Plantar fasciitis is an inflammation of the band that supports the arch of your foot. The pain and inflammation are usually located near the bottom of the heel. People with plantar fasciitis often complain of having more pain in the morning upon arising from bed or when they start to walk after sitting for a period of time. After being up on their feet for a few steps, the pain will often decrease. By the end of the day, the pain may worsen again. Often the arch and/or heel are very tender when pressed. Some people describe this pain similar to the feeling of walking on a “stone” under the heel.
How does plantar fasciitis occur?
Plantar fasciitis usually occurs in patients in their middle ages or older. It can start gradually or suddenly, usually because of an increase in activity level. This can occur with starting a walking or running program and doing too much too soon. Other things that can compound the problem include tight or weak ankle and foot muscles, as well as a thin cushioning pad under the heel. A heel spur or bone spur is present in only about 50% of people with plantar fasciitis and is not a cause of the pain.
How is plantar fasciitis treated?
Nonoperative treatment is typically successful for plantar fasciitis and often consists of multiple types of modalities/therapies. Your physician may recommend anti-inflammatory medication, inserts for your shoes to support and cushion your feet, and a night splint to decrease morning symptoms. Stretching exercises and icing are commonly used in the initial treatment. Physical therapy may also be ordered. The physical therapist will instruct you in an exercise program to stretch out the tight structures and strengthen the weak muscles in your feet. They will also address muscle imbalances in your legs/hips and evaluate your walking pattern to see if it may be affecting the foot pain. If your pain is acute (has occurred in the past 3-4 weeks), you will probably be better in about 2 months. Although 90% of patients will respond to this treatment, complete improvement may require 6 months to one year. Plantar fasciitis rarely requires surgery.
The picture below shows where the plantar fascia is and how it relates to the other structures in your foot.
| Achilles Tendon
Tightness in the Achilles tendon can cause additional strain in the plantar fascia.
Click here for plantar fasciitis exercises.