FAQs on Plantar Fasciitis
Plantar fasciitis is a common cause of heel pain. According to the National Institutes of Health (NIH), around 2 million people are treated for this condition each year. This condition is common among people who stand and walk a lot on their feet.
What is the plantar fascia?
The plantar fascia is a strong band of tissue that supports the arch of the foot. When the plantar fascia becomes inflamed or irritated, it is called plantar fasciitis. The fascia is actually a thin, long ligament that is beneath the skin at the bottom of your feet. This structure connects the heel to the front of your foot.
What causes plantar fasciitis?
The plantar fascia absorbs high stress and strain placed on the feet. However, when there is too much pressure, the tissue tears or is strained. The body’s response to injury is inflammation, which with plantar fasciitis, causes pain of the heel and stiffness.
What are the risk factors for plantar fasciitis?
Plantar fasciitis develops in certain people more than others. Risk factors for this condition include:
- Repetitive activity (running/sports)
- Walking/standing on feet
- High arches
- Onset of a new activity
Do heel spurs cause plantar fasciitis?
Many people with plantar fasciitis also have heel spurs. However, spurs do not cause plantar fasciitis. While 1 in 10 people develop heel spurs, only 1 in 20 people with heel spurs have foot pain, which is around 5%. The pain associated with this inflammation is treated without removal of the heel spur.
What symptoms are associated with plantar fasciitis?
Not all patients with plantar fasciitis have the same symptoms. Common symptoms are:
- Pain on the bottom of the foot near the fascia
- Pain with the first steps upon rising in the morning or after resting
- Pain that subsides after a few minutes of walking
- Pain after exercise or activity, but not during
The doctor will examine your foot arch, assess for tenderness along the bottom of the foot, and check for pain with flexing of the foot. In addition, x-rays will be taken to check for stress fractures and bone problems. Other imaging tests include magnetic resonance imaging and ultrasound, but these are not routine ordered.
How is plantar fasciitis treated?
More than 90% of patients with plantar fasciitis improve with conservative treatment measures. However, some patients have heel pain that is long-term (chronic). Treatment options include:
- Rest and ice – The doctor may advise you to cease activities that bring on the pain, or taking a rest from physical exercise. Athletes may need to avoid sports activities for 1-2 weeks. Ice is used to decrease swelling and inflammation.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These medicines reduce pain and inflammation and include ibuprofen, naproxen, and Clinoril. The doctor will advise these for short-term, as long-term daily use is not advised.
- Physical therapy – Since plantar fasciitis is aggravated by tight calve and feet muscles, the therapist will teach you stretching exercises to alleviate pain. Other therapy modalities include ultrasound and heat therapy.
- Cortisone injections – Cortisone, dexamethasone, and triamcinolone are corticosteroids used to decrease inflammation. The doctor can inject the plantar fascia with these medicines.
- Supportive shoes/orthotics – The doctor may have you see a specialist to recommend shoes with thick soles and extra cushioning. This will reduce pain with walking. In addition, pre-made or custom orthotics are shoe inserts that support the arch and sole of the foot.
- Night splints – To keep the plantar fascia in a stretched position, night splints may be recommended.
- Extracorporeal shockwave therapy (ESWT) – High-energy shockwave impulses stimulate the healing process of the injured plantar fascia. This helps with pain and inflammation.