If you are struck with a stabbing pain in your heel with your first steps in the morning, you may be suffering from plantar fasciitis. Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.
Wearing footwear that lacks support on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Obesity and overuse may also contribute to plantar fasciitis.
The symptoms of plantar fasciitis are:
- Pain on the bottom of the heel
- Pain in the arch of the foot
- Pain that is usually worse upon arising
- Pain that increases over a period of months
- Swelling on the bottom of the heel
People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.
Our podiatrists will determine a patient’s diagnosis based on patient history, risk factors and physical exam findings. In addition, diagnostic imaging studies, such as x-rays, may be used to distinguish if a patient is suffering from plantar fasciitis.
Treatment of plantar fasciitis begins with first-line strategies, such as:
- Stretching. Exercises that stretch out the calf muscles and plantar fascita help ease pain and assist with recovery. We offer Trigger Point foam rollers, handheld rollers and massage balls to help you with all your stretching needs.
- Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia. We offer a supportive flip flop that can be worn as your house shoe.
- Ice. Place a thin towel between the ice and your heel; do not apply ice directly to the skin.
- Limit activities. Cut down on extended physical activities to give your heel a rest.
- Orthotic devices. Custom devices that fit into your shoe and help correct the underlying structural abnormalities causing the plantar fasciitis. Many times, these devices are covered by your insurance.
- Stem cell injections. This type of injection if safely derived from human amniotic membrane while enhancing your body’s own healing process.
- Cortisone injections. Corticosteroid injections are used to help reduce the inflammation and relieve pain.
- Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while resting.
- EPAT (Extracorporeal Pulse Activation Technology). EPAT is an innovative, non-invasive way to treat pain. It is based on a unique set of pressure waves that stimulate the metabolism, enhance blood circulation, and accelerate the healing process.
When Is Surgery Needed?
Although most patients with plantar fasciitis respond to nonsurgical treatment, a small percentage of patients may require surgery. If, after several months of nonsurgical treatment, you continue to have heel pain, surgery will be considered. Our foot and ankle surgeons will discuss the surgical options with you and determine which approach would be most beneficial for you.
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventative measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.