Plantar fasciitis is a poorly understood condition. There is little consensus among medical professionals about what causes the problem, and no treatments have been reliably proven to treat it. A number of theories exists for why plantar fasciitis develops, but the ineffectiveness of conventional treatments suggests something is missing. The plantar fascia is a band of connective tissue that runs along the underside of the foot from the heel to the toes. The fascia helps maintain the integrity of the arch, provides shock absorption, and plays an important role in the normal mechanical function of the foot.
The plantar fascia can also become aggravated by repetitive activity. If you increase the number of times the heel hits the ground, that can cause plantar fasciitis, a number of people develop problems when their feet are unaccustomed to hard tile or wood floors. Other risk factors for plantar fasciitis include obesity, an extra high or low foot arch, and activities like running.
Symptoms of the plantar fasciitis include a gradual onset of pain under the heel which may radiate into the foot. Tenderness is usually felt under and on the inside of the heel which is initially worse first in the morning but eases as the foot warms up only to return later in the day or after exercise. Stretching the plantar fascia may be painful.
The health care provider will perform a physical exam. This may show tenderness on the bottom of your foot, flat feet or high arches, mild foot swelling or redness, stiffness or tightness of the arch in the bottom of your foot. X-rays may be taken to rule out other problems.
Non Surgical Treatment
Talk to your doctor about the best treatment plan for you. Options include. Apply ice or a cold pack to the heel and arch for 15 to 20 minutes several times a day. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin. A special splint that will hold your foot in a neutral position while sleeping. Special shoe inserts that support the mid-arch region of your foot. Inserts that are not customized may work just as well as those that are customized. Activity. Avoid running and other activities that may worsen pain. Begin stretching exercises to lengthen the Achilles tendon and plantar fascia as recommended by your doctor. This is usually done when pain has lessened or improved. To help manage pain, your doctor may recommend over-the-counter nonsteroidal anti-inflammatory medication (NSAIDs), such as ibuprofen or naproxen. Prescription pain relievers may also be required. Steroid injections may be used in some cases or if other treatment is not working. A special type of sound wave called extracorporeal shock wave may also be considered in certain cases. This treatment happens under the care of your doctor. At this time, this is generally a treatment for long-term cases that do not respond to other treatments. Massage therapy or accupuncture may also be effective for long-term cases. In a few cases, basic treatments don’t help. Surgery may be performed to cut the tight, swollen fascia.
More invasive procedures to treat plantar fasciitis are usually sought only after other treatment has failed to produce favorable results. Corticosteroid injections deliver medicine into the injured fascia to reduce pain. However, this treatment may weaken the plantar fascia and result in further damage. In addition, extracorporeal shock wave therapy (ESWT) is a treatment where sound waves are sent through the damaged tissue in order to stimulate the damaged tissue and encourage healing. This method is relatively new in treating plantar fasciitis and your doctor will be able to tell you if it is the right method for you. Lastly, surgery is the last option for those suffering from chronic or severe plantar fasciitis.