Plantar fasciitis is one of the most common causes of heel pain, resulting from inflammation of the plantar fascia - a thick band of tissue that runs across the bottom of the foot, connecting the heel bone to the toes. This condition often causes sharp, stabbing pain near the heel, especially during the first steps in the morning or after periods of inactivity. While it is more common in athletes, runners, and individuals who spend long hours on their feet, plantar fasciitis can affect people of all activity levels.
Symptoms
The symptoms of plantar fasciitis can vary in severity but typically include:
- Heel pain on first steps in the morning: Pain is often most severe during the first few steps after waking up or after long periods of sitting.
- Stabbing or burning sensation: A sharp, localized pain is usually felt in the heel or along the arch of the foot.
- Worsening pain after activity: Pain often increases after, not during, exercise or prolonged standing.
- Localized tenderness: Tenderness is felt when pressing on the heel or along the plantar fascia.
- Stiffness: Reduced flexibility of the foot, particularly after periods of rest.
Causes
Plantar fasciitis develops when the plantar fascia experiences excessive strain, leading to microtears and inflammation. Common contributing factors include:
- Overuse: Repetitive strain from running, dancing, or prolonged standing.
- Foot mechanics: Flat feet, high arches, or abnormal walking patterns can put extra stress on the plantar fascia.
- Improper footwear: Shoes with poor arch support or inadequate cushioning.
- Obesity: Excess body weight increases pressure on the plantar fascia.
- Age: More common in individuals between 40 and 60 years old.
- Occupational strain: Jobs requiring long hours of standing or walking on hard surfaces.
Treatments
Treatment for plantar fasciitis typically focuses on reducing pain, inflammation, and strain on the plantar fascia. Common medical and physiotherapy options include:
- Rest: Limiting activities that worsen the pain, allowing the fascia to heal.
- Ice therapy: Applying ice packs to the heel for 15–20 minutes several times a day to reduce inflammation.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen to ease pain and swelling.
- Stretching exercises: Targeted stretches for the Achilles tendon and plantar fascia to improve flexibility.
- Orthotics: Custom shoe inserts to support the arch and reduce strain.
- Night splints: Devices that keep the foot flexed overnight to stretch the plantar fascia.
- Physical therapy: Strengthening and mobility exercises under the guidance of a physiotherapist.
- Corticosteroid injections: Used in severe cases for short-term relief.
- Shockwave therapy: High-energy sound waves to stimulate healing in chronic cases.
- Surgery: Rarely required, considered only after 6–12 months of failed conservative treatment.
Home Remedies
Many cases of plantar fasciitis improve with self-care measures at home, such as:
- Regular stretching: Stretching the calf muscles and plantar fascia several times daily.
- Foot rolling: Rolling the arch over a frozen water bottle or tennis ball to massage and reduce tension.
- Supportive footwear: Wearing shoes with good cushioning and arch support, even at home.
- Avoiding barefoot walking: Minimizes strain on the fascia, especially on hard surfaces.
- Weight management: Maintaining a healthy weight to reduce stress on the feet.
- Alternate ice and heat therapy: Ice for inflammation and heat for improving blood flow.
Care and Prevention
Once symptoms improve, it’s important to continue preventive measures to avoid recurrence:
- Gradual activity increase: Avoid sudden increases in activity intensity or duration.
- Maintain flexibility: Continue stretching exercises for the calves and arches daily.
- Rotate shoes: Avoid wearing worn-out footwear and alternate between pairs for better support.
- Use proper technique: If running or exercising, ensure correct posture and movement patterns.
- Listen to your body: Reduce activity at the first sign of heel discomfort.
When to See a Doctor
Seek medical attention if:
- Pain persists despite several weeks of home care.
- Pain is severe and affects daily activities.
- There is swelling, redness, or numbness in the heel.
- You experience pain in both feet or in other joints.