Plantar Fasciitis: Symptoms, Causes, and Treatment

Evidence Based Article đź“„
This article has been based on relevant and up-to-date scientific studies. Our writers are unbiased and objective and present the facts as they are known. Numbers in brackets within the article refer to sources included in the reference list at the end of the article.

The inflammation of the plantar fascia ligament, plantar fasciitis is a condition triggered by a strain injury, which causes tiny tears to the ligament.

Plantar fasciitis is characterized by the pain in the bottom of the heel and require a special treatment to avoid the complications.

Chronic plantar fasciitis can turn into plantar fasciosis because of the plantar fascia avascular scarring.

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An intense pain occurs due to weak blood flow to the scarred tissues. Not to mention that plantar fasciitis causes a huge foot discomfort.

Read on to learn everything about this condition and how to treat it.

What’s plantar fasciitis?

The thick, web-like ligament connecting the front of the foot and the heel is called plantar fascia. It helps to support the arch of the foot, helping you walk properly.

The condition of plantar fasciitis usually causes a mild to intense pain in the heel’s bottom.

Plantar fasciitis is a widespread disease and is one of the biggest orthopedic complaints, but luckily, it can easily be treated.

Why does plantar fasciitis occurs, though? The thing is, the ligaments of your plantar fascia face tons of wear and tear on a daily basis.

These ligaments typically support the arch of the foot and act as the shock absorbers. When you place extra pressure on the feet throughout the day, it can lead to a tear or damage of the ligaments. When ignored, your plantar fascia gets inflamed, causing the heel stiffness and pain.

What are the major causes of plantar fasciitis?

People who are overweight or obese have a higher risk of developing plantar fasciitis than slimmer ones.

That’s because of the extra pressure placed onto the ligaments of the plantar fascia, particularly if you unexpectedly start putting on pounds. Pregnant women are at risk too, particularly if they frequently experience the plantar fasciitis bouts during the last trimester.

Athletes and people who spend a lot of time in the gym or runners can also face the problems with plantar fascia. You can also develop plantar fasciitis if you do a highly active job, which requires you to stand on your feet all work day, like being a restaurant server, chef, or working in a factory.

Scientists have conducted a number of studies that showed that active women and men who are 40 to 70 years old have an increased risk factor for the plantar fasciitis. They also concluded that women are more prone to this condition than men.

Both men and women with the structural foot issues like flat feet and fallen arches or very high arches, can also suffer from plantar fasciitis.

The tight Achilles tendons that attach the calf muscles to the heels have been shown to cause the plantar fascia issues, particularly a mild pain. Moreover, even wearing everyday shoes with poor arch support or soft soles can trigger the plantar fasciitis development.

Many people believe that plantar fasciitis is the result or consequence of a calcaneal spur. However, hundreds of studies have proven that a calcaneal spur doesn’t cause plantar fasciitis.

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A calcaneal spur is the hook of the bone forming on calcaneus, or the heel bone of the foot. 1 in 10 people suffer from a calcaneal spur, yet 1 in 20 people with a calcaneal spur experiences the pain, according to the American Association of Orthopaedic Surgeons.

What are the major symptoms of plantar fasciitis?

Since the symptoms of plantar fasciitis is often mistaken with the symptoms of other foot-related illnesses and conditions, sometimes even doctors have trouble to set a correct diagnosis without specific tests.

The pain on the bottom of the heel is considered the biggest complaint of people diagnosed with plantar fasciitis. However, some patients suffer from an intense pain at the bottom of the mid-foot area.

The symptoms of plantar fasciitis develop and show up gradually. It typically affects only one foot, even though both feet can be affected too.

The pain caused by plantar fasciitis is usually dull, albeit several patients reported a sharp pain in the heel area. There are also people with plantar fasciitis who experience a burning sensation or pain in the bottom area of the foot, which extends outward or upward from the heel.

In most cases, the pain gets more intense in the morning or if you have been lying down or sitting for a long period of time. People with plantar fasciitis usually have difficulty climbing the stairs because of the heel stiffness and pain.

The pain can also become more intense after certain prolonged activities like running or standing.

This is because of chronic inflammation. Some people with plantar fasciitis don’t experience any pain at all, which is why they often ignore the problem and experience some complications. In this case, a discomfort in the heel area can be a sign of plantar fasciitis or any other foot-related condition.

How is it diagnosed?

It’s important to see a doctor if you feel the pain or discomfort in your foot. The doctor performs a physical exam of the foot and checks the tenderness in the area where the pain occurs.

Generally, it helps a doctor to find out that the pain is the result of plantar fasciitis, but not some different foot issues.

During the examination, you may need to flex the foot as your doctor presses on the plantar fascia to check whether or not the pain becomes more intense when you flex or relieves when you point the toe. Any mild swelling or redness may indicate plantar fasciitis.

A doctor also evaluates the health of the nerves and the strength of the muscles by checking muscle tone, reflexes, coordination, a sense of sight and touch, and balance.

In some cases, an MRI scan or an X-ray may be required to check out that there’s no other foot-related disease that might be causing your heel pain. The bone fracture often triggers the heel pain and can be confused with plantar fasciitis.

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How to treat plantar fasciitis

The most critical part of the plantar fasciitis treatment is to fight inflammation in the plantar fascia ligament. Though, if there’s the underlying damage caused to the ligament, you may need a medical treatment.

However, if the symptoms of plantar fasciitis are mild, your doctor may suggest you to start your treatment at home.

Home treatment

Home treatment involves giving your feet a lot of rest and applying ice packs for 10 to 20 minutes, depending on the intensity of the pain, 3 to 4 times during the day for several days or a week. Cold therapy will help you alleviate your foot swelling and keep the heel pain at bay.

If you exercise each day, you’ll need to change your workout routine and keep it as simple as possible. Stretching exercises are effective in treating plantar fasciitis. Wearing the shoes with a good arch support is necessary for the pain reduction.

You’ll also need to incorporate foods that help to fight inflammation, such as olive oil, tomatoes, nuts like walnuts and almonds, fruits and berries like blueberries, strawberries, oranges, and cherries, fatty fish such as mackerel, salmon, sardines, and tuna, and green leafy vegetables like collards, kale, and spinach.

Avoid eating foods that trigger inflammation, such as meat, sugar-sweetened beverages, fried foods, refined carbohydrates like pastries and white bread, shortening, margarine, and lard.

Non-steroidal anti-inflammatory medications like ibuprofen or naproxen helps to eliminate inflammation and pain in the ligament.

You can also use lavender essential oil to fight inflammation. This essential oil boasts powerful anti-inflammatory abilities that aid in relieving the pain caused by chronic inflammation.

Dilute 1-2 drops of lavender essential oil in the carrier oil like coconut or olive oil, and massage the mixture into the heel. Or add 4 to 6 drops to a lukewarm foot bath and soak your feet for 10 to 15 minutes.

If your plantar fasciitis is caused by your weight, consider losing it. Oftentimes, that’s the best way to alleviate plantar fasciitis without harsh medications.

Carrying a lot of weight places extra pressure on the plantar fascia, causing a number of foot-related problems, including plantar fasciitis. Talk to your doctor to figure out the way you can shed pounds without ruining your health. A rapid weight loss can lead to more serious complications, so plan to lose weight gradually.

Medical treatment

When a home treatment doesn’t bring the relief and the anti-inflammatory medications don’t help to reduce the pain, your doctor may prescribe you the injections of a corticosteroid, which is injected right into the affected area of the ligament.

Don’t try to do these injections at home as the usage of an ultrasound device is required to find out the safest area for these injections.

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Doctors also use corticosteroids to apply onto the skin of the arch of the foot or the heel, and then use a painless electrical current to allow the steroids to pass through the skin into the muscle.

Injections aren’t the only part of the medical treatment. Physical therapy can also be needed to treat plantar fasciitis. The therapy helps to stretch the Achilles tendons and plantar fascia, reducing the pain.

You may also be required to do a range of exercises that aid in strengthening the muscles of your lower leg.  Regular physical therapy helps to reduce the workload and pressure on your plantar fascia and stabilize your walk.

If the pain gets worse and other medical methods don’t help, an extracorporeal shock wave therapy may be applied. This therapy involves bombarding your heel with sound waves to enhance the healing process within the ligament.

But since this therapy has many side effects, doctors turn to it in rare cases. The possible drawbacks are swelling, bruises, numbness, and a severe foot pain. The therapy hasn’t been scientifically proven to help in treating plantar fasciitis for good.

When you don’t treat plantar fasciitis, the symptoms can worsen and a surgery may be required to treat them. A surgery is performed in cases with increasingly severe pain.

The surgery involves detaching the plantar fascia partially from the heel bone. The procedure can weaken the foot arch and negatively impact a full function of it. The lengthening of the calf muscle is another surgery that can help to treat plantar fasciitis.

The surgery is called a gastrocnemius recession and is applied in very rare cases. A surgery is usually needed when patients with plantar fasciitis ignore the early signs of the condition and develop the complications associated with it.

What are the complications of plantar fasciitis?

If you fully ignore the symptoms of plantar fasciitis or treat in in a wrong way, you may gradually start experiencing the possible complications of this condition.

Not only can it change the way you move, but also can cause a serious injury or damage to your back, hips, knees, and legs.

Home treatments, steroid injections, and special orthotics can cause the potential ligament rupture and weaken the plantar fascia ligament.

A surgery can cause reactions to anesthesia, infection, and bleeding, but it may be required to treat the complications of plantar fasciitis. The detachment of the plantar fascia can lead to the nerve damage and drastic changes in your feet. The gastrocnemius recession might also lead to the nerve damage.

The best way to avoid all the complications is by treating the early symptoms of plantar fasciitis with a help of home treatment.

When treated on time and in a natural way, plantar fasciitis doesn’t possess any life-threatening complications. As soon as you get rid of this foot problem, it may not reoccur in the future.