Plantar Fasciitis Treatment
Plantar fasciitis is one of the most common causes of heel pain. It stems from inflammation of the plantar fascia, the thick tissue that spans the bottom of the foot and supports the arch. This pain often flares up with the first steps in the morning or after long periods of rest. Risk factors include prolonged standing, flat feet, high arches or tight Achilles tendons. This condition can make even walking quite painful.
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What Is Plantar Fasciitis?
The plantar fascia absorbs the high stresses and strains we place on our
feet. However, too much pressure can damage or tear the tissues. The body's
natural response to injury is inflammation, which results in the heel
pain and stiffness of plantar fasciitis, particularly with the first steps
in the morning or after periods of inactivity.
Plantar fasciitis conditions can vary in severity, often starting with mild discomfort and potentially progressing to more debilitating pain. A diagnosis for plantar fasciitis might include:
- Heel spur. Prolonged plantar fasciitis can sometimes lead to a heel spur, a bony growth that develops on the heel bone and can cause pain.
- Chronic plantar fasciitis. If the condition does not improve with standard treatments, it can become chronic, leading to a constant dull ache in the heel or arch of the foot.
- Plantar fascia rupture. In severe cases, usually due to an acute injury, the plantar fascia can partially or fully tear, which is often accompanied by a sudden sharp pain in the sole.
Causes of Plantar Fasciitis
Plantar fasciitis can result from everyday wear and tear, or from an injury, such as a sports injury. It can be caused by one or more of the following:
- Repetitive strain. Engaging in activities like running, jumping, or dancing puts stress on the ligament.
- Obesity. Being overweight can place extra stress on the plantar fascia.
- Tight calf muscles. Tightness can cause tension on the plantar fascia.
- Flat feet or high foot arches. These may affect how your foot distributes impact.
- Improper footwear. Wearing shoes that do not provide arch support can result in pain and eventually affect the plantar fascia.
Plantar Fasciitis Symptoms
Plantar fasciitis is characterized primarily by a sharp, stabbing pain at the bottom of the heel or mid-foot area. This discomfort is likely to be felt most during the initial steps after waking up but can also occur after standing for too long or when getting up from a seated position. Common symptoms of plantar fasciitis include:
- Heel pain. This signature symptom is usually a sharp ache near the heel.
- Arch discomfort. The pain extends along the arch of the foot.
- Stiffness. There is a sensation of rigidity in the affected area.
- Swelling. Often the patient will experience visible inflammation around their heel.
- Achilles tension. Tightness can occur in the Achilles tendon at the back of the heel.
Other signs to watch for include:
- Pain that lessens after a brief period of walking but returns after standing for long durations.
- Heel pain that intensifies when ascending stairs or after extended periods of sitting.
- A feeling of tightness or stiffness in the heel or arch, most noticeably after rest.
Recognizing these symptoms early and seeking appropriate treatment can prevent the progression of plantar fasciitis and lead to more effective management of the condition.
Plantar Fasciitis Diagnosis
To diagnose plantar fasciitis, your health care professional will:
- Review your medical history
- Ask about your symptoms and daily activities, the time of day when the pain is most pronounced, and activities that make it worse or better
- Conduct a physical exam assessing flexibility, stiffness, swelling and gait
- Have you walk, stand on your toes, and stretch your foot to check the pain
- Order imaging tests like X-rays, ultrasounds, or magnetic resonance imaging to rule out other problems
Plantar Fasciitis Treatment
Treatment plans for plantar fasciitis are designed to reduce inflammation, improve flexibility, strengthen foot muscles, and provide stability and support. They typically include a combination of the following:
- Rest. Taking a break from activities that put a strain on your feet can help relieve symptoms.
- Ice. Applying ice to the heel for 15 to 20 minutes several times a day can help reduce inflammation and pain.
- Stretching exercises. Stretching the plantar fascia and Achilles tendon can strengthen foot muscles, improve flexibility, and relieve pain.
- Orthotics. Custom-fitted arch supports can distribute pressure across your feet and provide better support.
- Supportive shoes. Wearing shoes with good cushioning and arch support can prevent further strain on the plantar fascia.
- Physical therapy exercises. Stretch the plantar fascia and Achilles tendons to strengthen lower leg muscles, which stabilize your ankle and heel.
- Night splints. Wearing a splint at night can stretch your calf and the arch of your foot, holding the plantar fascia and Achilles tendon in a lengthened position overnight.
- Anti-inflammatory treatment. Take prescription or over-the-counter medications to address pain and swelling. Sometimes, doctors administer corticosteroid injections. There are risks associated with repeated injections, including plantar fascia rupture.
- Platelet-rich plasma (PRP) therapy. This involves injections of your own platelets to stimulate healing in the injured fascial area.
- Surgery. As a last resort, if the pain is not relieved by other nonsurgical methods, surgery to release the plantar fascia may be considered.
Rehabilitation can be an essential part of recovery from plantar fasciitis. Your doctor may suggest a recovery plan that may include:
- Stretching and strengthening exercises
- Arch support and foot mobility exercises
- Massage therapy and activity modification
Prevent Plantar Fasciitis
To reduce the risk of developing plantar fasciitis or to prevent its recurrence, it's important to follow these key strategies:
- Maintain a healthy weight to minimize stress on the plantar fascia.
- Choose supportive shoes and avoid high heels.
- Stretch the arches and Achilles tendon.
Contact Us for Plantar Fasciitis Care in New Jersey
At RWJBarnabas Health, our orthopedists have specialized training in foot and ankle disorders and offer comprehensive treatment options, including noninvasive and surgical treatments. Don't let plantar fasciitis pain go untreated. Contact us today.
