Plantar fasciitis is one of the most common sources of heel pain. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes inflammed it is known as plantar fasciitis.
Plantar fasciitis is caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia, the connective tissue that runs from the heel to the base of the toes. The plantar fascia may look like a series of fat rubber bands, but it’s made of collagen, a rigid protein that’s not very stretchy. The stress of overuse, overpronation, or overused shoes can rip tiny tears in it, causing pain and inflammation, a.k.a. plantar fasciitis.
The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You’re more likely to feel it after (not during) exercise. The pain classically occurs right after getting up in the morning and after a period of sitting. If you don’t treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.
Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot, this could be a sign of nerve damage in your feet and legs (peripheral neuropathy) your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above – these could be signs of a bone infection, you have stiffness and swelling in your heel, this could be a sign of arthritis. Possible further tests may include blood tests, X-rays – where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.
Non Surgical Treatment
Orthotics are corrective foot devices. They are not the same as soft, spongy, rubber footbeds, gel heel cups etc. Gel and rubber footbeds may cushion the heels and feet, but they do not provide any biomechanical correction. In fact, gel can do the opposite and make an incorrect walking pattern even more unstable! Orthotic insoles work by supporting the arches while re-aligning the ankles and lower legs. Most people’s arches look quite normal when sitting or even standing. However, when putting weight on the foot the arches lower, placing added tension on the plantar fascia, leading to inflammation at the heel bone. Orthotics support the arches, which reduces the tension and overwork of the plantar fascia, allowing the inflamed tissue to heal. Orthotics needn’t be expensive, custom-made devices. A comprehensive Heel Pain study by the American Orthopaedic Foot and Ankle Society found that by wearing standard orthotics and doing a number of daily exercises, 95% of patients experienced substantial, lasting relief from their heel pain symptoms.
When more-conservative measures aren’t working, your doctor might recommend steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple injections aren’t recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone. Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It’s usually used for chronic plantar fasciitis that hasn’t responded to more-conservative treatments. This procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective. Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It’s generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.