Plantar Fasciitis is one of the most common causes of heel pain. It involves inflammation of the plantar fascia, a fibrous band running along the length of the sole from the toes to the heel.
Symptoms of Plantar Fasciitis
Plantar Fasciitis can be experienced as a sharp or stabbing pain when standing up first thing in the morning or after resting/sitting. The pain generally reduces after a few minutes. Exercising and movement may give temporary relief, but the pain is often worse afterwards. It may be felt as a constant throb and dull ache towards the end of the day.
Causes of Plantar Fasciitis
The following things can cause plantar fasciitis:
- Being on your feet all day
- Taking part in sports or activities without warming up or stretching afterwards.
- A sudden increase in activity levels
- A sudden increase in weight
- Ill-fitting shoes which lack support will leave you more prone to plantar fasciitis. Walking barefoot or wearing flip-flops at home could also contribute.
- Excessively high foot arches or very flat feet can increase susceptibility.
- Research suggests that once you have experienced plantar fasciitis, you are more prone to repeated episodes.
How is Plantar Fasciitis Diagnosed?
Plantar fasciitis is diagnosed after a physical examination and discussion. Further tests are rarely required, but if they are, MRIs and Ultrasound tests are excellent for this condition.
Treatment for Plantar Fasciitis
Generally, the quicker you embark on a treatment programme the quicker you will experience relief. The more chronic the situation, the longer the treatment regime.
Gold Standard Treatment
If you want to get back on your feet and heal quickly, the optimum treatment for plantar fasciitis is Shockwave Therapy combined with laser therapy of the foot, heel, and lower leg areas. It usually takes weekly sessions over 4 to 6 weeks. Chronic conditions may take longer.
For the best results, this therapy would be accompanied by:
- Rest/adaptation of activities of daily living
- Footwear advice
- Orthotics (bespoke or off-the-shelf)
- Stretching programme
Do It Yourself
You can try and treat plantar fasciitis yourself. We recommend you see a podiatrist for footwear advice, orthotics (if appropriate), an exercise programme, and self-massage/manipulation practices. You can then implement these things at home, in your own time. Plantar fasciitis can take weeks or months to resolve via this method, but it should happen eventually.
Ongoing Problems with Plantar Fasciitis
Do you feel like you have tried absolutely everything? If so, maybe surgery is required. Usually, the above treatments will provide relief and people rarely resort to surgery. But if the worst happens, here is a little more information on the types of surgery that may help:
Gastrocnemius Recession: The surgeon will lengthen your calf muscle to reduce the pull/pressure on the plantar fascia.
Plantar fascial release: The surgeon will make tiny incisions in the plantar fascia to elongate it and reduce the tension on the fascia.
Other Possible Conditions
If you are experiencing heel pain it is recommended you see a professional for diagnosis as it could also be attributed to other things such as:
Stress Fracture – With stress fractures, usually the pain occurs alongside swelling, warmth, and redness around the heel, and it also hurts when non-weight bearing.
- Bone Infection – This is very rare and usually presents with other symptoms of infection, such as fever, muscle aches, and flu-like symptoms.
- Nerve Entrapment or Compression – A pinched or compressed nerve in the back could manifest as heel pain (known as Sciatica). Treatment of the heel will not help this type of pain – the source of the pain (in the back) needs to be addressed to relieve the heel pain. Alternatively, nerve entrapment in this area could be “Baxter’s Nerve” or “Tarsal Tunnel Syndrome” (symptoms such as tingling, numbness, or burning sensations).
- Loss of fatty pad under the heel – Unfortunately, as we age, we lose the fatty pad on the plantar surface of our feet. The heel is one such area. The lack of fatty padding acting as a cushion means our heels and forefoot become more painful to walk on. Treatment for this includes footwear choice (rubber-soled shoes) and/or orthotics with padding to reproduce the cushion, which makes walking more comfortable.
At Cutting Edge Podiatry in Cambridge, we’re available to help you with personalised advice and professional care for all your foot health needs.