Plantar Fasciitis

The condition typically causes pain and discomfort in the heel or bottom of the foot, especially with the first steps in the morning or after periods of rest. Common symptoms of plantar fasciitis include:

Heel Pain. Pain is usually felt on the underside of the heel and may radiate along the arch of the foot. The pain is often described as a stabbing or sharp sensation.

Pain upon rising. Pain is often most severe with the first steps in the morning or after prolonged periods of rest, such as after sitting for an extended period or getting up from bed.

Pain after activity. Pain may worsen after prolonged standing, walking, or physical activity, especially activities that place strain on the fascia, such as running or jumping.

Stiffness. The foot may feel stiff or tight, particularly in the morning or after periods of inactivity.

Tenderness. The affected area may be tender to the touch, especially near the heel or along the arch of the foot.

Swelling. Some individuals may experience mild swelling in the heel or along the bottom of the foot, particularly if the condition is chronic or severe.

Difficulty bearing weight. Pain and discomfort may make it difficult to bear weight on the affected foot, leading to changes in gait or walking patterns.

Increased pain with activity. Pain may worsen with continued activity or standing, particularly if the underlying cause of the condition is not addressed.

What causes plantar fasciitis?

Plantar fasciitis is a condition that seems to be caused by repetitive micro-tears of the plantar fascia - a very strong layer of tissue on the sole of the foot that connects the heel to the toes and which serves an important role in normal foot function, helping to maintain the shape of the arches of the foot. Why some people develop plantar fasciitis is poorly understood but certain factors have been identified as potential causes of plantar fasciitis including obesity, repetitive activities such as running, an abrupt increase in activity levels, calf tightness, and poor quality or unsupportive footwear. In a very small proportion of people with plantar fasciitis, there may be evidence of an underlying inflammatory arthritis.

Sufferers of plantar fasciitis most often experience pain under the heel when bearing weight. The pain is classically worst with the first few steps in the morning and then gradually improves through the day. The pain can, however, be made worse after periods of exercise.

The majority of people with plantar fasciitis see improvement in their symptoms without needing any treatment, although it often takes a number of months to subside. Simple self-help measures can be very effective at relieving symptoms caused by plantar fasciitis. These include:

• Stretching exercises for your calf and Achilles tendon - be wary of symptoms of Achilles tendinopathy and rupture
• Wearing supportive, padded shoes
• Weight loss if you are overweight
• Anti-inflammatory medications (NSAIDs) - such as ibuprofen
• Application of an ice pack after periods of exercise - know when to use a heat or ice pack

If your symptoms have failed to improve despite these simple measures after six weeks you should contact your doctor. Your doctor may refer you to a physiotherapist or podiatrist for further management. You may be offered a structured stretching and exercise program which is very effective at relieving your symptoms. Additional treatment options include wearing a specialized splint at night or ultrasound shockwave therapy.

The doctor will ask you about your symptoms and examine your foot. If they are satisfied that you have plantar fasciitis, they may refer you to your physiotherapist or podiatrist, depending upon the local services available.

Very rarely, if your symptoms fail to improve despite physiotherapist/podiatry input, you may be referred to an orthopedic surgeon. An orthopedic surgeon may be able to offer additional treatment modalities. However, surgery is seldom an option for plantar fasciitis.