Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). Plantar fasciitis is more common in runners. People who are overweight and those who wear shoes with inadequate support also have an increased risk of plantar fasciitis.
Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.
Age. Plantar fasciitis is most common between the ages of 40 and 60.
Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
Foot mechanics. Flat feet, a high arch or even an abnormal pattern of walking can affect the way weight is distributed when you're standing and can put added stress on the plantar fascia.
Obesity. Excess pounds put extra stress on your plantar fascia.
Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage the plantar fascia.
Physical exam will be done to check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.
Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your:
Sense of touch and sight
An X-ray or an MRI scan may be necessary to check that nothing else is causing your heel pain, such as a bone fracture.
Doctormay prescribe few pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) to ease the pain and inflammation caused by plantar fasciitis.
Physical therapy. A physical therapist can show you a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist might also teach you to apply athletic taping to support the bottom of your foot.
Night splints. Your physical therapist or doctor might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and A chilles tendon in a lengthened position overnight to promote stretching.
Orthotics. Your doctor might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgical or other procedures
If more-conservative measures aren't working after several months, your doctor might recommend:
Injections. Injecting steroid medication into the tender area can provide temporary pain relief. Multiple shots aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture. Using ultrasound imaging, platelet-rich plasma obtained from the patient's own blood can be injected to promote tissue healing.
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.
Ultrasonic tissue repair. It uses ultrasound imaging to guide a needlelike probe into the damaged plantar fascia tissue. Using ultrasound energy, the probe tip vibrates rapidly to break up the damaged tissue, which is then suctioned out.
Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is severe and other treatments have failed. It can be done as an open procedure or through a small incision with local anesthesia.
Maintain a healthy weight. Carrying extra weight can put extra stress on your plantar fascia.
Choose supportive shoes. Buy shoes with a low to moderate heel, thick soles, good arch support and extra cushioning. Don't walk barefoot.
Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet.
Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging.
Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 minutes three or four times a day. Icing can help reduce pa in and inflammation.
Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.
Frequently asked questions
Q.Why does my heel hurt with plantar fasciitis?
Plantar fasciitis can cause intense heel pain. Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).
Q.What aggravates plantar fasciitis?
Conditions or activities that may lead to plantar fasciitis include: Things that affect how the feet work (biomechanical factors). These include abnormal inward twisting or rolling of the foot (pronation), high arches, flat feet, tight calf muscles, or tight tendons at the back of the heel (Achilles tendons).
Q.How do I know if I have plantar fasciitis or heel spurs?
There are important distinctions between heels spurs and plantar fasciitis. A heel spur is a calcium deposit that forms a bony protrusion along the plantar fascia. In contrast, plantar fasciitis is a condition where the plantar fascia gets irritated and swollen, which causes pain in the heel.
Q.What part of your body hurts if you have plantar fasciitis?
When you have plantar fasciitis, you usually feel pain in the bottom of the heel or the arch of the foot. Some people describe the pain as feeling like a bruise or an ache.
Q.When should I see a doctor for heel pain?
Severe pain and swelling near your heel.
Inability to bend your foot downward, rise on your toes or walk normally.
Heel pain with fever, numbness or tingling in your heel.
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