Plantar fasciitis is the most common cause of heel pain. Approximately two million people suffering from this condition are treated every year. It occurs because of the inflammation of plantar fascia. The plantar fascia is the band of tissues that connects heel bone to the toes. It supports the arch of the foot. Plantar fasciitis is most common in runners.
Plantar fascia acts like a shock-absorbent bowstring and supports the arch of the foot. If huge stress is applied to the bowstring, it can damage plantar fascia. Repetitive stretching and tearing can cause the inflammation of the fascia. In many other cases, the cause behind plantar fascia isn’t clear and it still requires research.
Risk Factors associated with Plantar Fasciitis
There are various risk factors associated with plantar fasciitis which are the followings:
Excess weight gain causes inflammation of the plantar fascia
The Exercises like aerobic dance, ballistic jumping, and ballet dancing cause plantar fasciitis. These activities which place a lot of stress on the heel can cause the onset of plantar fasciitis. Repetitive exercises can also be a causative agent.
Plantar fasciitis usually occurs in between the age of 40 to 60.
Type of Occupation
The Type of occupation can also contribute to this condition. The teachers and factory worker who spend most of their time walking on hard surfaces can damage their plantar fascia.
Pattern of walking
The Pattern of walking can also cause plantar fasciitis.
Medical examination and diagnosis
During the medical checkup for plantar fasciitis following signs are examined:
- Limited motion of the ankle
- High arch
- The area of maximum tenderness around heel bone
- Pain is also examined which occurs when the patient flexes the foot and improves when the toe is pointed down
The doctor can also examine the occurrence of plantar fasciitis by evaluating the symptoms associated with it by asking the following questions:
- During which time of day, the heel pain is most intense?
(Heel pain in the morning can be due to plantar fasciitis)
- How much exercise do you perform daily?
(People who perform excessive exercise can experience heel pain associated to plantar fasciitis)
- Are there any recent changes in your activities?
(changes like change of job, or the start of a new hobby can also cause the development of plantar fasciitis. The change in activities which apply more pressure on feet, can cause the injury of plantar fascia ligaments.)
- Do you experience any change in pain when you point your toes downward?
(If the pain disappears while pointing the toes downward, it can be because of plantar fasciitis
Your doctor can also perform an x-ray of your foot for better examination
X-rays for plantar fasciitis
X-rays can help in providing clear images of bones rather than the soft tissues like ligaments and muscles. Plantar fasciitis is related to the inflammation and irritation of foot ligaments. X-rays can only examine heel spurs associated with plantar fasciitis but not the ligaments. Heel spurs are the protruding calcium deposits that may accumulate into the fatty pad of the heel. The presence of heel spurs can be painful, but it doesn’t confirm the occurrence of plantar fasciitis
Alternative to Plantar Fasciitis X-rays
The x-rays cannot clearly predict the occurrence of Plantar fasciitis.
Therefore doctor can also recommend alternatives like an ultrasound. Ultrasound is very useful for the examination of soft tissues.
Ultrasound can reveal the condition of the plantar fascia. It can detect inflammation of plantar fascia. Ultrasound can also help in the detection of entrapped nerves and rheumatoid arthritis.
Magnetic resonance imaging (MRI)
MRI can also be performed if the initial treatments are not relieving.
Treatment of plantar fasciitis
The majority of cases of plantar fasciitis can be treated at home with simple treatments like icing and rest can relive it. Consistent attention and treatment can ease the condition.
More than 90% of cases of plantar fasciitis can be treated within 10 months of simple treatments. Some of the treatment methods are the following:
The first step is that the patient should reduce the activities which worsen the heel pain caused by plantar fasciitis. The patients must also stop athletic activities for a few months.
Medicated shoes can be used to reduce the pain of plantar fascia. These shoes contain the thick sole and extra cushioning.
During walking, heel strikes the ground and pressure is placed on the fascia which causes microtrauma. Medicated shoes can reduce the chances of microtrauma while walking.
Soft silicone heel pads can also be used to reduce microtrauma. These heel pads are inexpensive and work by cushioning your heel.
Physiotherapy is also effective for the treatment of plantar fascia. During these therapies, the focus is on the stretching of calf muscles and plantar fascia.
Some physiotherapy exercises can help in easing the pain due to Plantar fascists. Stretching the calves and plantar fascia are effective in this condition.
- Calf muscle’s stretch
For this exercise stand against a wall. Keep one knee straight and the heel on the ground. Then, Place the other leg in front and bent the knee. To stretch the calf muscles, push your hips toward the wall and stay in this position for 10 seconds and then, relax. This exercise should be repeated 20 times for each foot.
- Plantar fascia’s stretch
This exercise is performed in the seating position. For this exercise, cross the affected foot over the knee of the other leg. Then, Grasp the toes of the affected foot and slowly pull them toward yourself. Perform this exercise in a slow and controlled manner.
This stretch exercise should be repeated 20 times a day for each foot.
Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on. During physiotherapy, other treatments can also be involved like ice treatments and medications.
The patient must roll his/her foot over a cold-water bottle for a few minutes. It can help in the reduction of inflammation associated with this condition. it can be repeated three to four times a day.
Anti-inflammatory Drugs can be used to reduce pain and inflammation. Anti-inflammatory drugs used are ibuprofen or naproxen. These drugs should be used after the recommendation from the doctor.
Cortisone is a type of steroid. Cortisone injections are anti-inflammatory steroids. These can be injected into the plantar fascia of patients to reduce inflammation and pain. These injections are used after the recommendation of a doctor. Misuse of these injections can cause the rupture of the plantar fascia.
Extracorporeal shockwave therapy
During this treatment high-energy shockwave are used. These waves stimulate the healing process. The use of Extracorporeal shockwave therapy is not very common