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Heel Pain : Plantar fasciitis


Plantar Fasciitis

The plantar fascia is a thin fibrous band of tissue that connects the heel of the foot to the ball of the foot, and helps to support the arch. Plantar fasciitis is a painful inflammation of the plantar fascia, usually brought about when the plantar fascia is overloaded or overstretched. This causes small tears in the fibers of the fascia, especially where the fascia meets the heel bone. The symptom is intense heel pain along the bottom of the foot during the first few steps after getting out of bed in the morning. This heel pain often goes away once you start to walk around, but it may return in the late afternoon or evening.

Plantar fasciitis may develop in just about anyone but it is particularly common in the following groups of people: people with diabetes, obese people, pregnant women, runners, volleyball players, tennis players and people who participate in step aerobics or stair climbing. You also can trigger plantar fasciitis by pushing a large appliance or piece of furniture or by wearing worn out or poorly constructed shoes. In athletes, plantar fasciitis may follow a period of intense training, especially in runners who push themselves to run longer distances. People with flat feet have a higher risk of developing plantar fasciitis.

Diagnosis and Treatment

A podiatrist can often diagnose plantar fasciitis simply through physical examination of the foot. This involves palpation (feeling the structures in the foot for swelling or other abnormalities), review of symptoms, and strength and mobility tests. In some cases, a physical examination might not provide enough information about the inner structures of your foot to make a definitive diagnosis. In these cases, X-rays may be ordered to get a better look.

Often relief from the pain can be found by resting and stretching the foot and lower leg. The first line of treatment for plantar fasciitis includes conservative treatment methods like ice and rest. Other treatment methods that are considered conservative include:

  • make sure your shoes fit right
  • massagers and foot baths
  • Custom orthotics to realign the foot
  • Heel pads to provide padding and protection to the heel
  • Night splints to maintain proper ligament position while you rest
  • Non-invasive drug-free laser therapy to reduce inflammation at the source
  • Steroidal or stem cell injections to address pain and inflammation

If all these conservative measures fail to relieve the pain, then surgery is indicated. The newer minimal incision surgeries such as the Endoscopic plantar fasciotomy surgery is extremely beneficial for this condition, and for earlier ambulation, the use of the newer Cast Walking Boot is recommended.

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