Plantar Fasciitis (foot pain)
The plantar fascia is a thick band of ligament tissue that runs from the heel to the toes at the bottom of the feet. This ligament is in the form of a bowstring and supports the arch of the foot. Inflammation or damage to this ligament can result in intense heel pain.
What is plantar fasciitis?
Plantar fasciitis is the inflammation of the plantar fascia and is one of the most common reasons for stabbing heel pain. It usually affects only one foot, but sometimes it affects both feet. If this problem is ignored, it can lead to prolonged periods of heel pain. It can also lead to foot, knee, hip, or back problems due to the changes in the walking style to relieve the heel pain.
What are the symptoms of plantar fasciitis?
Plantar fasciitis can lead to stabbing pain in the bottom of the heel, which is especially worse when taking the first steps after prolonged rest. However, this pain decreases with further movement during the day. Pain can return with prolonged periods of standing or standing up after sitting. Exercise can also worsen the pain, which is, however, not felt during the stretches. Heel stiffness associated with plantar fasciitis can make it difficult to climb stairs.
What are the causes and risk factors of plantar fasciitis?
The plantar fascia supports the arch of the feet and acts as a shock absorber while walking. This ligament can stretch and tear when exposed to excess stress. When this stretching and tearing occurs repeatedly, it can lead to irritation and inflammation of the ligament, resulting in plantar fasciitis.
The risk of plantar fasciitis is high in the following groups of people:
- Sports players such as runners
- Factory workers and teachers who spend several hours standing or walking on hard surfaces
- Obese or overweight people
- Pregnant women, especially during the third trimester
- People who wear shoes that doesn't provide proper support
- People between the ages 40 and 60 years
- People who carry out activities such as ballet dancing and aerobic dancing
Additionally, foot mechanics such as an abnormal pattern of walking, flat feet, or a high arch can lead to an uneven distribution of the weight on the feet and can increase the risk of plantar fasciitis.
How is plantar fasciitis diagnosed?
The medical history of the patient is reviewed, and a physical examination of the foot is performed to check for redness, swelling, tenderness, and the exact point of pain. Further, the strength of the muscles and the health of the nerves are determined by checking the reflexes, muscle tone, coordination, and balance.
To rule out other conditions, such as fractures with similar findings, an x-ray or an MRI (magnetic resonance imaging) may be advised.
What are the treatment options?
Most cases of plantar fasciitis usually resolve with the traditional methods, which include resting the affected foot, applying an ice pack, using braces, and taking anti-inflammatory medicines. If the pain does not get better, then corticosteroid medicine may be injected directly into the damaged part of the ligament. An ultrasound may be necessary to determine the exact location of the steroidal injection.
Physiotherapy plays a key role in the treatment of plantar fasciitis. It helps in the stretching of the ligaments, strengthening the lower leg muscles, and stabilizing the way a person walks, thereby lowering the workload on the plantar fascia.
If the above treatments are not effective, then the doctor might recommend shock wave therapy. It involves using sound waves that bombard the heel to stimulate the healing of the ligament. However, due to its lower efficacy and risk of side effects such as pain, swelling, and bruising, this method is only considered in certain cases.
Surgery is performed only in cases of severe pain that lasts longer than 6-12 months. Due to the risk of long-term pain and nerve damage, surgery is only considered when other treatment options are not effective. Plantar fascia release is a surgical method in which the plantar fascia is detached from the heel to reduce the tension on the heel. Gastrocnemius recession is another surgical method in which the calf muscle is lengthened to increase the range of motion of the ankle and relieve stress on the plantar fascia.
Self-care
Self-care measures which can help in a faster healing include:
- Carry out stretches to loosen the calf muscles and reduce the heel pain
- Avoid certain exercises, such as running, until complete healing occurs
- Stretch before beginning any workouts
- Stop and stretch during exercises to prevent pain from recurring
- Wear braces and supports to assist in the stretching of the calf muscles
Prevention
Plantar fasciitis can be prevented by making certain lifestyle changes, which may include:
- Wear supportive shoes with good arch support.
- Replace athletic foot-wear regularly.
- Carryout low-impact exercises such as bicycling or swimming everyday.
- Avoid activities such as running, which can put stress on the plantar fascia.
- Try to lose extra weight to reduce pressure on the plantar fascia.