Plantar Fasciitis or Heel Pain

Plantar Fasciitis (pronounced as “PLAN-ter: fash-ee-EYE-tus”) is perhaps the most common cause of heel pain. It is commonly misplled as Plantar Fascitis.

It gets it’s name from “plantar fascia” – a flat band of tissue (ligament) that connects your heel bone to your toes which supports the arch of your foot. With the passage of time if  plantar fascia tissue gets strained, it eventually becomes worn out and inflamed. Therefore your heel hurts when you stand or walk after a break. Plantar fasciitis is commonly found in middle-aged people. It can also occurs in younger people who are constantly on the move, especially athletes or soldiers. The pain might manifest in one feet or both.

What is Plantar Fasciitis?

Do you suffer from heel pain?

Does your heel hurt when you wake up from your sleep and take your first step?

If yes, it is most likely that you are suffering from Plantar Fasciitis.There are a wide variety of conditions that can cause foot and heel pain but I am going to be talking about Plantar Fasciitis which is the most common cause of heel pain. This is one among those health conditions which most of the people will go through at some point of time in their lives.

The Symptoms of Plantar Fasciitis:

The symptoms of plantar fasciitis are classical.

When you start to move after a period of rest, that is after sleep or sitting for a while; your heel hurts. And, usually after taking a few steps the pain disappears. In chronic cases, the pain will be there throughout the day but it intensifies more on walking. This condition is caused because there is a soft tissue which is called plantar fascia which forms the arch of the foot. It contracts abnormally while at rest and then when you put weight on your foot this tissue stretches and causes pain. Plantar fascia originates from the heel bone that is why the pain feels like it is originating from the bone itself and going up your leg. The pain can extent to the sole of the foot along the fascia. It is a idiopathic disease.

Diagnosis of Plantar Fasciitis:

Clinically, most of the cases of plantar fasciitis can be diagnosed. It can be either bilateral or unilateral but, usually one is more painful than the other. An X-Ray is sufficient to confirm the condition. On the X-Ray, a thorn-like bony growth is seen.  There isn’t much to worry as it is just a bony out-growth due to repeated pulling of plantar fascia by the heel bone.

There are two investigations that you should not miss. One is to check your Serum Uric Acid level and Blood Sugar level as well as the RA factor. Most of the cases are know to be associated with elevated Uric Acid or diabetes. Plantar Fasciitis is usually a harmless self limiting disease which gets cured by itself in 3 to 6 months, but if you have diabetes or high Uric Acid it can take up to 1 – 2 years or even longer to get relief from heel pain.

What to do if you have Plantar Fasciitis?

Using soft shoes, that is, shoes with insoles which are soft will provide some relief and comfort. Heel inserts are quite inexpensive. I always prefer a good sports shoe like Sketchers or Nike etc. because they do enough gait analysis while making them. Remember to have light weight shoes with good grip. Avoid formal leather shoes, if your job permits.

Stretching your foot and ankle is the main modality of treatment especially after a period of rest. Keep your plantar fascia stretched. There are night splits available in the market but I believe they are unnecessary.

Try to keep your foot warm by not exposing them to cold. A short course of anti- inflammatory medication can really help one recover fast at the initial phase itself before the inflammation becomes chronic, leading to months of suffering. Try not to walk on bare foot especially at home and also avoid walking a lot on slippery, smooth surfaces especially the kind that you find in the malls or hotels as it really stresses the plantar fascia.

If there is no relief for more than three to six months you can opt for a local steroid injection if the pain is intolerable. But this is not really advisable considering the ill-effects of steroids. It truly works like a magic shot. You will have pain for 2 days post injection and then the pain disappears like magic. However it can recur after 3 to six months and you would have to re-take another injection. This is of course associated with some local complications, and more than 3 injections is not recommended in the same heel. Avoid it if you can.

Extra corporeal shock wave therapy has some benefits. There are even surgical options available but I don’t believe it will reach to that extend.The most important thing for you to remember is that it is a self limiting disease and you should wear a good foot wear and practice stretching. It is also important to get your diabetes and Uric Acid under control.

Image Credits: Esther Max Via (No changes have been made to the original)

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