What is Plantar Fasciitis?
Do you have a job where you are on your feet all day? Now, imagine having to walk around with a small piece of rock stuck onto the bottom of your heel. Ouch, ouch, ouch! This is how patients with plantar fasciitis feel.
Do you have a job in which you’re on your feet all day? A security guard, perhaps? In construction? Sales? You know your heels bear a lot of your job when they ache by the end of the day. But now, imagine having to walk with a small piece of rock stuck in your shoe at the bottom of your heel. Ouch, ouch, ouch! This is how patients with plantar fasciitis feel.
What is Plantar Fasciitis?
Whether you’re a business owner or a /health-fitness/exercise/is-running-bad-for-you, you should know that plantar fasciitis is a very common cause of heel pain. It sends approximately one million adults running (ok, maybe walking…very slowly) to the doctors’ office each year. Patients often describe the condition as a sharp pain underneath the foot near the heel. The pain feels worst in the first few steps they take in the morning or after a period of rest, and tends to improve with activity. It can worsen by the end of the day if patients are on their feet for prolonged periods of time.
I know what you’re thinking, and no, despite the similarities, plantar fasciitis has nothing to do with Planter’s nuts. The name of the condition comes from the tight band of fibrous tissue, or “fascia,” that runs underneath the foot. This band tightens, causing the pain. That is why the first few steps after a period of rest are the most painful – because that’s when the fascia gets stretched out from a very tight form.
Contrary to popular belief, a “heel spur” is not the cause of plantar fasciitis. In fact, planter fasciitis can cause the heel spur, and not the other way around.
Who Is at Risk for Plantar Fasciitis?
Those who suffer from plantar fasciitis often have the following risk factors:
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Walking or standing on the feet for prolonged periods of time
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Excessive running
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High arch or low arch (flat feet)
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Obesity
Diagnosis of Plantar Fasciitis
Plantar fasciitis is typically diagnosed based on the patient history (the symptoms) and an exam by the doctor. Unless you’ve had trauma to your heel, an x-ray or other imaging is not routinely performed and is unnecessary. Like previously mentioned, the presence of a heel spur is usually insignificant so doctors don’t search for one.
Treatment of Plantar Fasciitis
If left untreated, plantar fasciitis typically resolves within a year. But when you are in pain, a year can seem like an eternity, so our goal is to mitigate the discomfort as much as possible. Here are the recommendations to help treat plantar fasciitis:
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Rest: Avoid prolonged standing and walking as much as you can in order to keep the plantar fasciitis from getting further inflamed so that it can allow it to heal (pun intended).
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Ice massage: Freeze a water bottle and roll it underneath your foot several times a day.
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Anti-inflammatory medications: Anti-inflammatories, like ibuprofen, are the mainstays of treatment for plantar fasciitis since the not only improve the pain, but also calm inflammation. (Just make sure you have no contraindications to taking them, like a history of bleeding ulcers, chronic kidney disease, or if you are on blood thinners. Ask your doctor before you take any medication if you aren’t sure.)
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Stretching exercises: Ask your doctor or look up videos of stretching exercises on the internet for plantar fasciitis, and make sure you perform them before taking your first step in the morning and after periods of rest. You can also ask for a physical therapy referral from your doctor.
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Foot support: Doctors recommend orthotic arch supports (which can be bought over-the-counter) to keep the foot arch in its proper place and relieve the stress on the fascia, or heel cups.
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Night splints: Special foot splints can be used (and can be bought over-the-counter) to keep the foot in a neutral position while sleeping at night. In that way, the fascia is kept stretched and discomfort is minimized with walking in the morning. However, many patients complain that it is uncomfortable to sleep in the night splints.
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Weight loss: The less pressure you place on your heels, the less inflamed the fascia gets. Therefore, weight loss should be a mainstay of treatment and prevention of plantar fasciitis if the patient is overweight.
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Steroid injection: An injection of a corticosteroid into the foot can be done. However, it is not risk-free, and can cause atrophy of the fatty cushioning that we all have underneath our feet, in addition to rupturing the fascia itself.
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Surgery: Surgically relieving the fascia by cutting it, called a “fasciotomy,” is definitely a last resort. Most patients with plantar fasciitis never reach this point since it is usually, thankfully, a self-resolving condition.
Do you suffer from plantar fasciitis? Share your story with us on the House Call Doctor’s https://www.facebook.com/HouseCallDr and https://twitter.com/#!/housecalldoc pages!
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Plantar Fascitis image from Shutterstock
About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
