Pain

Plantar Fasciitis

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Plantar fasciitis is the most common type of heel pain. The plantar fascia is a thick band of tissue reaching from the heel to the front of the foot; it supports the arch of the foot and acts as a shock absorber. If this tissue gets stretched too far, it causes tiny tears and inflammation that results in heel pain; this is referred to as plantar fasciitis. Heel spurs can also be caused by plantar fasciitis.

Plantar fasciitis is more common in runners, the obese, people who stand on their feet excessively (cashiers, food servers, teachers, etc.), and people who wear shoes without arch support. The most common symptom is a stabbing pain upon waking and taking the first few steps. The pain from plantar fasciitis is often worse after standing for an extended period of time or initially standing after sitting for prolonged periods of time. Heel stiffness can occur which can cause difficulty in everyday activities such as climbing stairs. The discomfort usually eases a bit with gentle movement. During exercise or physical activity, the pain may not be noticeable but appears after the activity is completed due to inflammation. To help reduce the risk of plantar fasciitis, avoid wearing high heels, wearing shoes with no arch support, and going barefoot. Be sure to gently stretch the calf muscle, Achilles tendon, and the plantar fascia on a daily basis; try low- impact activities; and wear athletic shoes that have good support and are not worn out.

A health-care provider can diagnose plantar fasciitis with a physical exam by checking the tender points of the foot. A physician will check the foot reflexes, balance, touch sensitivity, and muscle tone. The location of the pain helps determine the cause. In rare cases, an X-ray or MRI will be ordered to obtain a proper diagnosis. If these symptoms last for several months and are not treated, the gait can change causing damage to the legs, hip, back, and knees.

Plantar fasciitis usually goes away with at-home care including using over-the-counter medications such as naproxen or ibuprofen, resting the foot, and icing the painful area. Physical therapy is often prescribed to teach how to properly stretch and how to use athletic tape to provide support. Water therapy has also been successful in aiding with this condition. Used during sleeping, a splint that stretches the arch of the foot and calf muscle helps relieve pressure. During waking hours, custom-fit arch support helps distribute pressure points in the foot. Shock-wave therapy is also an alternative in healing; the nerve endings in the foot are basically shocked with electrical impulses to ease pain and assist with blood flow. If the pain is severe, steroid injections help to reduce inflammation. A Tenex procedure is likewise a possible treatment; this is a quick procedure requiring a small incision to remove scar tissue. As a last resort, surgery may be performed to remove the plantar fascia from the heel bone. This procedure is only performed if all other avenues of relief have been unsuccessful in treating the pain.

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