Plantar fasciitis is a common foot condition that causes pain in the heel, across the sole, and sometimes into the arch area of the foot.
The main symptom of plantar fasciitis is a sharp pain in the heel, sole, or arch of the foot. The pain is sometimes described as a burning or aching sensation and tends to come on gradually. It is often most severe when weight is first placed on the foot after a long period of rest or inactivity, such as when getting out of bed in the morning or standing up after a long period of sitting. The pain also tends to worsen after standing, walking or jogging for extended periods.
Plantar fasciitis is caused by ligament damage, which can be a simple part of the aging process. The condition is most common in people over the age of 40. However, there are several other contributing factors which are usually associated with excessive or extended stress being placed on the ligament.
The main risk factors associated with activities include the following:
- Standing for prolonged periods
- Jogging or running long distances
- Suddenly increasing the distance when running
- Running on hard surfaces
- Wearing inappropriate footwear (non-cushioned soles)
- Walking barefoot for extended periods
Certain physical factors can also cause plantar fasciitis. These include the following:
- Being overweight
- Flat feet or high arches
- Tightness in the Achilles tendon
- Rheumatoid arthritis
- Ankylosing spondylitis
Testing and Diagnosis
Preliminary diagnosis is usually based on a review of the patient’s history and recent activities together with a physical examination to assess the severity of the symptoms. In some more severe cases, the doctor will request additional imaging tests to rule out more serious causes of the pain, such as fractures or tumors. Additional tests include:
Once the condition is diagnosed, the doctor will choose the most appropriate treatment based on the severity of the symptoms and the extent of damage to the ligament. Medication may be prescribed to reduce inflammation. However, non-medicinal treatments can also be very helpful in treating the condition.
Orthotic devices, such as arch supports or heel cushions, can help take the strain off the ligament. Physiotherapy in the form of stretching the foot, ankle and Achilles tendon is also an effective form of treatment in many cases.
If the symptoms persist and do not respond to the treatments already mentioned, then steroid injections may be required in some rare cases. Steroid injections are effective in curing more than 98% of patients’ symptoms. However, they can take up to 18 months to take full effect and the symptoms may also re-occur later, requiring a new round of injections to be given. Surgery is only recommended in the most severe cases.