Plantar fasciitis is a condition that causes heel and arch pain through inflammation on the bottom of the foot. The part thatâs inflamed (swollen) is actually the plantar fascia, which is the
connective tissue or ligament that stretches from the base of the toes, across the arch of the foot, and inserts into the heel bone. This painful condition can interfere with your daily activity and
severely decrease your quality of life.
Plantar fasciitis occurs when the ligament in your foot arch is strained repeatedly, which causes tiny tears and significant pain. There are several possible causes for this condition. Excessive
pronation, or overpronation, which happens when your feet roll excessively inward as you walk. Flat feet or high arches. Walking, standing, or running for long periods of time, particularly on hard
surfaces (a common problem for athletes). Excess weight, such as overweight or obesity. Shoes that are worn out or donât fit well. Tight calf muscles or Achilles tendons.
Symptoms of plantar fasciitis can occur suddenly or gradually. When they occur suddenly, there is usually intense heel pain on taking the first morning steps, known as first-step pain. This heel pain
will often subside as you begin to walk around, but it may return in the late afternoon or evening. When symptoms occur gradually, a more long-lasting form of heel pain will cause you to shorten your
stride while running or walking. You also may shift your weight toward the front of the foot, away from the heel.
After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch, an area of maximum tenderness on the bottom of your
foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion
of your ankle. Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in
ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not
routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.
Non Surgical Treatment
No single treatment works best for everyone with plantar fasciitis. But there are many things you can try to help your foot get better. Give your feet a rest. Cut back on activities that make your
foot hurt. Try not to walk or run on hard surfaces. To reduce pain and swelling, try putting ice on your heel. Or take an over-the-counter pain reliever like ibuprofen (such as Advil or Motrin) or
naproxen (such as Aleve). Do toe stretches , calf stretches and towel stretches several times a day, especially when you first get up in the morning. (For towel stretches, you pull on both ends of a
rolled towel that you place under the ball of your foot.) Get a new pair of shoes. Pick shoes with good arch support and a cushioned sole. Or try heel cups or shoe inserts ( orthotics ). Use them in
both shoes, even if only one foot hurts. If these treatments do not help, your doctor may recommend splints that you wear at night, shots of medicine (such as a steroid ) in your heel, or other
treatments. You probably will not need surgery. Doctors only suggest it for people who still have pain after trying other treatments for 6 to 12 months.
In very rare cases plantar fascia surgery is suggested, as a last resort. In this case the surgeon makes an incision into the ligament, partially cutting the plantar fascia to release it. If a heel
spur is present, the surgeon will remove it. Plantar Fasciitis surgery should always be considered the last resort when all the conventional treatment methods have failed to succeed. Endoscopic
plantar fasciotomy (EPF) is a form of surgery whereby two incisions are made around the heel and the ligament is being detached from the heel bone allowing the new ligament to develop in the same
place. In some cases the surgeon may decide to remove the heel spur itself, if present. Just like any type of surgery, Plantar Fascia surgery comes with certain risks and side effects. For example,
the arch of the foot may drop and become weak. Wearing an arch support after surgery is therefore recommended. Heel spur surgeries may also do some damage to veins and arteries of your foot that
allow blood supply in the area. This will increase the time of recovery.
Stretching your plantar fasciitis is something you can do at home to relieve pain and speed healing. Ice massage performed three to four times per day in 15 to 20 minute intervals is also something
you can do to reduce inflammation and pain. Placing arch supports in your shoes absorbs shock and takes pressure off the plantar fascia.