What is Plantar Fasciitis?
Plantar fasciitis is a common disorder of the plantar fascia which is a thin ligament that stretches from the heel to the middle foot bones. It supports the arch of the foot and works as a shock absorber while walking. These ligaments can get damaged or inflamed, causing stiffness and pain in the heel. It is normally caused by overuse of the feet like standing for long hours, over exercise, weight or age. It is found to be more prevalent in persons with flat feet when there is excessive inward rolling of the feet. Plantar fasciitis is also associated with lack of physical exercise and overweight. Plantar fasciitis is a common condition which most people suffer sometime in their life. Earlier this condition was simply inflammation of the plantar fascia, but lately studies have revealed that structural changes in the ligament of the heel take place with the degenerative process with age.
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Symptoms of Plantar Fasciitis
Persons suffering from plantar fasciitis complain of pain and stiffness in the bottom of the heel. This pain develops gradually over a period of time. Some people complain of dull nagging pain while others complain of shooting sharp pain in the heel, still others complain a feeling of burning and aching on the bottom of the foot moving towards the heel. This pain is found to be worst in the mornings while getting out of bed, or on getting up after sitting or lying down for some time. As the heel becomes inflamed, the person finds difficulty in climbing stairs.
Other rare symptoms of plantar fasciitis are numbness, tingling, swelling or moving pain from the arch to the heel… If plantar fasciitis is left untreated and continues for a long time, the plantar fascia can rupture. The typical symptoms of rupture are a clicking sound, apparent local swelling and sharp pain in the sole of the foot.
Treatment of Plantar Fasciitis
The most important part of treatment of plantar fasciitis is to reduce the inflammation in the plantar fascia ligament.
Initial home treatment includes resting the feet and applying ice for 15 to 20 minutes three or four times a day to reduce the swelling. Reducing or changing of activity can also help in relieving the pain and reducing the inflammation.
If the pain persists for long, doctor must be consulted. He may give an injection of a corticosteroid directly into the damaged section of the ligament for instant relief.
Physical therapy is an important part of treatment for planter fasciitis.
Extracorporeal shock wave therapy is given when other methods do not work. It is done by throwing sound waves against the heel to treat the ligament
Surgery is the most dramatic therapy for plantar fasciitis, but is used in only severe cases. There are chances of the arch foot becoming weak after surgery.
Risk Factors of Plantar Fasciitis
Plantar fasciitis is a very common problem found in most people at some age or the other. With proper care, exercise and weight reduction, the condition can be managed easily.
- If plantar fasciitis is neglected one can develop a chronic heel pain. It can change the style of walking which may cause injury to knees, legs, back and hips.
- Steroid injections can weaken the plantar fascia ligament and cause potential rupture to it.
- Known risk factors for plantar fasciitis include excessive running, standing for long periods of time on hard surfaces, high arches, flat feet and ageing. The development of plantar fasciitis has close association with obesity in non-athletic people.
- Surgery carries the common risk of bleeding, reaction to anesthesia and infection.
- Improper footwear contributed to the development of plantar fasciitis.
- If the plantar fascia is detached, it can cause nerve damage and changes in the structure of the foot.
Diagnosis of Plantar Fasciitis
There are no clinical tests required to diagnose Plantar Fasciitis. Diagnosis of plantar fasciitis is based on patient’s history, risk factors and physical examination findings. It can be diagnosed by a doctor by physical examination of the foot. He will be able to pinpoint the exact location of the pain and also eliminate any other foot problem. The reflexes of the feet will help in determining the strength of the muscles and health of the nerves. The expert eyes of the doctor will also check the muscle tone, sense of touch, coordination of the feet and the balance of the feet.
X-rays or a magnetic resonance imaging (MRI) scan is done when physical examination does not reveal much. Imaging can be used to confirm some injury to plantar fasciitis or to rule out other heel pathology.
Ultrasonography is useful in ruling out soft tissue pathology of the heel
Magnetic resonance imaging MRI is a valuable tool for assessing causes of heel pain with detailed picture of the heel.
Exercise for Plantar Fasciitis
Regular, gentle exercises by stretching the Achilles tendon and plantar fascia may help to ease the symptoms of plantar fasciitis. In cases where plantar fasciitis has a slight tightness of the Achilles tendon exercises are very helpful.
Here are some effective exercises for plantar fasciitis—
- Stand on the bottom step of some stairs with legs apart and heels just off the edge of the step. Take support of the rails and lower the heels while keeping the knees straight and taking the stretch on the calves. Stay in this position for 30 seconds and then relax. Repeat six times.
- Sit on the floor with legs stretched in front. Loop a towel around heel of one toe. Pull the toes to the nose, keeping the knees straight. Hold in the same position for 30 seconds and then relax. Repeat it 2-3 times on the same foot and then repeat the same exercise with the other foot.