What Is Plantar Fasciitis?
Plantar fasciitis is a common cause of heel pain that occurs due to collagen degeneration and inflammation in the tendons of the foot . Plantar fasciitis can interfere with daily activities such as walking and exercise, and, symptoms can become chronic and result in pain in other body parts such as the knee and hip.
Approximately 2 million people receive treatment for this condition each year .
Many treatment options exist for plantar fasciitis, including rest, specific exercises and stretches, special shoes and orthotics, medications, and surgery.
You can safely treat this condition on your own with over-the-counter pain killers (Advil, Motrin), as well as shoe inserts (orthotics) to help distribute pressure to the feet more evenly. If pain does not begin to subside, seek consultation with a physical therapist.
How common is Plantar Fasciitis?
Symptoms that always occur with Plantar Fasciitis:
- Pain in the sole of the foot
- Sharp, stabbing foot pain
Plantar Fasciitis is also known as
- Heel spurs
- Plantar heel bursitis
- Heel spur syndrome
- Policeman's heel
Plantar Fasciitis Symptoms
Symptoms of plantar fasciitis can vary in regards to the time of day, severity, and persistence. You may feel:
- Heel pain that improves throughout the day: The classic presentation of plantar fasciitis is heel pain that occurs first thing in the morning, when you take your first steps, and it generally improves throughout the day.
- Heel pain when beginning activity: Such as starting to exercise and then feeling better as you keep working out
- Heel pain at night: Although, this is atypical.
- Tenderness: Usually at the back of the heel
- Pain localized to the bottom of the foot: This pain may come and go.
- Pain that worsens with prolonged standing: Felt in the heel or middle of foot
- Pain that worsens after activity or exercise is over: Felt in the back of the heel
Plantar Fasciitis Causes
Plantar fasciitis means "inflammation of the plantar fascia." The plantar fascia is a thick band of connective tissue that runs along the bottom of your foot and connects the heel bone to the bones of your toes. The connective tissue is mostly made up of collagen. See a photo here of the plantar fascia.
The plantar fascia acts like a shock-absorber, supporting the foot. With increased tension and stress, small tears can occur in the fascia which leads to irritation and pain. Specifically, these small tears lead to collagen degeneration as the body is not able to heal as quickly as the tears are occurring.
Plantar fasciitis can occur in anyone; however, there are certain factors that can put you at greater risk such as :
- Age: Plantar fasciitis is most common in adults the 40 to 60 age group .
- Obesity: Extra weight can put increased tension and stress on the plantar fascia.
- Structural foot mechanics: Characteristics such as flat-feet, high arches or an imbalanced gait can affect the way that weight is distributed throughout the foot, putting increased stress on the plantar fascia.
- Sports activities: Sports such as long distance running, ballet, and dancing put a lot of stress on the feet. In fact, people who participate in such activities often experience plantar fasciitis.
Treatment Options and Prevention for Plantar Fasciitis
Plantar fasciitis and associated pain can be remedied with a variety of treatment options, such as stretching, changes in foot support and special shoes, rest, and further treatment from a medical provider, if necessary.
One study showed that stretching can successfully treat 83 percent of patients with plantar fasciitis, with 29 percent saying it was the most helpful treatment they tried .
- Dynamic stretching: Using a golf or tennis ball, roll the ball under your feet at the point of pain first thing in the morning. This stretching before you take your first steps will reduce the microtears that occur and speed up healing.
- Static stretching: Calf stretches using a wall, stairs, or a slant board can increase the flexibility of the calf and reduce tension on the plantar fascia.
Change in foot support
This includes special shoes or arch supports.
- Shoes: Fourteen percent of people with plantar fasciitis showed improvement with a change in their footwear . For people who developed plantar fasciitis by wearing shoes that are too small, simply switching to comfortable, well-fitting shoes can help. For runners, switching out older pairs of shoes that have lost their cushioning for newer ones has been shown to be effective. People with flat feet can reduce the load on their plantar fascia with shoes that have more midsole support.
- Arch supports: Arch supports available at your local pharmacy, custom orthotics that a podiatrist can create for you, heel cups, and arch taping are all viable ways of reducing the strain on your plantar fascia by absorbing more of the forces that occur when the foot strikes the ground.
Rest and other at-home treatments
A few methods can be tried at home to help relieve pain from plantar fasciitis.
- Rest: Limit weight-bearing on the heel as much as possible.
- Night splints: Because most people sleep with the foot in plantar flexion (pointed downward), people with plantar fasciitis can actually have their plantar fascia tighten as it remains in a shortened position during sleep. A night splint keeps the foot in a position that stretches the plantar fascia through the night.
- Over-the-counter pain medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil and Aleve) are helpful in plantar fasciitis by reducing pain and inflammation.
- Ice: Placing an ice pack on your heel can reduce swelling and pain.
However, if you continue to experience pain despite home remedies, see your physician for appropriate care as treatment plans vary [5,6].
- Physical therapy: Your physician may prescribe stretching exercises or a physical therapy/rehabilitation program to help you restore strength and stability to your heel.
- Surgery: As a last treatment option and only If the treatments and methods above do not work, your physician may suggest surgery to repair the structures contributing to your heel pain.
Plantar fasciitis usually goes away on its own, but this can take six to 18 months . This process can be sped up if you try the above treatments and seek medical advice when necessary.
When to Seek Further Consultation for Plantar Fasciitis
If you experience pain in the heel or foot that does not improve with the treatments above, make another appointment with your doctor in order to better assess your injury.
Questions Your Doctor May Ask to Determine Plantar Fasciitis
To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.
- Is your foot pain getting better or worse?
- Is your foot pain constant or come-and-go?
- How long has your foot pain been going on?
- How severe is your foot pain?
- Have you ever injected drugs?
The above questions are also covered by our A.I. Health Assistant.
- Plantar Fasciitis. Mayo Clinic. Published March 7, 2018. Mayo Clinic Link.
- Kadakia AR, Fischer SJ, Haddad SL. Plantar Fasciitis and Bone Spurs. American Academy of Orthopaedic Surgeons: OrthoInfo. Published June 2010. OrthoInfo Link
- Buchbinder R, Isaac Z, Curtis MR. Plantar Fasciitis. UpToDate. UpToDate Link. Published April 27, 2018.
- Young CC, Rutherford DS, Niedfeldt MW. Treatment of Plantar Fasciitis. American Family Physician. 2011;63(3):467-475. American Family Physician
- Furey JG. Plantar Fasciitis. The Painful Heel Syndrome. The Journal of Bone and Joint Surgery. 1975;57(5):672-673. JBJS Link
- Gill LH, Kiebzak GM. Outcome of Nonsurgical Treatment for Plantar Fasciitis. Foot & Ankle International. 1996;17(9):527-532. Sage Journals Link