Plantar Fasciitis

The plantar fascia is the thick tissue on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis.

Cause

Swelling occurs when the thick band of tissue on the bottom of the foot (fascia) is overstretched or overused. This can be painful and make walking more difficult.

You are more likely to get plantar fasciitis if you:

• Have foot arch problems (both flat feet and high arches)
• Run long distances, downhill or on uneven surfaces
• Are obese or gain weight suddenly
• Have a tight Achilles tendon (the tendon connecting the calf muscles to the heel)
• Wear shoes with poor arch support or soft soles
• Change your activities

Plantar fasciitis is seen in both men and women. It is one of the most common orthopeadic foot complaints.

Signs & Symptoms

The most common symptom is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.

The pain is often worse:

• In the morning when you take your first steps
• After standing or sitting for awhile
• When climbing stairs
• After intense activity
• Walking, running, and jumping sports

The pain may develop slowly over time, or come on suddenly after intense activity.

Diagnosis

A physical examination may show:

• Pain on the bottom of your foot.
• Pain along the sole of the foot.
• Flat feet or high arches.
• Mild foot swelling or redness.
• Stiffness or tightness of the arch in the bottom of your foot.

X-rays may be taken to rule out other problems.

Treatment

Non-surgical treatments almost always improve the pain. Treatment can last from several months to 2 years before symptoms get better. Most people feel better with 6 to 18 months.

Often, these steps are recommended first:

• Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
• Heel and foot stretching exercises
• Night splints to wear while sleeping to stretch the foot
• Resting as much as possible for at least a week
• Wearing shoes with good support and cushions

You can also apply ice to the painful area. Do this at least twice a day for 10 to 15 minutes, more often in the first couple of days.

If these treatments do not work, these next steps may be recommended:

• Wearing a boot cast, which looks like a ski boot, for 3 to 6 weeks. It can be removed for bathing.
• Custom-made shoe inserts (orthotics)
• Steroid shots or injections into the heel

Sometimes, foot surgery is needed. Some people need surgery to relieve the pain.

Prevention

Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis. Stretch your plantar fascia in the morning before you get out of bed. Doing activities in moderation can also help.