Common Causes of Foot Pain - Plantar Fasciitis
We often take our feet for granted.
That is... until something goes wrong with them.
Our feet are the foundation of our body and they take us where we want to go. When this vital body component is hurting, our mobility becomes problematic and it can negatively impact our body's structure and balance.
I see many patients with foot pain. In otherwise healthy individuals this problem is usually one of two problems: plantar fasciitis or Morton's Neuroma.
Part I of this two-part blog will discuss the cause, care and prevention of plantar fasciitis.
What is Plantar Fasciitis?
The plantar fascia functions to support the foot, which in turn supports the body. It draws beneath the foot like a bowstring. Imagine all the force that occurs on this small piece of tissue with each step and then imagine this times the thousands of steps we take each day. Indeed, the plantar fascia works a huge amount even in a typical day. Overuse or misuse can cause repeated microscopic tears in the plantar fascia leading to the chronic inflammation of plantar fasciitis.
Plantar fasciitis (pronounced "plan-tar fas-E-I-tis") involves inflammation and subsequent pain in the thick, band of tissue extending from the bottom of the heel bone and branching to the base of each toe.
Plantar Fasciitis Symptoms: The onset of discomfort is typically gradual and not associated with a defining injury. The pain itself is typically sharp and stabbing, located at the bottom of the heel. It may radiate into the arch. Often the pain is most excruciating with the first step out of bed in the morning. It may lessen as the day progresses and as the tissue limbers up. Plantar fasciitis is usually one-sided but can occur in both feet at the same time.
Plantar Fasciitis Risk Factors: Plantar fasciitis is most common in:
Plantar Fasciitis Causes: A cause in most cases of plantar fasciitis is usually not identified. Associated factors, however, may be present.
Shoe wear with inadequate support can also cause plantar fasciitis. Sometimes the shape of the foot causes the fascia to work extra in supporting the foot. When looking for a cause, I will often explore with patients any change that has occurred in the previous months which may have affected their ambulation (getting around) such as a new job, new shoes or an injury to another part of their body.
Plantar Fasciitis Treatment Options: Most cases of plantar fasciitis improve with conservative treatment over a few months. It does take time for that deep and chronic inflammation to subside.
Rest for Plantar Faciitis. Refraining from walking is, of course, not an option, but decreasing any overuse will help.
Stretching for Plantar Faciitis. Stretching the plantar fascia is also helpful, particularly in the morning. While in bed, it is possible to stretch the tissue before putting any weight on it by laying on the back and flexing the ankle, pointing the toes upward toward the nose.
Supportive Shoes for Plantar Fasciitis. Correcting any foot issues is also paramount. Get rid of those shoes that are harming the feet. Invest in supportive shoes (yes, you can find stylish shoes that accomplish this). In general, shoes are considered supportive if they are made of a durable material (like leather), have decent arch support, have at least four shoelace eyelets and have a durable heel cup.
Arch Supports for Plantar Fasciitis. If there is a defect in the foot, this should be corrected. Namely this involves getting arch supports, preferably rigid ones. I encourage patients to visit a reputable shoe store to be fitted for some generic arch supports. These help most of the time and are much less expensive than custom arch supports. If ineffective, custom arch supports may be required.
Anti-Inflammatory Medicine for Plantar Fasciitis. To help with pain, antiinflammatory medication may be taken.
Steroids for Plantar Fasciitis. For severe or refractory cases, steroid injections into the plantar fascia can be performed.
Surgery for Plantar Fasciitis. Surgery is considered the last resort in therapy.
Foot pain can be a definite nuisance, slowing us down and starting us down a path of unhealth. Plantar fasciitis is a common cause of foot pain.
Though there is not a quick remedy, conservative management with stretching, arch support and backing off any overuse/abuse will often bring relief.
Once improved, gradually resume activities and tend to the plantar fascia with proper stretching, arch support and shoes that are kind to your feet.
See your doctor if the condition worsens or fails to improve.
Part II of this topic will cover the other common cause of foot pain: Morton's Neuroma.