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Pain that is felt at the bottom of the heel

Plantar Fasciitis

Plantar fasciitis is a condition that leads to pain and discomfort that is felt at the bottom of the heel. The plantar fascia is a ligament that is thick and weblike and has the function of connecting the heel to the front of the foot. It works as a shock absorber, supporting the arch of the foot and assisting with walking.

Plantar fasciitis is one of the orthopedic complaints, which occur the most, as the plantar fascia ligaments are being put under a lot of pressure every day. Too much of this pressure on the feet can lead to damage and tear of the ligaments.

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What Are the Symptoms of Plantar Fasciitis?

When there is damage to the ligaments, they become inflamed and the inflammation can cause pain and stiffness. Other symptoms that occur after such damage to the feet include numbness and swelling.

The main symptom of plantar fasciitis is considered to be the pain, which is felt at the bottom of the heel and in some cases at the bottom mid-foot area. The pain affects one foot in most cases, however, there are also cases, where both feet are affected. The pain in plantar fasciitis patients develops over time and is described as a dull or sharp pain. Some patients experience a burning or ache which starts at the bottom of the foot and extends outward from the heel.

Plantar fasciitis patients experience the pain being worse in the morning, when they take the first steps, or after they’ve been sitting or lying down for a long time. Climbing stairs can also cause difficulties when the heel is stiff. When plantar fasciitis patients do activities for a long time, the pain can flare up again, as the affected area gets irritated. In some cases, plantar fasciitis patients don’t experience any pain while doing activities but experience them as soon as they stop to take a rest.

What Causes Plantar Fasciitis?

Women and men between the age of 40 and 70 are at the highest risk for developing plantar fasciitis, especially if they are active. Studies show that plantar fasciitis is a bit more common in women than in men. Women who are are more likely to experience bouts of plantar fasciitis, especially during late pregnancy, due to the additional weight that they need to carry.

People who are overweight or obese are also at a greater risk of suffering from plantar fasciitis, as the increased pressure on the plantar fascia ligaments increases the possibility of suffering from the condition. Long-distance runners are also at an increased risk, as well as those who have a job that is very active and requires them to be on their feet often.

Structural foot problems can increase the possibility of suffering from plantar fasciitis as well, such as having very flat feet or very high arches. Those who have tight Achilles tendons might also suffer from plantar fasciitis. It is important, that those who suffer from such structural foot problems, get treatment for the condition.

How Is Plantar Fasciitis Diagnosed?

To diagnose plantar fasciitis, the doctor will first need to do a physical exam and check whether there is tenderness in the foot, as well as where the pain is located. By doing so, the doctor makes sure that there isn’t another foot problem present.

For the evaluation, you might need to flex the foot while pushing on the plantar fascia. This helps the doctor determine whether the pain gets worse when you flex your feet, or whether it gets better when you point the toe. During a physical exam, the doctor will also check for swelling and redness.

To evaluate how strong your muscles are and how healthy the nerves are, the doctor will also check your sense of touch and sight, coordination and balance, muscle tone, and reflexes. In some cases, you might need to get an X-ray or an MRI scan, as this helps to exclude the possibility of a bone fracture or other issues.

How Is Plantar Fasciitis Treated?

In most cases, the first treatment option for plantar fasciitis includes home treatments, such as resting, icing it, using anti-inflammatory drugs and wearing braces. If all these options don’t help to treat the pain, the doctor might suggest injecting corticosteroids into the affected ligament. To be able to determine where the best spot to inject is, your doctor might use an ultrasound device. In some cases, corticosteroids are applied to the skin of the heel or the arch of the foot. To pass the corticosteroids into the muscle, an electrical current is used, which is however painless.

Physical therapy is a very important part of treating plantar fasciitis, as it helps to stretch both the Achilles tendon and the plantar fascia. During physical therapy, the doctor will show you different exercises, which will help to strengthen the muscles of the lower leg, to stabilize how you walk and to prevent additional pressure being put on the plantar fascia.

When physical therapy turns out to be unsuccessful, other methods, such as extracorporeal shock wave therapy might be used. During this treatment, sound waves will be used to stimulate healing within the ligament. This treatment comes with some side effects, such as bruising, numbness, pain, and swelling. It is a treatment that still is being researched and there is still no scientific evidence, which proves that it effectively can reduce plantar fasciitis symptoms.

Surgery is considered to be the last option, as it is also the most dramatic therapy. It is only used in cases where the pain lasts for over 6 to 12 months. During a plantar fascia surgery, the surgeon will detach the plantar fascia from the heel bone, which helps to reduce tension. However, it is also a procedure that weakens the arch of the foot, and there are cases where the full function is lost. Side effects of such a surgery include nerve damage and chronic pain, which is why doctors only recommend it after trying all other possible treatment options.

Can Home Remedies Help to Treat Plantar Fasciitis?

When the plantar fascia ligament is irritated or inflamed, home treatments do help to reduce the pain and the inflammation, but they aren’t effective in treating the damage that has been done to the ligament.

The first home treatment that is recommended is to rest and apply ice on the affected area, as this helps to reduce swelling. You can also take nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, to help relieve the pain.

There are also braces and night splints available, which can help to stretch the arch and the calf of the foot. They are helpful in preventing stiffness and pain, which occurs in the morning.

Some experts recommend using essential oils in the treatment of plantar fasciitis. There is not enough scientific evidence to support this belief, however, there are many patients who have claimed, that certain essential oils have helped with pain and inflammation reduction.

Some of the essential oils that are recommended include rose essential oil, eucalyptus oil, lavender essential oil, and lemongrass essential oil. When using essential oils, it is important to note, that you need to dilute them first with a carrier oil before massaging it. An example of carrier oil is coconut oil. Essential oils can also be inhaled, however, you need to steam the essential oil and mix it with hot water.

Can Plantar Fasciitis Be Prevented?

Some lifestyle changes might help you to avoid the possibility of suffering from plantar fasciitis. It is recommended that you wear shoes, which provide good arch support. People who are long-distance workers or work very active jobs need to be very careful with their shoe choice.

For physical activity, it is recommended to turn to low-impact workouts, such as bicycling or swimming. When working out, it is important to stretch the calves, plantar fascia and Achilles tendon before and after exercising. Your weight plays an important role, so if you’re overweight, do your best to lose the additional weight, as this reduces the pressure that is being put in your plantar fascia.

What Does Recovery Look Like?

Plantar fasciitis is a condition that in most cases, improves within a couple of months using home treatments only, such as stretching, resting, and icing. In severe cases, or when the condition is left untreated for a longer period of time, more invasive treatment options might be necessary.

Recovery time will depend on the treatment that is used. Patients who have to undergo surgery might need longer to recover, as those who are treated with physical therapy only.

What Is the Connection Between Plantar Fasciitis and Heel Spurs?

There was a belief, that heel spurs lead to plantar fasciitis, however, studies show that this is not the case. A heel spur is a hook of bone, which can develop on the heel bone. It is caused by the same factors as plantar fasciitis, such as long-term pressure being put on the feet. Heel spurs can be diagnosed with the help of an X-ray. Some believe that heel spurs are the reason behind their foot pain, however, it is important to note that heel spurs usually don’t cause any symptoms at all.

Some causes of heel spurs include being obese or overweight, wearing poorly-fitted shoes, or shoes that are worn-out, suffering from arthritis, or walking with an unnatural or incorrect gait.

Those who suffer from plantar fasciitis are at an increased risk of developing heel spurs. Heel spurs don’t heal without surgery, but in most cases, they don’t cause any pain, so that surgery is not needed at all. When heel spurs do cause symptoms, they can be treated with the same home treatments that are used in plantar fasciitis, such as pain medications, resting, icing, and wearing shoe inserts for additional support or cushioning.

Can Plantar Fasciitis Affect Children?

Plantar fasciitis is a condition that can affect children as well, if they wear old or unsupportive shoes, or if they overuse the ligament. As the condition can get worse over time, it is very important that as soon as you experience symptoms, you visit a doctor and get the proper diagnosis and treatment.

Icing the heel can help to reduce plantar fasciitis symptoms in children. It is also recommended to massage the area and prevent the children from jumping, running, or standing for a long time, as resting helps the healing process.

Do your best to teach your children warmup exercises and stretches, and how important it is to do them before being physically active. Your doctor might also recommend a change of shoe-wear.

What Nutrition Helps to Improve Plantar Fasciitis?

What we eat makes a big difference, especially if we suffer from a certain condition and are in the healing process. While more research is necessary on what helps with plantar fasciitis, there are certain supplements that are known to help with tissue healing and repair.

These supplements include glucosamine, bromelain, zinc, vitamin C, and fish oil. It is better to take in all these nutrients through a balanced diet, rather than from taking supplements.

Before taking supplements, it is important that you speak to your doctor first, who can determine whether it is necessary for you to take such supplements or not. Eating a balanced diet will not only assist your healing process but also help you lose weight or maintain a healthy weight, which relieves your heels.

Can Plantar Fasciitis Cause Complications?

When the condition is left untreated, it can lead to chronic heel pain, which can change the way that you walk and increase the risk of an injury to the knees, legs, hips, or back. Some treatment options, such as corticosteroid injections, can weaken the plantar fascia ligament, which increases the risk of a rupture of the ligament. Surgery is also connected to some side effects, amongst which reactions to anesthesia, bleeding, and infection. Detaching the plantar fascia can also cause nerve damage and permanent changes in the foot.

What Is the Outlook for Plantar Fasciitis?

In most cases, plantar fasciitis patients are able to get treated without the need for surgery but use physical therapy, home treatments, and other medical treatments instead. Depending on the individual, the severity of the damage, and the treatment used, symptoms might take from a couple of months and up to two years to improve.