Plantar fasciitis, a leading cause of heel pain, involves the degeneration or inflammation of the plantar fascia—a thick tissue band beneath the foot. The condition typically worsens in the morning but improves as the foot warms up throughout the day.
Medically reviewed by Dr Chaminda Goonetilleke, 20th Jan. 2022
Symptoms
Plantar fasciitis symptoms generally develop over time and commonly include:
- Heel pain, occasionally radiating into the foot’s arch
- Heel tenderness upon pressure
- Increased pain in the morning
- Temporary relief as the foot warms, with possible late-day return
What is Plantar fasciitis?
Plantar fasciitis involves inflammation or degeneration of the plantar fascia where it connects to the heel.
Anatomy
The plantar fascia is a sturdy tissue band extending from the heel bone to the foot’s front, providing foot support when standing and shock absorption during running.
Plantar fasciitis or Plantar fasciopathy?
Plantar fasciitis traditionally implies inflammation, but current studies suggest the absence of inflammatory cells in most cases. Instead, tissue degeneration is typically the culprit, making “Plantar fasciopathy” a more accurate term as it denotes wear and tear.
What causes Plantar fasciitis?
The primary cause of Plantar fasciitis is overuse, but several factors may heighten its development risk:
Foot biomechanics: Overpronation or having a rigid, high-arched foot can contribute.
Inappropriate footwear: Flat, unsupportive shoes or mismatched running shoes for your foot type may pose a risk.
Bodyweight: Excess weight increases foot load, raising susceptibility.
Flexibility: Tight calf muscles or plantar fascia elevate the injury risk.
Plantar fasciitis treatment
Plantar fasciitis treatment includes:
Cold Therapy: Apply cold for 10-15 minutes every few hours, reducing to thrice daily as symptoms improve.
Taping: Supports the foot arch, relieves symptoms, and fosters tissue healing.
Footwear: Opt for comfortable shoes, steering clear of hard or flat-soled ones.
Insoles & Heel Pads: Use cushioning devices or orthotic insoles if overpronation is present.
Night Splint: Prevents fascia and calf muscles from tightening overnight.
Massage: Deep tissue massages aid in stretching and relaxing the plantar fascia.
Electrotherapy: Techniques like Extracorporeal shock wave therapy or Ultrasound therapy may be utilized by your physiotherapist.
Medication: Anti-inflammatory medicines like ibuprofen can reduce early-stage pain and inflammation but avoid long-term use.
Gait Analysis: Corrects biomechanical issues via orthotic inserts if overpronation or foot flattening is observed.
Injections: Corticosteroid or platelet-rich plasma injections may be used for persistent cases. Surgery is a rare last resort.
Exercises
Performing exercises that stretch the plantar fascia and calf muscles is essential. While rest can alleviate pain and inflammation, if fascia tension is a contributing factor, the discomfort may recur.
Surgery
Surgery, adopted in approximately 5% of cases unresponsive to nine months of continuous treatment, has an estimated success rate of 70-80%. A common procedure, plantar fascia release, cuts 30-50% of the fascia’s fibres to reduce stress.
Possible complications include nerve damage, fallen arches, infection, and persistent symptoms. If successful, recovery generally takes 9-12 weeks before work resumption.
