Medical condition characterized by pain and inflammation of the tissue plantar fascia that joins the heel bone to the toes by running across bottom of the foot is termed as Plantar Fasciitis. Risk of this disease is high in pregnant women and in people who are in their forties and sixties, overweight, possess flat or higher arches, use of shoes that do not give proper support, long hours of standing at work and increased tension on the foot that causes tearing of fascia repeatedly. Diseases such as arthritis, diffuse idiopathic skeletal hyperostosis and ankylosing spondylitis may also result in plantar fasciitis.
Symptoms of Plantar Fasciitis
Pain in the foot and heel: Stabbing pain is felt in the foot upon taking first steps in the morning. Pain reduces gradually as you continue to walk. Pain is also felt after long hours of standing or getting up after long hours of sitting or while climbing steps or during the start of exercises. The pain may be felt in either one or both foot and it develops gradually. Other symptoms include
- Tenderness at the bottom of the foot.
- Redness and mild swelling of the foot.
- Arch of the foot will be stiff or tight.
Treatment of Plantar Fasciitis
About 90 percent of the cases can be treated successfully in few months to year. Plantar fasciitis symptoms are similar to those caused by minor stress fractures. Hence, before starting the treatment the physician confirms the condition by knowing the history of previous injuries, symptoms, regular physical activity and by physical examination. X-ray may also be taken to rule out problems with other bones of foot.
Treatment involves use of medications and conservative therapies to relieve pain, reduce inflammation, healing of small tears in plantar fascia and also at improving the strength of feet. Surgery is performed if plantar fasciitis symptoms do not relieve with medications and therapies.
Medications that are commonly used include
- Non steroidal anti inflammatory drugs such as naproxen and ibuprofen are used to reduce pain and inflammation. However, these drugs do not treat the underlying cause.
- Corticosteroids that are delivered either by iontophoresis or injection are also used to relieve the pain. In iontophoresis the corticosteroid solution is applied over skin of the affected area and the solution is absorbed in to the body by applying non painful electric current. To exactly guide the location of injection ultrasound may be used. However, frequent injections are not recommended as it would destroy the fat pad covering the heel bone and will also weaken the plantar fascia.
Therapies involving strengthening and stretching exercises or specialized equipment may also be used to provide relief from plantar fasciitis symptoms.
- Physical therapy: Involves practicing exercises that strengthen the lower leg muscle as well stretch the Achilles tendon and plantar fascia under the guidance of a physical therapist.
- Use of night splints: Splint to stretch the calf as well as the arch of the foot is used at nights while sleeping. These splints help in holding the Achilles tendon and plantar fascia in stretched position.
- Orthotics: Custom fitted arch supports may be used to spread the pressure evenly to the entire feet.
- Extracorporeal shock wave therapy: Sound waves are used in this therapy to facilitate healing in chronic conditions where other treatments fail. However, the treatment is not very effective all the time and even results in pain, swelling, numbness and bruises.
If the pain is unbearable and other treatments fail even after continuing for six to twelve months surgery is used as a last option to eliminate plantar fascia. However, it weakens the arch of the foot. Surgery is performed either as open surgery or endoscopic surgery. In open surgery cut is made in to heel to release plantar fascia. In endoscopic surgery plantar fascia is accessed by making a smaller incision. Endoscopic surgery is advantageous compared to open surgery as the recovery time is very short.
Simple self care tips to relieve plantar fasciitis symptoms:
- Reduce the extent of standing, walking and running when the pain is severe.
- Apply ice pack in the region of pain for about fifteen to twenty minutes thrice a day or after strenuous activity. You can even try ice massage to reduce inflammation and pain.
- If the pain keeps recurring give up activities such as dancing and running to avoid stress of plantar fascia.
- Practice simple exercises regularly to stretch calf muscles, Achilles tendon and plantar fascia.
Plantar Fasciitis : Prevention and precautions
Painful plantar fasciitis symptoms can be prevented by taking simple precautionary steps.
- Maintain optimal body weight to lower weight on plantar fascia.
- Use shoes that are good at absorbing shock and offer good support to arch. Avoid using high heels and going barefoot on rocks or other hard surfaces.
- Change the shoes if they are not giving enough cushion and support to the heel and foot. This is very important if you are an athlete.
It is important to treat plantar fasciitis without delay as it can change the way of your walking. This in turn causes problems in back, knee and foot.