The foot is a complicated body part that puts up with a lot of abuse. The average person can walk about 100,000 miles in a lifetime, and 75 percent of Americans will experience foot problems at one time or another. One of the most common is plantar fasciitis.
Connecting the heel bone to your toes, the plantar fascia ligament is a thick band of tissue that supports the arch of the foot and aids in walking. The ligament absorbs a huge amount of force each day, as much impact as a fully loaded cement truck. Sometimes it becomes irritated or inflamed, which causes a condition called plantar fasciitis. According to American Academy of Orthopaedic Surgeons, approximately two million people in the United States suffer from plantar fasciitis.
Symptoms and causes
Plantar fasciitis can be mistaken for a stone bruise – because it is typically a sharp, stabbing pain in the heel – but the discomfort can occur anywhere on the bottom of the foot. The pain might be greater in those first few steps of the morning after getting out of bed – as you walk more, it often eases.
“It used to be known as ‘heel spur syndrome,’ and most people describe a sharp, stabbing pain, as if they’ve stepped on something,” explained Kenneth Foster, DPM, a podiatrist with Kettering Health Network. “Sometimes, we do find there is a heel spur, but what’s causing the pain is inflammation of the plantar fascia ligament around it.”
While heel spurs are found in about 50 percent of plantar fasciitis cases, they are not the source of pain. Plantar fasciitis creates heel spurs, not the reverse, and treating it early can help to prevent them. Plantar fasciitis can be caused by anything from fallen arches or flat feet, to tight calf muscles. Obesity has been shown to be factor in 70 percent of cases, so a healthy weight can help prevent the condition.
“The plantar fascia becomes irritated at the insertion point on the bottom of the heel,” said Dr. Foster. “It can be aggravated by an increase or decrease in arch height, weight gain, and tight calf muscles.”
Treating the inflammation, even with home remedies, can be effective if started early. Professional treatment begins with a determination of its severity. If the pain is mild-to-severe, an injection of steroids and over-the-counter anti-inflammatories might be prescribed. Icing – alternating off and on for 20 minutes each – and the addition of new, properly fitted running shoes may also be suggested for better support, as well as physical therapy and possibly a second round of steroid injections.
Research also suggests stretching can improve or eliminate heel pain entirely over the long term. A study published by the Journal of Bone and Joint Surgery indicated that, while relief was not immediate, 52 percent of patients treated with an exercise program saw a reduction in plantar fasciitis pain.
“Wearing properly fitting shoes with good arch supports can help to greatly reduce the risk of plantar fasciitis,” Dr. Foster said.
It’s important to note plantar fasciitis may not always be the reason for pain in the heel and bottom of the foot. When orthotics or other remedies do not ease the discomfort, and stretching makes it worse, you may not have the condition. However, it is best to consult your doctor and have it checked out.
If icing, over-the-counter anti-inflammatory medications and stretching aren’t relieving your foot pain, contact Kettering Health Network Orthopedics to request an appointment and find out precisely what is causing the discomfort. Visit www.ketteringhealth.org/ortho or call 1-844-228-6683.