What is Plantar Fasciitis?
Plantar fasciitis is a common foot condition that causes pain in the heel and bottom of the foot. It occurs when the plantar fascia—a thick band of tissue that connects your heel bone to your toes—becomes inflamed. This inflammation results from repetitive stretching and tearing of the fascia, leading to pain and stiffness.
The condition affects approximately 2 million Americans annually and accounts for about 15% of all foot complaints requiring professional care.
Common Symptoms
- Stabbing heel pain, especially with the first steps in the morning
- Pain after prolonged standing or when getting up after sitting
- Pain that worsens after (not during) exercise or activity
- Tenderness on the bottom of the foot near the heel
- Pain that develops gradually over time
Risk Factors
Several factors can increase your risk of developing plantar fasciitis:
- Age: Most common between ages 40-60
- Certain exercises: Long-distance running, ballet, dance, and aerobic exercise
- Foot mechanics: Flat feet, high arches, or abnormal walking patterns
- Obesity: Excess weight puts added stress on the plantar fascia
- Occupations: Jobs that keep you on your feet for long periods
- Improper footwear: Shoes with poor arch support or soft soles
Diagnosis
Diagnosis of plantar fasciitis typically involves a physical examination of the foot. Your podiatrist will check for tender areas and may observe your stance, walk, and range of motion in the affected foot.
In some cases, imaging tests may be ordered to rule out other causes of heel pain:
- X-rays: To check for bone spurs or fractures
- Ultrasound: To visualize soft tissue abnormalities
- MRI: For more detailed imaging when the diagnosis is unclear
Treatment Options
Conservative Treatments
Most cases of plantar fasciitis can be treated with conservative approaches:
- Rest: Reducing or avoiding activities that worsen the pain
- Ice: Applying ice to the painful area for 15-20 minutes, 3-4 times per day
- Stretching exercises: For the plantar fascia and Achilles tendon
- Physical therapy: Specific exercises to strengthen lower leg muscles
- Supportive shoes: Proper footwear with good arch support
- Custom orthotics: Prescribed by your podiatrist to distribute pressure evenly
- Night splints: Devices that stretch the calf and foot while you sleep
- Over-the-counter medications: NSAIDs to reduce pain and inflammation
Advanced Treatments
For persistent cases that don't respond to conservative treatment:
- Corticosteroid injections: To reduce inflammation and relieve pain
- Extracorporeal shock wave therapy (ESWT): Sound waves to stimulate healing
- Ultrasonic tissue repair: Using ultrasound imaging to guide removal of damaged tissue
- Surgery: Rarely needed, but can release the plantar fascia from the heel bone
Prevention Tips
- Maintain a healthy weight to reduce pressure on your feet
- Wear supportive shoes with good arch support and cushioning
- Replace athletic shoes regularly (every 300-500 miles)
- Stretch your feet before and after physical activity
- Avoid going barefoot on hard surfaces
- Gradually increase the intensity of new physical activities
- Maintain good flexibility in your calf muscles, Achilles tendon, and feet
When to See a Podiatrist
Consult with a podiatrist if you experience:
- Heel pain that persists for more than a few weeks
- Severe pain or swelling
- Pain that interferes with normal activities
- Heel pain accompanied by fever, numbness, or tingling
- Heel pain that worsens despite home treatments
Early intervention can prevent the condition from becoming chronic and more difficult to treat.