A friend phoned and said doctor told her she has plantar fasciitis in her right foot. “The pain is killing me,” she said. “Could be the walking.”
She has recently taken up walking exercise and strength training, and has been very enthusiastic about it.
So, what is plantar fasciitis?
Plantar fasciitis is a foot problem that results in pain and stiffness in the bottom of the foot, usually in the heel. The pain is most unbearable when you climb stairs or standing still.
What causes plantar fasciitis?
Despite advance medical science, the cause of plantar fasciitis is not very clear.
The plantar fascia is the ligament that connects the heel to the front of the foot (runs under the arch of your feet). It supports the arch of your foot and helps you walk.
In plantar fasciitis, the ligament is damaged by tiny tears and breakdown of collagen. It is the result of repetitive injury of excessive straining. The damage is most significant where the plantar fascia joins the bones, especially the heel bone.
Some known risk factors include standing, walking, running over long period, especially on hard surfaces. Flat feet, high arch, inward rolling of the foot, a tight Achilles tendon or calf muscles, pregnancy and obesity have also been blamed.
Wearing shoes with poor sole and arch support when you do training can also result in plantar fasciitis.
Although heel spur, a small bony calcification on the heel bone, is found in up to 50% of those with plantar fasciitis, it is not the cause of heel pain.
Who are likely to suffer?
Plantar fasciitis is a common cause of heel pain. One in ten people are affected at some point of their life, especially people between 40–60 years of age.
The condition tends to happen to people whose occupations or sports put a lot of stress and strain on their feet. They include: teachers, shop assistants, catering staff, factory workers, ballet dancers, soldiers, athletes, long distance runners etc. It seems more common in women.
What are plantar fasciitis symptoms?
Typical symptom of plantar fasciitis is sharp heel pain. It usually affects just one foot but may happen to both feet. The pain is most acute in the first few steps after getting out of bed, or after sitting down for some time. The pain may ease off when you continue walking. Symptoms of numbness, tingling, swelling, burning, or radiating pain have been reported but they are rare.
Although heel pain is the most common complaint, we may have pain in the ball of the foot and along the arch too. It hurts most when climbing stairs or standing for a long time.
Common plantar fasciitis treatments
If you have foot pain, please go to see your doctor or a podiatrist to get a proper diagnosis. It is important to differentiate plantar fasciitis from other foot complaints such as arthritis or stress fracture.
In most cases, plantar fasciitis will improve with rest and conservative treatment. There isn’t a best treatment applicable to everybody. You may find relief from a combination of remedies. And it may take several months for the symptoms to clear.
To start with, rest and stay off your feet if possible. You should stop or reduce the activity which brought on the problem. In the acute stage, apply cold compress to the sore area for 15 to 20 minutes, three or four times a day may help to reduce pain and swelling.
Stretching the plantar fascia and Achilles tendons is a recommended treatment for plantar fasciitis. You can get help from a physical therapist for this. He or she can also teach you plantar fasciitis exercises to strengthen your calf muscles, to stabilize your walk and lessen the workload on your plantar fascia.
You can wear a night splint to stretch the Achilles tendon and plantar fascia. This can help prevent pain and stiffness in the morning.
Inappropriate footwear is often the culprit of foot problems. You must wear shoes that have good arch support and heel cushioning.
Orthotic or shoe insert for arch support may be helpful. It is designed to alleviate the pain, and reduce the strain on the ligament to prevent further damage. If the pain is specifically in the heel, a gel heel cradle can be worn to cushion and support the heel.
A boot cast can be worn to immobilize the foot and reduce strain, thus allow the plantar fascia to heal. You can take the boot cast off when you need to, for example, to take a shower.
Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, may help to relieve the pain. You should ask for medical advice if there is any worry about allergies or contraindications.
If the problem has not improved after trying all the above for several months, your doctor may recommend other options:
- steroid injection
- platelet-rich plasma injection
- extracorporeal shockwave therapy
- Tenex procedure
Surgery is the last option when all else failed to stop pain. But it must weigh against the unwanted side effects of weakening the arch of the foot.
If you ignore the condition and not getting treatment or rest, further strain can rupture the plantar fascia. Typical signs and symptoms of plantar fascia rupture include a clicking or snapping sound, significant local swelling, and acute pain in the sole of the foot.
You can develop chronic plantar fasciitis from recurring acute attacks. This can change the way you walk and cause injury to your legs, knees, hips, and back.
Therefore, it is wise to stay with some of the preventative remedies even when all the symptoms have cleared.