Plantar Faciitis: The Signs, Symptoms and Treatment

Your foot and ankle are made up of 26 bones, 33 joints, and more than 100 tendons. The heel is the largest bone in your foot. If you overuse or injure your heel, you may experience heel pain. Plantar fasciitis is the most common cause of heel pain, but it can also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst. Because there are several possible causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities to determine the underlying source of your heel pain.

Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. Faulty structure of the foot is the most common cause of planar fasciitis. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet.

Symptoms of plantar fasciitis include:

• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that is usually worse upon arising
• Pain that increases over a period of months
• Swelling on the bottom of the heel

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process, the surgeon rules out all possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies, such as x-rays or other imaging modalities, may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.

Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. Treatment of plantar fasciitis begins with basic remedies, which you can begin at home. These remedies include, stretching exercises, avoiding going barefoot, ice therapy, limiting strenuous activities and shoe modifications. If you continue to experience pain after several weeks, see your foot and ankle surgeon for further treatment options.