What Causes Plantar Fasciitis

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Foot Pain

Overview

Plantar fasciitis is that pain in the bottom of your foot usually in the heel. That pain hurts especially with the first few steps in the morning as you get out of bed. This strange name comes from: "Plantar" means something that belongs to the foot, "fascia" means a band or ligament or a connective tissue, and "itis" means inflammation. You can see in the picture the plantar fascia band as it runs along the foot. This band connects your heel bone to the toes.




Causes

A number of factors can contribute to plantar fasciitis. While men can get plantar fasciitis, it is more common in women. You're also more likely to have this condition as you age or if you are overweight. Take up a new form of exercise or suddenly increase the intensity of your exercise. Are on your feet for several hours each day. Have other medical conditions such as rheumatoid arthritis or lupus (systemic lupus erythematosus). Tend to wear high-heeled shoes, and then switch abruptly to flat shoes. Wear shoes that are worn out with weak arch supports and thin soles. Have flat feet or an unusually high arch. Have legs of uneven lengths or an abnormal walk or foot position. Have tight achilles tendons, or ‘heel cords’.




Symptoms

The classic sign of plantar fasciitis is that the worst pain occurs with the first few steps in the morning, but not every patient will have this symptom. Patients often notice pain at the beginning of activity that lessens or resolves as they warm up. The pain may also occur with prolonged standing and is sometimes accompanied by stiffness. In more severe cases, the pain will also worsen toward the end of the day.




Diagnosis

Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot, this could be a sign of nerve damage in your feet and legs (peripheral neuropathy) your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection, you have stiffness and swelling in your heel, this could be a sign of arthritis. Possible further tests may include blood tests, X-rays - where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.




Non Surgical Treatment

Plantar fasciitis treatment can be conservative (non-surgical) or invasive (surgical). Among the non-surgical ways to manage plantar fasciitis involves stretching and icing exercises. A night splint which help stretch the Achilles tendon and plantar fascia overnight, so that they can be more easily stretched during the morning. Orthotics that can be custom-made for the feet can also distribute tension on the feet more consistently. Corticosteroid is injected into the affected area to relieve pain and decrease inflammation. Doctors may also use extracorporeal shockwave therapy before considering plantar fasciitis surgery. During the therapy, sound waves are used to stimulate the affected area and eventually heal it. Physical therapy incorporation, deep massage stretching, and other modalities can at times be a helpful adjunct treatment. Surgery for plantar fasciitis is only considered when all other conservative treatments have failed.

Foot Pain




Surgical Treatment

Most studies indicate that 95% of those afflicted with plantar fasciitis are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don't improve with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the inflammation of the ligament. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. While the success rate is very high following surgery, one should be aware that there is often a prolonged postoperative period of discomfort similar to the discomfort experienced prior to surgery. This pain usually will abate within 2-3 months. One should always be sure to understand all the risks associated with any surgery they are considering.

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