What Is It, Symptoms, Treatment, and More
Author: Ashley Mauldin, MSN, APRN, FNP-BC
Editors: Ahaana Singh, Lisa Miklush, PhD, RN, CNS
Copyeditor: Joy Mapes
Illustrator: Abbey Richard
What is plantar fasciitis?
Plantar fasciitis refers to a condition in which the tissue on the bottom of your foot, also known as the plantar fascia, becomes inflamed, irritated, and swollen. Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a thick rubber-band-like ligament that connects the heel bone to the toes, supporting the arch of your foot.
What causes plantar fasciitis?
Plantar fasciitis is usually caused by overstretching of the fascia. The plantar fascia can absorb and withstand a lot of pressure and stretching, but when it experiences tension and pressure over long periods of time, small tears and inflammation can occur.
Although the exact cause of an individual’s plantar fasciitis is often unclear, the most commonly associated causes are related to repetitive walking or standing for long periods. It commonly occurs in runners, as well as in individuals whose occupations keep them on their feet, such as teachers or factory workers. Plantar fasciitis can also result from wearing shoes that fit incorrectly or are not adequately supportive.Plantar fasciitis most commonly occurs in adults between the ages of 40 and 60 and is slightly more prevalent among women. Other risk factors that may lead to plantar fasciitis include being overweight, walking around barefoot, and having certain anatomical mechanics, such as flat feet, a high arch, tight calf muscles, or a tight achilles tendon. Due to the increased weight and pressure pregnancy exerts on the feet, plantar fasciitis can also occur during the last trimester. Oftentimes heel spurs, or bony growths on the bottom of the heel bone, can occur concurrently with plantar fasciitis; however, they are usually not the cause of the heel pain.
What are the signs and symptoms of plantar fasciitis?
Heel pain is the first symptom of plantar fasciitis. The pain usually gets worse over time and is present with the first few steps in the morning. Heel pain due to plantar fasciitis can also flare after long periods of rest or after periods of prolonged standing. The pain will usually subside with activity and return after stopping the activity.
Plantar fasciitis can feel like sharp or aching pain or a soreness on the bottom of your foot. The pain will usually begin to fade when you start to walk around.
How is plantar fasciitis diagnosed?
Plantar fasciitis is usually diagnosed through a review of medical history and physical examination. The healthcare provider may examine your foot for areas of tenderness. Most of the time, no imaging is required to diagnose plantar fasciitis. However, your healthcare provider might order an X-ray or magnetic resonance imaging (MRI) in order to rule out other conditions that cause heel pain, like a bone infection, bone fracture, or bone tumors.
How is plantar fasciitis treated?
The treatment for plantar fasciitis usually depends on the severity of the condition. In most cases, conservative treatment involving rest, ice, and stretching exercises can help to resolve the inflammation. Shoe inserts can also be used to help stabilize the fascia, support the arch of the foot, and prevent the fascia from stretching further. Night splints may be worn during sleep in order to keep the foot at a 90 degree angle, which will provide continuous, passive stretching. In addition, anti-inflammatory medications, like ibuprofen or naproxen sodium, may be taken to help reduce pain and inflammation. A referral for physical therapy or sports medicine may also be recommended in order to help stretch and exercise the plantar fascia and achilles tendon.
If the conservative treatments are not effective, prescription of steroidal anti-inflammatories, usually in the form of corticosteroid injections, is another treatment option. The injections will reduce inflammation on the plantar fascia, which may help ease heel pain. In some severe cases, a total or partial surgical release of the plantar fascia, also known as a plantar fasciotomy, may be advised. Surgery is usually reserved for those whose plantar fasciitis doesn’t resolve after application of conservative treatments and steroidal anti-inflammatories.It will usually take several weeks to a month for the symptoms of plantar fasciitis to completely resolve, but in some cases it can take six months to a year for the inflammation to fully heal. Following the medical advice of a healthcare provider is important with plantar fasciitis. If left untreated, plantar fasciitis can lead to persistent, chronic heel pain.
What are the most important facts to know about plantar fasciitis?
Plantar fasciitis refers to a condition in which the tissue on the bottom of your foot, also known as the plantar fascia, is irritated and inflamed from repeated irritation and overstretching. Plantar fasciitis is the most common cause of heel pain, often due to prolonged walking and standing. Running or jogging regularly, working at jobs that require standing or walking for long periods of time, and wearing shoes that don’t fit correctly or are not supportive can lead to plantar fasciitis. Heel pain that gets worse with time is the key sign and symptom of this condition. Plantar fasciitis is usually diagnosed with a medical history and physical examination. Conservative treatment is typically recommended and involves rest, application of ice, stretching exercises, and use of shoe inserts and night splints. Anti-inflammatory medications may be recommended, as well as a referral to physical therapy or sports medicine. In some cases, surgery may be advised.
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Resources for research and reference
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Young, C., Rutherford, D., & Niedfeldt, M. (2001). Treatment of plantar fasciitis. American Family Physician, 63(3): 467-475. Retrieved from https://www.aafp.org/afp/2001/0201/p467.html