Plantar fasciitis is the bane of athletes everywhere and one of the most common orthopedic complaints. This condition results in either sharp or dull heel pain with every step you take. Other symptoms of plantar fasciitis include heel swelling and heel stiffness. Although several treatments for plantar fasciitis have been tried, there is no definitive treatment for this condition.
About Plantar Fasciitis
The plantar fascia is a thick band of fibrous tissue that stretches like a fan from your heel (calcaneus) to your toes. The plantar fascia forms the arch of the foot and covers the bones at the bottom of the feet.
When the plantar fascia is overstretched or overused, it loses its resiliency, and swelling and heel pain result. More specifically, continued stress on the plantar fascia results in microtears that cause pain. These microtears are often accompanied by heel spurs (bony outgrowths), tissue changes and vascular changes. Of note, heel spurs don't cause the heel pain of plantar fasciitis, and many people with heel spurs have no heel pain at all.
The pain of plantar fasciitis is exacerbated by walking and is usually worse in the early morning hours after you wake up.1 After you walk for a while, the pain may subside, but once you start walking again, the pain recurs. This heel pain is further exacerbated by vigorous exercise and climbing stairs.
In addition to exercise and overuse (think long-distance walking or running), several other factors may contribute to the development of plantar fasciitis including the following:2
shoes with improper support or soft soles
weight gain (especially rapid weight gain)
a tight Achilles tendon
a discrepancy in leg length (one leg is longer than the other)
previous injury to the heel
recent change in activity
Although plantar fasciitis is common among athletes like runners, it can affect anybody. Most commonly, plantar fasciitis affects men between 40 and 70 years old.3
Many people with this condition present to their physicians early during this course of illness seeking relief. More than 90% of people with plantar fasciitis will improve within 10 months of beginning nonsurgical treatment.1 Although rarely needed, surgery for plantar fasciitis can be done when the pain persists and non-surgical interventions fail.
Here are some treatments for plantar fasciitis:1
icing the area
orthotic supports like heel cups, felt pads, or shoe inserts
joint and soft tissue mobilization (plantar-stretching exercises as well as ankle and calf stretches)
pain medications (ibuprofen and acetaminophen)
injection of botulinum toxin (Botox;
extracorporeal shock wave therapy (ESWT)
Plantar fasciitis is typically treated in a step-wise fashion beginning with joint and soft tissue stretching, pain medications and orthotic supports. Data from research studies suggest that steroid injections are most effective at providing short-term relief of acute plantar fasciitis.4
For longer-term relief, stretching and joint exercises can help. Furthermore, treatments for plantar fasciitis can also be combined with extracorporeal shock wave therapy, where sound waves are directed at the plantar fascia. These sound waves result in palliative pressure.
A Word From Verywell
If you or a loved one suffers from heel pain and suspect plantar fasciitis, it's a good idea to make an appointment with your physician and have them check it out. Moreover, there are things you can do to prevent plantar fasciitis from regularly stretching your plantar fascia and exercising in moderation.