Ever wonder what that pain in your heel could be? You’re not alone: with over 2 million people in the United States diagnosed each year, one of the most common causes of heel pain comes from plantar fasciitis. Plantar fasciitis involves inflammation to the plantar fascia, with many describing a stabbing pain in the bottom of their foot near their heel. The plantar fascia is a tough fibrous band of tissue that runs across the sole of the foot, connecting the heel to the front of the foot. It supports the arch of the foot, absorbing any stress or strains placed on it. After repeated overuse or excess strain, the plantar fascia can have a decrease in elasticity and become inflamed, resulting in pain in the foot and heel.
Symptoms
Inflammation of the plantar fascia can cause a sharp or dull pain and stiffness in the bottom of the heel. Many report that the pain can be especially worse in the morning while taking their first few steps of the day. The pain can also be worsened by extended periods of physical activity and walking after long periods of standing or sitting. These symptoms may prompt people to change the way that they walk to avoid the pain, potentially leading to other problems in the foot, knee, hip, or back.
Risk Factors
Some risk factors include: having flat feet or high arches, extended periods of exercise on your feet, obesity or sudden weight gain, having a tight Achilles tendon, improper footwear with inadequate arch support, changes in activity levels, and presence of heel spurs. It is also most commonly found in people between the ages of 40 and 60.
How is it diagnosed?
To diagnose plantar fasciitis, a healthcare provider can conduct a physical exam that involves lightly pressing on the plantar fascia. In some cases, they may order an X-ray, MRI, or US of the foot to rule out other conditions that may be causing the pain.
Treatment options
Plantar fasciitis is typically able to be treated through nonsurgical interventions. Most commonly, healthcare providers will aim to relieve symptoms through over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS), rest, physical therapy, shoe inserts for arch support, icing the foot, use of a walking boot, steroid injections, and shockwave therapy. While the need for surgical procedures for plantar fasciitis is rare, the two most common surgical options are Gastrocnemius recession and Plantar fascia release. Gastrocnemius recession involves lengthening one of the muscles in the calf, resulting in increased range of motion in the ankle which reduces pressure on the plantar fascia, enabling it to stretch and relax. Plantar fascia release involves making small incisions in the plantar fascia to loosen some of the tension in the band of tissue.
Prevention and Outlook
Plantar fasciitis is most effectively prevented through stretching before and after exercise, rest to avoid overuse of the feet, and supportive footwear.
Once treated, symptoms of plantar fasciitis can show immediate improvement. Alternatively, it may take a few weeks or months for full resolution of symptoms.
References
Assessed and Endorsed by the MedReport Medical Review Board