Plantar Fasciitis — Symptoms, diagnosis, and treatment

People of all ages are susceptible to the prevalent foot condition known as plantar fasciitis. Inflammation of the plantar fascia, a substantial band of tissue that spans the sole of your foot and links your heel bone to your toes, is one of its defining characteristics. 

It is challenging to walk or stand for extended periods when this ailment affects the heel or arch of the foot. We’ll examine plantar fasciitis in more detail in this post, along with its signs, causes, and available treatments.

What causes plantar fasciitis?

Inflammation of the plantar fascia, a thick band of tissue that spans the sole of your foot and links your heel bone to your toes, causes plantar fasciitis [1].

The issue may result from overuse injuries to the plantar fascia, such as those sustained from jogging, standing still for extended periods, or wearing improperly fitted shoes.

The probability of getting plantar fasciitis can also be increased by being overweight, having flat feet or high arches and indulging in strenuous foot-related activities like jogging or jumping.

What causes plantar fasciitis?
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Who is at risk for developing plantar fasciitis?

Anyone can get plantar fasciitis, but certain things can make you more likely to get it. Plantar fasciitis is more likely to occur in those who are overweight, have flat feet or high arches, or participate in strenuous foot-related activities like jogging or jumping [2]. 

Wearing uncomfortable footwear that does not offer enough support may also raise the chance of acquiring the illness. Although it can affect persons of any age, plantar fasciitis is more prevalent in middle-aged and older folks.

Symptoms of plantar fasciitis

Pain and stiffness in the arch or heel of the foot are the main symptoms of plantar fasciitis. The discomfort is typically at its worst in the morning or after a long rest, such as prolonged sitting or standing. 

There may also be additional signs of plantar fasciitis, which are:

Pain in the foot

Foot discomfort is the most typical sign of plantar fasciitis. Although the arch of the foot can also experience pain, the pain is typically felt in the heel.

The discomfort may be described as a mild ache, severe, or stabbing. It is typically at its worst in the morning or after a lengthy rest, such as prolonged sitting or standing.

Stiffness

People with plantar fasciitis may also experience foot stiffness and pain. It could be challenging to move or bear weight on your foot due to the stiffness. Usually, the stiffness is most noticeable in the morning or right after a period of rest [3].

Swelling

One such sign of plantar fasciitis is foot swelling. The region surrounding the foot’s heel and arch is often where the edema is concentrated. It may be difficult to wear shoes or stand for extended periods due to the swelling.

Tenderness

Tenderness in the foot may potentially be a symptom of plantar fasciitis. It is often felt when pressure is given to the bottom of the foot, especially in the region between the heel and arch.

It may be painful to walk or put weight on the afflicted foot because of the discomfort.

Pain after exercise

The fact that the discomfort is frequently greater after an activity is one of the peculiar characteristics of plantar fasciitis.

This is because exercise may strain a plantar fascia that is already irritated.

People who have plantar fasciitis might find that after running, jumping or doing other high-impact activities, their pain gets worse.

Difficulty walking or standing

Plantar fasciitis can make it more challenging to walk or stand for extended periods [4].

Putting weight on the afflicted foot may be unpleasant because of the discomfort and stiffness in the foot.

This may impact your ability to carry out common tasks like walking about the home, doing errands, or exercising.

How is plantar fasciitis diagnosed?

It’s essential to contact a doctor for an accurate diagnosis if you have pain or discomfort in your foot. Some of the diagnoses of plantar fasciitis are:

Physical examination

The physical examination of your foot is the first stage in diagnosing plantar fasciitis. In addition to asking about your symptoms and medical background, your doctor will check your foot.

They may ask you to explain the location and level of your discomfort while they search for inflammation-related symptoms like swelling or redness.

Imaging tests

Your doctor may occasionally request imaging studies to aid in diagnosing plantar fasciitis.

X-rays can be performed to rule out other disorders that might cause foot discomforts, such as stress fractures or bone spurs.

You can also utilize magnetic resonance imaging (MRI) to thoroughly examine the soft tissues in your foot, such as the plantar fascia.

Ultrasound

Another imaging method that can be utilized to identify plantar fasciitis is ultrasound. High-frequency sound waves are used in this method to produce photographs of the inside components of your foot.

Your doctor can use ultrasound to determine if the plantar fascia has thickened or inflamed.

Differential diagnosis

To rule out any further disorders that could be causing your foot discomfort, your doctor will also make a differential diagnosis.

This can apply to ailments like Achilles tendonitis, which is brought on by inflammation of the Achilles tendon or tarsal tunnel syndrome, which is brought on by compression of a nerve in the foot.

Treatment of plantar fasciitis

Depending on how severe the issue is, there are several non-invasive and minimally invasive therapy options for plantar fasciitis. The following are a few of the commonest treatments:

1. Rest and ice

Resting your foot and icing the injured region might help to decrease swelling and relieve discomfort.

Your doctor might advise avoiding high-impact exercises like jogging or jumping until your symptoms subside.

Resting your foot can help the plantar fascia recover and lessen the chance of additional injury.

2. Stretching and physical therapy

Physical therapy and stretching exercises can help your foot become more flexible and strong, lessening the chance of additional damage and easing discomfort.

Home stretching exercises and physical treatment with a certified physical therapist are also options.

Your physical therapist can demonstrate several exercises to help you build up the leg and foot muscles that support your plantar fascia.

3. Orthotics and arch supports

Orthotics and arch supports can help you shift pressure on your foot and provide your arch and heel more support [5].

A podiatrist or orthopedic professional may make custom orthotics; most pharmacies provide over-the-counter arch support.

Your plantar fascia will experience less stress and your overall foot health will improve if you wear orthotics or arch supports.

4. Medications

Ibuprofen and acetaminophen are two over-the-counter medications that can aid with pain relief and inflammation reduction.

Your doctor may occasionally advise corticosteroid injections to treat inflammation. These intramuscular injections can reduce pain and inflammation since they are given directly to the afflicted region.

medications
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5. Extracorporeal Shock Wave Therapy (ESWT)

High-energy shock waves are used in ESWT, a non-invasive therapy approach, to encourage healing in the injured region [6].

ESWT can assist in reducing inflammation and fostering the development of new tissue. Usually, patients that have not responded to conventional types of treatment are the only ones that receive this treatment.

6. Surgery

In extreme circumstances, surgery could be required to replace or remove damaged tissue. It is normally only advised when all other treatment options have failed.

Surgery can help reduce discomfort and enhance foot function, but a lengthy recovery is sometimes required.

Although plantar fasciitis can be painful and disabling, most people can effectively manage their symptoms and resume regular activities with the right treatment plan.

Rest and ice, physical therapy and stretching, orthotics and arch supports, medication, extracorporeal shock wave therapy and surgery are all possible treatments for plantar fasciitis. 

Working with your doctor can help you choose the best course for your requirements.

Most people with plantar fasciitis may effectively manage their symptoms and return to their regular daily activities with the correct treatment plan.

Can plantar fasciitis be prevented?

Taking basic steps can frequently avoid plantar fasciitis or at least lessen its symptoms. Here are some recommendations for avoiding plantar fasciitis:

  • Put on shoes that fit properly and offer sufficient foot support.
  • Avoid high-impact sports like sprinting or leaping that put a lot of strain on your feet.
  • Regularly stretch your legs and feet to increase flexibility and lower your chance of injury.
  • To ease the strain on your feet, maintain a healthy weight.
  • Take pauses to stretch and move about during long periods of standing or sitting.
  • Consider adopting orthotics or arch supports to give your feet more support.

By heeding these recommendations and taking proper care of your feet, you may lower your chance of acquiring plantar fasciitis or, if you already have it, stop the symptoms from worsening.

Recovery time of plantar fasciitis

The time it takes to heal from plantar fasciitis varies depending on how bad it is and how well the therapy works.

Most persons with plantar fasciitis can anticipate noticeable improvement in their symptoms within a few weeks to a few months with appropriate therapy [7].

But for some people, recovering might take longer, particularly if their condition is severe or they have another health issue that makes treatment more difficult.

Factors affecting recovery time:

  1. The severity of the condition: The length of recuperation may depend on how serious the disease is. If the problem is slight, healing might go faster; if it’s severe, it might take longer.
  2. Age: The length of time it takes for plantar fasciitis to heal depends on age. Older folks may need more time to recover from the disease since their bodies slowly mend.
  3. Treatment plan: The time it takes for plantar fasciitis to heal might also depend on how well the treatment method works. The most efficient course of treatment for minimizing symptoms and accelerating healing frequently combines rest, ice, stretching exercises and medicine.
  4. Underlying health conditions: Recovering from plantar fasciitis may depend on any underlying medical conditions that impede the healing process, such as diabetes or peripheral neuropathy.

Can I still exercise if I have plantar fasciitis?

People with plantar fasciitis can typically still exercise, but adjusting your routine is important to prevent overstressing your feet.

Running or leaping exercises should be avoided until symptoms improve [8]. Your plantar fascia may experience a lot of strain from these activities, exacerbating the inflammation and slowing the healing process.

Low-impact exercises

These activities are a terrific way to keep healthy and active while putting less stress on your muscles and joints.

High-impact activities like running or jumping can aggravate plantar fasciitis symptoms. Therefore, affected individuals should pay special attention to these types of exercises. 

Here are some examples of low-impact workouts you may include in your fitness regimen:

1. Walking

This is a fantastic low-impact activity that can be performed inside and outside. Walking can strengthen your leg muscles, lower joint stress, and enhance cardiovascular health.

It’s vital to start your walks with lesser distances, gradually increase the length and intensity as your fitness level rises, and use the correct footwear.

2. Swimming

Another fantastic low-impact workout that can be done in a pool or on open water is swimming.

Swimming can help you build stronger muscles, enhance cardiovascular health, and put less strain on your joints. Your arms and legs’ flexibility and range of motion may both be enhanced by swimming.

3. Cycling

This low-impact workout may be performed either outside or on a stationary cycle. Cycling can strengthen leg muscles, lower joint stress, and enhance cardiovascular health.

Modifying your bike’s resistance and intensity is crucial to correspond to your fitness level.

4. Yoga

Another low-impact activity, yoga can help increase strength, flexibility, and balance. Yoga entails a sequence of postures held for a while and can be altered to meet your fitness level. Additionally, yoga can help with stress management and general well-being.

5. Pilates

Pilates is a low-impact workout similar to yoga, emphasizing core strength, flexibility, and balance.

A set of motions are used in Pilates, either on a mat or with specialized apparatus like a reformer. Pilates may be adjusted to your fitness level and can help you feel better by reducing stress.

Low-impact activities are a terrific way to keep healthy and active while putting less stress on your muscles and joints [9].

They can help you build stronger muscles, enhance cardiovascular health, and put less strain on your joints.

It’s crucial to begin softly and build up to longer, more intense workouts as your fitness level increases.

Preventive measures from recurring plantar fasciitis
Photograph: Satura/Envato

Preventive measures from recurring plantar fasciitis

Maintaining a healthy lifestyle and properly caring for your feet will help you avoid developing plantar fasciitis again.

Here are some recommendations for avoiding the recurrence of plantar fasciitis:

  1. Put on correctly fitting shoes:  Wearing shoes with enough cushioning and support can help avoid the recurrence of plantar fasciitis. Wearing out-of-date or improperly fitting shoes is not recommended.
  2. Stretch frequently: Regularly stretching your legs and feet can help you become more flexible and lower your risk of injury. Your doctor or physical therapist may suggest particular stretches that will increase the flexibility and power of your foot and leg muscles.
  3. Maintain a healthy weight: To lower the chance of recurrence, it’s vital to keep a healthy weight since being overweight increases the risk of getting plantar fasciitis.
  4. Avoid high-impact exercises: Exercises that pressure your feet, including sprinting or leaping, might increase your chance of developing plantar fasciitis. Avoid them or change your workout regimen to incorporate low-impact exercises like yoga, cycling, or swimming.
  5. Use arch supports or orthotics: By giving your feet more support and cushioning, arch supports or orthotics can help lower the chance of recurrence if you have flat feet or high arches.
  6. Rest and recover correctly: If you’ve previously experienced plantar fasciitis, it’s crucial to rest and heal correctly to avoid a recurrence. This can entail avoiding physical activity for a while, applying ice to the area and resting to minimize inflammation, and working with a physical therapist to create a safe and efficient training regimen.

Can plantar fasciitis lead to other foot problems?

Plantar fasciitis can cause other foot issues if not addressed or treated incorrectly. For instance, the plantar fascia cushions your foot as you walk, but when it is inflamed and uncomfortable, your stride may shift to lessen the force applied to your heel.

Other foot issues, including heel spurs, Achilles tendonitis, metatarsalgia (pain in the ball of the feet), and knee, hip or back discomfort, can result from this shift in stride [10]. 

In addition, stress fractures in the bones of your feet or toes may form if you continue to exert pressure on your foot. These fractures can be painful and need a lot of rest to heal.

To avoid any more difficulties or foot issues, it is crucial to seek medical care and start the right therapy as soon as possible if you feel you have plantar fasciitis.

When should I see a doctor for plantar fasciitis?

It’s crucial to contact a doctor for a correct diagnosis and treatment plan if you have plantar fasciitis symptoms, including pain in the heel or sole, stiffness, swelling or soreness.

Your doctor will consider your symptoms, medical history, and physical examination results to diagnose plantar fasciitis.

They could also prescribe imaging tests like an X-ray or an MRI to rule out other illnesses that might produce comparable symptoms.

If you are diagnosed with plantar fasciitis, your doctor might suggest a customized treatment strategy to meet your specific requirements.

Rest, ice, stretching routines, physical therapy, orthotics, medicine, extracorporeal shock wave therapy and surgery are all possible forms of treatment.

Most individuals with plantar fasciitis may effectively control their symptoms and return to their daily activities with the correct treatment plan.

Ask your doctor or another qualified healthcare provider for advice if you have any worries or questions about your foot pain. It might be more challenging to manage your health if you put off seeking care or ignore your symptoms.

Closing thoughts

Maintaining a healthy lifestyle and properly caring for your feet will help you avoid developing plantar fasciitis again. This includes avoiding high-impact activities that put a lot of strain on your feet, stretching frequently, wearing shoes that fit properly, and keeping a healthy weight.

Most individuals with plantar fasciitis may effectively manage their symptoms and return to regular daily activities with the correct treatment strategy and preventative measures.

You can keep your feet healthy and lead a pain-free lifestyle by caring for them and getting early medical assistance when necessary.

[1] https://www.hopkinsmedicine.org/health/conditions-and-diseases/plantar-fasciitis
[2] https://www.saintlukeskc.org/health-library/understanding-plantar-fasciitis
[3] https://www.physio-pedia.com/Plantar_Fasciitis
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951039/
[5] https://www.upstep.com/a/blog/benefits-of-wearing-arch-supports-for-your-feet-and-ankles
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275282/
[7] https://pubmed.ncbi.nlm.nih.gov/31194492/
[8] https://www.foot-ankle.com/blog/exercise-dos-and-donts-when-you-have-plantar-fasciitis
[9] https://www.thenationshealth.org/content/48/7/16
[10] https://www.thecenteroregon.com/medical-blog/what-happens-when-plantar-fasciitis-is-left-untreated

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