Plantar fasciitis, or jogger’s heel as it is also known, is a common condition that affects not only the heel but also the underside of the foot. It is usually associated with aging, weight gain or activities such as standing for extended periods or excessive jogging. Although the condition can become quite painful, it can usually be treated without the need for surgery.
The first sign that someone has plantar fasciitis is usually when they start to feel a sharp pain in their foot. As the pain often builds up slowly, many people expect it to be a temporary condition that will pass. However, the pain persists and creates a feeling of burning or itching that will gradually become worse after long periods of standing, walking or jogging. The foot will also become increasingly inflamed. Resting the foot may help to relieve the aching, but this only provides a temporary respite because you will feel an intense pain when you first put your weight on the foot again.
The pain is actually caused by damage to a ligament in the foot. Since this ligament damage is often brought on by natural wear and tear, plantar fasciitis is more common in people over the age of 40. However, it can also affect younger people who have risk factors associated with their activities and physical condition.
These risk factors include excessive stress on the ligament due to extended periods of standing, walking or jogging, especially on hard surfaces. As a result, people whose work involves being on their feet for several hours each day or people who suddenly increase the distance they jog are at increased risk.
Other contributing factors include physical conditions, such as excessive body weight placing constant stress on the feet, or foot shapes, including flat feet or high arches. A tightness of the calf or Achilles tendon can also contribute to plantar fasciitis, while rheumatic conditions such as rheumatoid arthritis or ankylosing spondylitis can also damage the ligament that leads to plantar fasciitis.
When diagnosing plantar fasciitis, the doctor will first ask the patient a series of question to determine whether their routine activities or if any recent change in their activities may have contributed to the condition. The doctor will also conduct a physical examination and may use x-rays, ultrasound or MRI to rule out more serious causes of the pain, such as fractures or tumors.
There are a number of treatment options for plantar fasciitis. The inflammation can be reduced by medication, while arch supports or heel cushions can reduce the strain on the ligament. Stretching exercises can also be effective in treating plantar fasciitis.
Steroid injections are another option for more severe cases. While the injections can relieve most symptoms, they can take up to 18 months before they take full effect. Since the symptoms may also come back again after the injections are stopped, the treatment may need to be repeated. Surgery is a final option but is only recommended in the most severe cases that do not respond to other treatments.
As always, prevention is better than cure. Try to avoid standing for extended periods, and if you increase the distance you run, do so gradually. Wearing the appropriate footwear is also important. Whenever possible, choose shoes with sufficient cushioning, such as running shoes, and avoid walking barefoot.
If you start to experience a sharp pain in your heel or the underside of your foot, seek medical advice so that you can have it treated before the symptoms worsen.
By Dr. Withoon Boonthanomwong, Orthopedist at the Orthopedic Center, Bumrungrad Hospital.