Understanding Plantar Fasciitis
Plantar fasciitis is an inflammatory response that is caused by degenerative irritation at the insertion of the plantar fascia ligament—which is a thick band of tissue that attaches your heel bone to your toes. These ligaments act as shock absorbers that support the arch of your foot. However, too much pressure can cause the ligaments to become inflamed—when this occurs, the inflammation often causes heel pain and stiffness. This pain is most often felt when you take your first steps after getting out of bed or after extended periods of inactivity.
While most people associate plantar fasciitis with runners, it can be diagnosed in almost anyone regardless of their activity level. Increased pressure on the plantar fascia is thought to be the main cause of plantar fasciitis. Because of this, individuals who are overweight or obese have more risk of developing the condition.
How is Plantar Fasciitis Diagnosed?
Your podiatrist will perform a physical exam to check for pain and/or tenderness in your foot. He or she will locate the exact location of your pain in order to rule out other foot conditions. Next, your podiatrist may ask you to perform various stretches to test the strength and health of the plantar fascia ligaments.
If the physical exam is not enough to diagnose the cause of your heel pain, your doctor may order x-rays to identify any bony pathology.
Plantar Fasciitis Treatment
Initial treatment for plantar fasciitis usually involves conservative approach such as rest, ice, and avoidance of certain exercises. Other conservative treatment methods include:
- Orthotics/padding: Custom orthotics or heel pads may be used to cushion the foot and prevent pain.
- Stretches: Various stretches can be performed to elongate the plantar fascia ligament and relieve pain.
- Night splint: Your doctor may recommend a night splint to hold your foot at a specific angle to prevent ligaments from contracting during sleep.
- Injections: Anti-inflammatory steroid injections may be used to relieve inflammation and prevent pain.
More severe cases of plantar fasciitis might require surgery. The most common surgical procedure is known as a plantar fascia release, where the surgeon releases a portion of the plantar fascia ligament from the heel bone to relieve tension and pain. Surgery is often seen as a last result after conservative approaches have failed.