The Foot Clinic

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Plantar Fasciitis (heel pain) Causes and Treatment

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Plantar Fasciitis is an inflammation of the connective tissue band that runs under the foot. This link connects the heel bone to the ball of the foot. The band helps stabilise the foot and helps the toes to bend. If this band is inflamed, it will cause pain and discomfort in the heel area.. Plantar Fasciitis is sometimes simply called heel pain or heel spur syndrome. The pain is at the bottom of the heel, especially in morning when getting up, taking your first steps out of bed. As the day progresses, the pain will lessen. At the end of the day there is sometimes a dull pain on the inside of the heel and with rest the pain will further decline. Plantar fasciitis is caused by activities that put extra stress on the feet including: physical exertion, especially in sports that require running and jumping such as: athletics, volleyball, tennis, football etc. A risk factor is something that increases your chance of getting a disease, condition, trauma or injury. The main risk factors for plantar fasciitis are: sudden changes in activity or physical forces endured by the feet, weight gain, pre-existing foot problems, including an abnormally tight Achilles tendon (heel cord), tight calf muscles, flat feet, overpronation, or very high arches, badly worn unsupportive footwear. If you are running again, the pain will gradually return. Also,redness and swelling in the heel may be present. Plantar Fasciitis pain is most common in men between 45 and 65 years, mostly because of work demanding long hours of standing. Plantar Fasciitis is a clear result of overuse of the foot. The connective tissue band may be corrupted in many ways. This common foot condition can be determined by physical examination. An X-ray of the foot may provide additional information. Sometimes a bone spur is visible, this is an extra bone growth of the heel bone. A bone spur may not be the cause of heel pain. Symptoms of plantar fasciitis may come on gradually or suddenly and include the following: burning pain on the sole of the foot, heel pain when taking the first steps in the morning, tenderness when touching the sole or heel, pain when standing on your tiptoes. The treatment of fasciitis is designed to reduce the pain. Therefore, the affected foot should be rested. Some stretching exercises for the heel may also help. You doctor or physiotherapist can provide more information about these exercises. In case of severe pain your foot specialist may prescribe painkillers or give an injection of steroids into the heel bone. It is advisable to use orthotic insoles. If the pain persists, surgery may help. In this case the band is loosened, reducing the strain on the connective tissue.

The following medications can relieve pain and inflammation: Ibuprofen (for example Motrin, Advil and Nurofen), Naproxen (Naprosyn), Acetaminophen (Tylenol) or just plain aspirin can help as well. Corticosteroid injections may be an option in some cases given by your GP. In certain cases, a new special type of sound wave called extracorporeal shock wave may be appropriate.  To reduce the risk of getting plantar fasciitis we advice you to do the following: maintain an appropriate, healthy weight, wear well-fitted and supportive shoes during sports, walking, running and exercise. Do some simple stretching exercises for the Achilles tendons, plantar fascia and calves. Miminise walking and apply ice on the heel in the evenings. The low-cost prefabricated and customized foot orthotics had similar effectiveness in the treatment of plantar fasciitis after 10 weeks of use. The trial results were similar to other trials although those trials did not use orthoses made from EVA. Thus, EVA prefabricated orthotic shoe inserts may be the best choice for the treatment of plantar fasciitis without complication.