Introduction
Plantar fasciitis is one of the most common causes of heel pain, according to the American Academy of Orthopaedic Surgeons (AAOS). It can make walking, standing at work or your morning routine uncomfortable, so it helps to understand the causes, symptoms and treatment options.
This article gives an overview of plantar fasciitis and shares practical tips for managing it.
I. What is Plantar Fasciitis?
Plantar fasciitis is irritation and inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. This fascia supports the arch of the foot and absorbs shock when you walk or run. When it is overloaded or strained, it can become painful.
II. Causes and Risk Factors
In many cases, plantar fasciitis develops without one clear cause. The AAOS lists several factors that can raise the risk:
- •Foot shape: Flat feet or a high arch can put extra strain on the plantar fascia.
- •Age: Plantar fasciitis is most common in people aged 40 to 60.
- •Weight: Carrying extra weight can increase pressure on the plantar fascia.
- •Occupation: Jobs that involve long hours of standing or walking on hard surfaces can contribute.
- •Tight calf muscles: Tight calves can limit ankle movement and increase strain on the plantar fascia.
- •Activity changes: A sudden jump in walking, running or time on your feet can overload the tissue.
III. Symptoms
The most common symptom is pain on the bottom of the foot near the heel. According to the AAOS, it is often worst with the first few steps after getting out of bed or after a long rest, such as a long car ride, and usually eases after a few minutes of walking. Pain may also be worse after (not during) exercise.
IV. Diagnosis
A doctor usually diagnoses plantar fasciitis from your history and a physical exam. Imaging such as X-rays or MRI is sometimes used to rule out other causes of heel pain (AAOS). A manual osteopathic practitioner can assess how your foot, ankle and leg move, but does not diagnose medical conditions.
The NHS advises seeing a doctor if the pain is severe or stops you doing normal activities, keeps coming back or has not improved after 2 weeks of self-care, or if you have tingling or loss of feeling in your foot. If you have diabetes and foot pain, see your doctor, as foot problems can be more serious with diabetes.
V. Treatment Options
Most people improve with simple care. The AAOS says more than 90% of people with plantar fasciitis improve within 10 months of starting simple treatment. Options range from home care to medical procedures:
- •Rest: Cutting back on activities that make the pain worse, such as running or jumping, can help the tissue settle.
- •Ice: Rolling your foot over a cold water bottle or ice pack can ease pain.
- •Stretching and strengthening: Stretching the calf and the plantar fascia, and strengthening the muscles of the foot, can improve flexibility and reduce strain.
- •Supportive shoes and orthotics: Arch supports, whether custom-made or over the counter, can help spread pressure across the foot.
- •Manual therapy: Hands-on treatment of the foot, ankle and calf may help some people. In one small 2019 randomized trial of 63 people with plantar fasciitis, manual therapy, custom foot orthoses and the two combined all reduced pain and improved function over three months, with the manual therapy group improving most. It is one small study, so more research is needed.
- •Medications: Anti-inflammatory medicines such as ibuprofen may help with pain. Check with your doctor or pharmacist first.
- •Corticosteroid injections: In some cases, doctors may recommend an injection for short-term relief.
- •Surgery: Rarely, surgery is considered when other treatments have not helped after many months.
VI. Prevention
These habits may lower your chance of developing plantar fasciitis, or of it coming back:
- •Wear supportive footwear with good arch support and cushioning.
- •Keep to a healthy weight to reduce stress on the plantar fascia.
- •Warm up and stretch before activity, focusing on the calves and the bottom of the foot.
- •Increase the intensity and length of workouts gradually.
- •Replace worn-out athletic shoes.
- •Add strength exercises for the foot and lower leg to support the arch.
VII. When to See a Professional
If heel pain does not improve with rest and home care, or it keeps coming back, talk to your doctor or another qualified health professional.
Getting advice early can help you choose the right mix of care and get back to your usual activities sooner.
Dr. Raj Salaria, DOMP, is a manual osteopathic practitioner who sees patients at both our Chilliwack and Abbotsford clinics. Plantar fasciitis is one of the areas of focus listed on his profile.
VIII. Conclusion
Plantar fasciitis is common and can be painful, but most people improve with time and simple care. Understanding the causes, symptoms and treatment options can help you take sensible steps and lower the chance of it returning.
If heel pain is getting in the way of your day, you can book manual osteopathic therapy at our Chilliwack or Abbotsford clinic. You do not need a referral to book with us, though some extended health plans ask for one before they reimburse a claim. Session lengths vary. Fees vary by practitioner. Confirm the fee when you book. Direct billing depends on the practitioner. Ask when you book.
Resources
- •AAOS OrthoInfo: Plantar Fasciitis and Bone Spurs
- •NHS: Plantar fasciitis
- •Manual therapy, foot orthoses or both for plantar fasciitis: a randomized trial (2019)
- •Journal of the American Osteopathic Association: Diagnosis and Management of Plantar Fasciitis
- •Practical Pain Management: Plantar Fasciitis, Diagnosis and Management
Plantar Fasciitis FAQs
Q1. How long does plantar fasciitis take to improve?
A1. It varies with how long you have had it and how you respond to care. Many people notice improvement within a few weeks of consistent care, but it can take several months to settle fully. The AAOS says more than 90% of people improve within 10 months of starting simple treatment.
Q2. Can plantar fasciitis cause pain in other parts of the foot or leg?
A2. The main symptom is heel pain, but it can also cause discomfort in the arch. Some people notice ankle, knee or hip discomfort because they change the way they walk to avoid heel pain.
Q3. Is it okay to keep exercising with plantar fasciitis?
A3. It usually helps to cut back on high-impact activities that make the pain worse. Low-impact options such as swimming, cycling or an elliptical machine can help you stay active without aggravating it. Check with a health professional before returning to full activity.
Q4. Can I prevent plantar fasciitis from coming back?
A4. There is no sure way to prevent it from returning, but you can lower the risk by keeping to a healthy weight, wearing supportive footwear, stretching and strengthening the foot and lower leg, and building up activity gradually.
Q5. Are there other treatments for plantar fasciitis?
A5. Besides the options above, some people try acupuncture, massage therapy or extracorporeal shock wave therapy (ESWT). Results vary from person to person and the research is mixed, so talk with a health professional before trying something new.
This article is general information, not medical or psychological advice. For advice about your situation, talk to a qualified practitioner.