Causes, incidence, and risk factors
Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult.Risk factors for plantar fasciitis include:
- Foot arch problems (both flat feet and high arches)
- Obesity or sudden weight gain
- Long-distance running, especially running downhill or on uneven surfaces
- Sudden weight gain
- Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
- Shoes with poor arch support or soft soles
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.
Symptoms
The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn.The pain is usually worse:
- In the morning when you take your first steps
- After standing or sitting for a while
- When climbing stairs
- After intense activity
Signs and tests
The doctor will perform a physical exam. This may show:- Tenderness on the bottom of your foot
- Flat feet or high arches
- Mild foot swelling or redness
- Stiffness or tightness of the arch in the bottom of your foot.
Treatment
Your doctor will usually first recommend:- Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation
- Heel stretching exercises
- Resting as much as possible for at least a week
- Wearing shoes with good support and cushions
- Apply ice to the painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days.
- Try wearing a heel cup, felt pads in the heel area, or shoe inserts.
- Use night splints to stretch the injured fascia and allow it to heal.
- Wearing a boot cast, which looks like a ski boot, for 3-6 weeks. It can be removed for bathing.
- Custom-made orthotics
- Shockwave Therapy
- Steroid shots or injections into the heel
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