Responsible of 80 percent of the cases, plantar fasciitis is one of the most common causes of heel pain. The condition has a tendency to occur in women, military recruits, older athletes, the obese, and young male athletes. Plantar fasciitis is estimated to affect 1 in 10 people during their lifetime and most commonly affects people between 40-60 years old. It involves pain and inflammation of a thick band of tissue, plantar fascia, which runs across the bottom of your foot connecting your heel bone to your toes.
Plantar fasciitis causes stabbing pain in the bottom of your foot near the heel usually when you wake up and get out of bed. Once your foot “warms up”, the pain typically decreases, but it may come back after long periods of standing or after getting up from sitting.
The risks are greater for developing plantar fasciitis if you are:
• Between the age of 40-60 years old.
• Overweight because of the increased pressure on your plantar fascia ligaments, especially if you have sudden weight gain. Women who are pregnant often experience stretches of plantar fasciitis, mostly during late pregnancy.
• A long distance runner, have a job that involves you being on your feet often, such as a factory worker, teacher or a restaurant server, or if you wear shoes with inadequate support (soft soles, poor arch support).
• If you have foot problems, such as very high arches, very flat feet or an abnormal walking pattern, you may develop plantar fasciitis. Tight Achilles tendons (the tendons attaching the calf muscles to the heels) can also result in plantar fascia pain.
When to See a Doctor
The longer you ignore your heal pain, you may get chronic heel pain that impedes your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.
The diagnosis is made from a series of questions and a physical examination. Occasionally your ankle and foot doctor may advise an X-ray or magnetic resonance imaging (MRI) ensure your pain isn’t being caused by another issue, such as a stress fracture or a pinched nerve.
Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about:
• Your past health, including illnesses and injuries.
• Your symptoms, pain location and time of day your foot hurts most.
• How active you are and the types of physical activity you do.
Most people (90 percent) who have plantar fasciitis recover with conservative treatments within 6 months.
With plantar fasciitis, no single treatment works best for everyone. Stretching and strengthening exercises or use of specialized devices may provide symptom relief.
Conservative Treatment includes:
• Rest: Give your feet a rest from the activities that make your foot hurt. Try not to walk or run on hard surfaces.
• Ice your heal or take pain relievers: ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) may ease the pain and inflammation.
• Physical therapy: Exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel.
• Night splints: wearing a splint that stretches your calf and the arch of your foot while asleep. This holds the plantar fascia and Achilles tendon in an elongated position overnight and assists stretching.
• New shoes: get a new pair of supportive shoes with good arch support and a cushioned sole.
• Orthotics. Your doctor may prescribe heel cups, cushions or custom-fitted arch supports to aid in distributing pressure to your feet more evenly.
• Steroid shots. Injecting a type of steroid medication into the area can provide temporary pain relief. Multiple injections aren’t recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone.
When conservative treatment isn’t working after 6 to 12 months, your foot and ankle doctor may recommend surgery to detach the plantar fascia from the heel bone.