pain subsiding after being up and about for a few minutes. The pain typically decreases because walking works to stretch the fascia; however, for some, the pain will return after they’ve been on their feet for an extended period of time.
How is Plantar Fasciitis Diagnosed?
After your foot and ankle surgeon goes through your medical history with you and discusses your symptoms, s/he will examine your feet. It’s through this process that the physician is able to rule out other causes of your heel pain. X-rays or other diagnostic imaging may be ordered as well, to check for fractures, bonThroughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis.
In addition, diagnostic imaging – like x-rays or MRI’s – may be utilized to determine the exact cause of your heel pain. Occasionally spurs are found in patients who are diagnosed with plantar fasciitis, but these are rarely the source of pain. However, when spurs are found, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Plantar Fasciitis Treatment
Fortunately there are a lot of things you can do at home in regards to the treatment of plantar fasciitis. These would include:
Stretching exercises that work to stretch out the calf muscles can help ease pain and assist with recovery.
Wear your shoes! Walking around barefoot puts a LOT of undue strain and stress on your plantar fascia.
While we’re talking about shoes, make sure the ones you’re wearing have good support! Shoes with an ample amount of arch support – as well as a bit of a raised heel – can help reduce fascia stress.
Placing an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. With that said, remember to never place the ice directly on your skin – always have a thin towel covering the bag of ice.
Take a break – by decreasing your physical activity, you can give your heels a rest.
Over the counter non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen and naproxen, can help reduce pain and inflammation.
If you’re still experiencing pain after several weeks of home care, make sure to let your foot and ankle surgeon know so that s/he can pursue more aggressive forms of treatment. These would include:
Placing pads in your shoe(s) to soften the impact of walking, and/or “strapping” your arch to helps support the foot and reduce strain on the fascia.
Having you wear a night splint, which will help to stretch and extend your plantar fascia while you’re sleeping – this can help alleviate some of the pain that individuals experience in the morning after waking.
Your physician may recommend that you be fitted for custom orthotic devices – this can help correct any underlying structural issues that may be exacerbating the problem.
Physical therapy and steroid injections are also common courses of treatment for plantar fasciitis.
Will I Need Surgery?
Fortunately, most individuals respond quite well to non-surgical treatment, making surgery unnecessary. However, there are those that do not experience adequate relief from the more conservative courses of therapy and, for them, surgery may be recommended. Rest assured that your orthopaedic physician will discuss all the options available, as well as which approach they feel would work the best for your particular circumstance.
Regardless of the type of treatment your physician prescribes for your plantar fasciitis, the underlying cause(s) will not be affected – this means that you will need to continue on with the preventative measures even after the pain and inflammation has abated. This would include wearing proper footwear, custom orthotics, and continuing with stretching exercises.
Typically, the earlier plantar fasciitis is caught, the easier it is to treat. So, if you’re experiencing foot pain, don’t wait to make an appointment! Dr. Krejci, Prairie Orthopaedics foot and ankle surgeon, is a board certified Doctor of Podiatric Medicine and is well versed in dealing with a multitude of foot and ankle conditions, including plantar fasciitis. Give us a call and let Dr. Krejci and her team get your foot health back on track!