When every step you take is painful, it’s difficult to do anything. One common cause of foot pain is plantar fasciitis (PLAN-tur fas-ee-I-tis), a common condition seen most often in runners or other athletes, overweight women, and seniors. Although not life-threatening, it can interfere with your lifestyle and normally doesn’t get better without treatment.
Our family practice doctors in Delray Beach, however, want to reassure you that plantar fasciitis can often be relieved through simple measures. Drugs and surgery are necessary only as a last resort.
What is plantar fasciitis?
“Fasciitis” means inflammation of the fascia, and can occur in any of the body’s many fasciae (a thin sheet of fibrous tissue). “Plantar” relates to the foot, so plantar fasciitis is inflammation of the stretchy thick band, or ligament, that runs from the heel to the toes. It acts as a shock absorber when you run or walk.
Inflammation can occur anywhere along this ligament but is most often felt in the heel. As many as two million people a year see their doctors for the pain associated with plantar fasciitis.
Heel spurs, by the way, are not the same as plantar fasciitis. Heel spurs are small pieces of bone that extend from the heel. One does not cause the other, although both can cause heel pain.
Sometimes you’ll wake up, put your feet on the floor, and be greeted with a stabbing pain. At other times, it can feel like a dull ache. Both types of pain may lessen as you walk throughout the day, but can recur if you sit too long. It can also occur or worsen if you spend a long time standing.
The pain can occur on the bottom of the heel, in the arch of the foot, the ball of the foot, or all along the fascia in the foot.
The pain may also be accompanied by swelling of the heel, a feeling of heat, or redness anywhere along the fascia. Pain may even be felt in the toes, although this is unusual.
What causes it?
Plantar fasciitis is most common in certain types of exercise which involve repeated stretching or impact on the fascia in the foot: long-distance runners, or basketball players, or ballet or aerobic dancers, for example. Such stressors can produce micro-tears in the fascia, resulting in painful inflammation.
Other risk factors include:
- age, especially those between 40-60 years old
- being female, especially if you wear high heels frequently
- being overweight
- spend a lot of time standing: grocery store workers, teachers, factory workers, etc.
- having flat feet or a high arch
- wearing flat shoes that don’t support the feet
Seniors can also develop plantar fasciitis due to changes in the feet resulting from the aging process.
Because we’re constantly on our feet, plantar fasciitis doesn’t get a chance to heal itself, so the pain typically won’t go away on its own. It can also lead to pain or damage elsewhere in the foot, back, knees, or hips as you change your gait to try to avoid the pain.
So if you’re experiencing plantar fasciitis, it’s best to let us evaluate it. Depending on the diagnosis, we may order X-rays or other imaging tests to rule out other conditions.
If it is plantar fasciitis, most people will recover with various at-home treatments.
- This begins with using the right footwear: sturdy, well-cushioned shoes with arch support. We may also recommend shoe inserts or other custom-made orthotics.
- Massage is often helpful, either by hand or by rolling a tennis ball under the fascia to help relieve tension.
- Icing the area several times a day can help with inflammation.
- Wearing splints overnight can gently stretch your calf and the arch of your foot while you sleep.
- Over-the-counter (OTC) anti-inflammatory medications can also help with pain and inflammation.
If you spend a lot of time on your feet during the day, we’ll recommend you reduce time spent standing or stop doing so entirely until the pain is resolved.
And if you’re overweight, we’ll recommend you reduce your weight to ease the stress and resulting pain on the fascia.
In general, such simple remedies will usually resolve the problem within 10 months.
If these treatments don’t work, we may move on to other outpatient treatments. This may include:
- physical therapy
- cortisone (steroid) injections
- sound wave therapy
These types of solutions, however, are usually not necessary. If you baby your feet and give them time to heal, you can recover from this common condition.