Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot. Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation which leads to pain.
What causes plantar fasciitis?
The plantar fascia is a very thick band of tissue that connects the heel bone to the toes. This band of tissue is what creates the arch of the foot. When the fascia is overstretched or overused, it can become inflamed. When the fascia is inflamed, it can be painful and make walking more difficult.
Risk factors for plantar fasciitis include:
- Foot arch problems (both flat feet and high arches)
- Repetitive loading on the feet from long-distance running, especially running downhill or on uneven surfaces
- Sudden weight gain
- Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
- Shoes with poor arch support or soft soles
This condition is one of the most common orthopedic complaints relating to the foot.
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
The most common complaint is pain in the bottom of the heel, which is usually worse in the morning and may improve throughout the day. By the end of the day the pain may be replaced by a dull ache that improves with rest.
Exams & Tests
Typical physical exam findings include:
- Mild swelling
- Tenderness on the bottom of the heel
X-rays may be taken to rule out other problems, but having a heel spur is not significant
To relieve plantar fasciitis:
- Apply ice to the painful area. Do this at least twice a day for 10 – 15 minutes, more often in the first couple of days.
- Rest as much as possible for at least a week.
- Take acetamin for pain or ibuprofen for pain and inflammation.
- Try wearing a heel cup, felt pads in the heel area, or an orthotic device.
- Use night splints to stretch the injured fascia and allow it to heal.
- Wear properly fitting shoes.