Plantar fasciitis (pronounced PLAN-tar fashee-EYE-tiss) is an inflammation of the fascia or connective tissue (also called aponeurosis) on the bottom of the foot. It is often considered the same as, or seen with, heel spur.
What Causes Plantar Fasciitis and Heel Spurs?
Plantar fasciitis and heel spurs are conditions caused by such factors as:
- too much standing;
- unpadded shoes on hard ground;
- poor shoes (see below);
- repetitive stress;
- diets low in vitamin C;
- a change or increase in activities;
- being overweight;
- age-related shrinkage of the heel fat pad (a.k.a. fat ad atrophy);
- an injury.
Bad shoes are those that ...
- have poor or no arch support;
- do not have a raised heel;
- are worn out
- do not bend at the ball of the foot
- do not have any cushion and are worn on a hard surface
What Are the Symptoms of Plantar Fasciitis?
The pain is usually in the front and bottom of the heel. It can also be over the entire bottom area of the foot. The pain can be mild or debilitating. It can last a few months or a lifetime. It can go away by itself, only to return in a few weeks or months. Many patients complain of increased pain when first getting out of bed in the morning which slowly improves as the feet warm up.
If you have heel pain at the inside, front and bottom of your heel, especially if it's in the morning or after sitting a long time, then your probably have plantar fasciitis. When the pain is severe, it is believed to be the result of bone and/or nerve irritation that is the result of too much tension, inflammation or scar tissue in the fascia. The pain often increases with more walking and standing. The pain is usually where the fascia attaches to the heel, but it can be over the entire bottom area of the foot.
If the heel pain began concurrently with a change or increase in activity, or an increase in weight, then it can be considered more of a cause of plantar fasciitis (heel spur). A stress fracture where the fascia attaches to the heel is sometimes seen in bone scans. Fifty percent of the sufferers say the pain is constant. About 90 percent say it hurts when pressed deeply with a finger.
What Is the Treatment for Plantar Fasciitis?
Our treatment for this condition includes ultrasound, electrical stimulation, deep tissue work and now LASER THERAPY.
- Decrease activity or switch to exercises that keep the weight off of the feet such as stationary bike riding or swimming. Avoid or modify anything that causes an increase in pain. Be patient, it may take months of reduced activity. Increase activities very slowly. Complete rest is not good, as some activity is necessary for recovery.
- Stretching. Stretching is often recommended. In the few cases where it is caused by a sudden injury, stretching and strengthening may not be necessary. Stretching can reinjure the traumatized fascia.
- Taping can help to simply protect the fascia or enable a patient to walk again. The tape should be tight when you stand and the pain is immediately relieved (unless the pain is present 24 hours a day). If not, consider the "other causes" section.
- Arch support and medial wedges. Certain shoes, inserts (name the type you recommend) or custom-made orthotics can give more arch support. Heel pads can sometimes be worn under inserts.
- Heel pads, 1/2" to 1" thick in both shoes. The waffle-bottomed Tuli cups or viscoelastic designs may not work as well because they are thin when compressed. Playing tennis or similar activity while wearing heel pads can cause a serious ankle injury.
- Reduce inflammation with ice, anti-inflammatory medication, compression and elevation. The swelling may not be noticeable, but it is often there and causes pain by putting pressure on tissue in the area.
- Ice immediately after activities or injury. Place ice on a towel, step on it and roll it under the feet for five minutes. Repeat every hour until bedtime.
- Massage in the morning and evening.