Have you been struggling with that dull but annoying pain in your heel that only seems to be worsening? The kind of pain that stretches across the arch of your foot and forces you to hobble all day? The underlying culprit might be plantar fasciitis.
Plantar fasciitis remains one of the most common causes of heel pain in adults. Don’t know much about this very prevalent foot condition? Keep reading the article to understand plantar fasciitis, its causes, diagnosis, and treatment.
Understanding Plantar Fasciitis
To understand what plantar fasciitis is, let’s first talk a bit about the anatomy of your foot. The human foot has a long, thin ligament called the plantar fascia that lies next to the skin on the bottom. The purpose of this ligament is to connect your heel to the front of your foot while supporting the arch. This fascia has been naturally designed to absorb all the strains and stresses you put on your foot while running, walking or playing sports. However, there is a limit to what it can bear and the minute it goes under too much pressure, the fascia tissue tears apart. The wear and tear triggers the body’s natural response to inflammation, leading to stiffness and pain related to plantar fasciitis.
While anyone can get plantar fasciitis at any point in life, you are at a higher risk if you are:
- Between 40 to 60 years old
- Walking on the inside of your foot
- On your feet for longer durations, more likely on hard surfaces
- Having flat feet, high arches, or a tight Achilles tendon
- Habitual of wearing ill-fitted shoes
What Is It Like To Have Plantar Fasciitis?
Plantar fasciitis may not have any obvious symptoms on the outside; it can be extremely uncomfortable and painful for the person experiencing it. The most common manifestation is heel pain, sometimes extending to the foot's arch.
In general, everyone experiences plantar fasciitis a bit differently from others. However, the most common symptoms may include the following:
- Dull, stabbing, or sharp pain in the heel
- Stiffness and pain that is more severe when you move after a rest period
- Burning or aching sensation extending from the heel to the entire bottom of the foot
- An increase in pain intensity as the day goes on, especially if it involves a lot of walking or standing
Diagnosing Plantar Fasciitis
A podiatrist is an expert with speciality training in diagnosing and managing foot and ankle conditions, such as plantar fasciitis. This may begin with a physical foot examination to clinically confirm a diagnosis. They may ask you to walk around and stand for some time to observe how your foot responds. Additionally, they usually conduct a general assessment to enquire about:
- Your current and past medical history, including all injuries and illnesses
- Your level of activity and exercise per day
- The location of pain and severity
In most cases, x-rays are unnecessary as plantar fasciitis normally involves ligament inflammation instead of bony injury/ However, depending on the symptoms, x-rays may be ordered in case a podiatrist believes that the pain stems from an underlying stress fracture, plantar bone spur, etc.
Is Plantar Fasciitis Manageable at Home?
For most people, plantar fasciitis takes around 6 to 12 months to heal. In the meantime, the following are some tips to follow to ease pain and promote healing:
Keeping weight off your foot as much as possible is important for healing and lowering inflammatory levels.
Pain Relief Medications
If your plantar fasciitis is too painful, consider taking a nonsteroidal anti-inflammatory drug (NSAIDs) like ibuprofen or supplemental turmeric to manage the pain. Make sure not to take NSAIDs persistently for too long, as it can easily lead to stomach ulcers and internal bleeds. Turmeric is safe for longer term use as long as it does not conflict with any of your medications.
Wrap a pack of crushed ice or frozen vegetables in a towel and place it on your heel for 15 to 20 minutes. Repeat the practice up to 4 times a day to bring down swelling and manage pain. Alternatively, take a shallow pan and fill it with cold water. Soak your heel in it a few times daily for 5 to 10 minutes. Feel free to keep your toes out of the water. If none of the remedies works well for you, take a paper cup, fill it with water, and put it in the freezer. Get rid of the ice that forms in the center and apply the frozen cup on your heel for up to 10 minutes. Remember to never put ice directly on your heel whichever method you choose for cold therapy.
Stretching and Exercise
Consider stretching your Achilles tendon, the bottom of your foot, and calves regularly with easy-to-perform exercises. These exercises can ease pain, stabilize the ankles, and heal plantar fasciitis.
Also known as orthotics, arch supports, or insoles, shoe inserts provide added support and extra cushion to the foot. These inserts are easily available over the counter but can also be custom-made to fit individual needs. Make sure to choose a firm one that provides good arch support.
An athletic tape can support the foot and prevent it from moving in a way that exacerbates the symptoms of plantar fasciitis. Some providers even specialize in athletic taping.
Whenever you take a step, your heel pounds the ground and exerts pressure on the plantar fascia, which only worsens the symptoms of plantar fasciitis. To minimize this pressure, try wearing heel-shaped pads in your daily shoes. These pads can elevate your heels and save them from direct pressure by cushioning them. While heel cups may not work as well as shoe inserts, they can be a much more affordable option.
Walking Boot or Cast
Also known as a controlled ankle motion (CAM) walker, a walking cast and boot is recommended for people who do not respond to other modes of treatment. This cast forces an individual to rest their foot which, in turn, relieves pain. However, remember that a CAM walker only provides temporary symptomatic relief and is not a permanent cure.
Most people sleep with their feet pointing downward, which can shorten the Achilles tendon and plantar fascia. To keep the feet at a 90-degree angle, consider wearing night splints that stretch the plantar fascia considerably. Some people find these splints too bulky; however, they can work well and provide good pain relief.
When to Visit a Doctor?
If none of the above mentioned remedies has worked well for you and you are still in considerable pain and discomfort, try visiting a doctor. Depending your individual case, a professional may suggest:
Shock Wave Therapy
This therapy involves delivering high- or low-energy shock waves to the specific area to create a microscopic trauma. This trauma activates the body's healing response, promoting plantar fascia recovery.
If the painful symptoms of plantar fasciitis continue after a few months, a doctor may recommend getting steroid injections to reduce inflammation.
Surgical intervention is usually the last resort for people who fail to respond to home remedies, shock wave therapy, and steroid injections for the past 12 months. The type of surgery to be performed varies case-by-case.
Is Preventing Plantar Fasciitis Possible?
If you have just recovered from an episode of plantar fasciitis or are at a high risk of developing it, there are certain things you can do to prevent the condition. These include the following:
Roll your foot on a tennis ball
There is no need to spend a ton of money on equipment. You can use a small ball or even a tennis ball to massage and roll along the bottom of your feet. While seated, slowly apply pressure to the bell and roll your foot back and forth along it. Do this two to three times daily for about 30 seconds.
Overweight or obese people put more pressure on the bottom of their feet and are more vulnerable to tearing their plantar fascia. Hence, try losing weight by adopting healthy dietary habits and regular exercise routines where possible.
Indulge in low-impact exercise
Activities like cycling and swimming are low-impact exercises and very unlikely to cause or worsen plantar fasciitis. Try engaging in these activities, and don’t forget to stretch out your feet and calves once you are done.
Choose well-fitted shoes with good support
Avoid wearing high heels whenever you can, and keep replacing your athletic shoes now and then. Avoid going barefoot on hard surfaces, even if it is only a few steps. Consider asking a doctor if using shoe inserts can help with your problem.
Steer clear of heavy exercise
These exercises include jumping, running, and any other activity that puts direct stress on your feet and tightens the calf muscles.
Remember to untuck your bedsheets
Tightly tucked bed sheets can put your feet in a pointed position, increasing the likelihood of getting plantar fasciitis once again.
Stretch your foot and leg arches
Talk to your podiatrist about the best stretching practices you can adopt to relax your calves and foot muscles. Incorporating them into everyday life can reduce the risk of acquiring plantar fasciitis in the future
Whether you spend your time behind a store register, at a desk, or on your feet, plantar fasciitis can easily hit you. Fortunately, the condition is manageable with simple home remedies. Even if these hacks don’t work out for you, you can always visit a podiatrist and seek treatment. The goal is to keep your arches and heels happy and pain-free.