What is Plantar Fasciitis?
Plantar fasciitis explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Plantar fasciitis is a relatively common chronic pain condition that affects the heels and feet. Current lifetime prevalence estimates suggest that approximately one in every ten adults will suffer from heel or foot pain associated with plantar fasciitis at some point during their adulthood.
The plantar fascia is a thick, flat connective tissue that is found on the bottom of the foot and connects the ball of the foot to the heel. The plantar fascia creates support at the arch of the foot. Given its location, the plantar fascia is susceptible to injury. For instance, the plantar fascia can become strained, causing tiny tears along the ligament. This damage and irritation can cause the connective tissue to become inflamed that then places compression on the surrounding tissue and nerves, resulting in pain.
The typical complaint from individuals with plantar fasciitis is severe pain when they first awake in the morning. Others may complain of pain when applying weight onto their feet following long periods of sitting. This pain may be so severe that it causes the patient to limp upon standing. This pain can be significantly reduced once the patient begins moving around. This allows the ligament to stretch and become loose. Below is a list of other common symptoms that may accompany plantar fasciitis.
- Stiffness along the heel
- Achiness or pain along the arch of the foot
- Arch stiffness
- Burning sensations
- Tenderness in the bottom of the foot
- Flat feet
- High arch
- Difficulty climbing stairs
In order to achieve a proper diagnosis, patients must undergo a physical examination, including a detailed assessment of the degree of pain and swelling. This assessment will also include a detailed personal history as well as a detailed account of the current episode of heel and foot pain.
Causes of Plantar Fasciitis
Most cases of plantar fasciitis are caused by excessive strain placed on the plantar fascia ligament. Over time, excessive strain or stretching causes small tears along the ligament. This can lead to inflammation and significant pain. Indeed, most patients with plantar fasciitis pain report that their pain began suddenly following a discrete event; however, others describe that their symptoms occurred much more gradually, with the pain increasing over time. The most common causes of injury to the plantar fascia ligament are from overuse and excessive strain. For instance, individuals who do not complete the proper warm-up routine prior to physical exertion can place themselves at significant risk for injury.
Plantar fasciitis is found to occur much more commonly among men who are between the ages of 40 and 70 years of age, though plantar fasciitis can affect anyone. Other factors that have been found to place an individual at risk for developing plantar fasciitis are history of bone spurs, alcoholism, liver disease, increasing age, smoking, diabetes, thyroid problems, and obesity.
Treatments for Plantar Fasciitis
Patients are encouraged to speak with their physician regarding their symptoms of pain associated with plantar fasciitis, as a number of treatment options are available. Should the patient not be experiencing severe and debilitating pain associated with their condition, it is recommended that they first attempt conservative, at-home treatment for managing their pain. In fact, many interventions that can provide significant relief for plantar fasciitis pain can be done at home. For instance, it may be recommended that patients give the ligament proper rest following an injury to allow the tissue to heal properly. Patients may also use a cold compress to help reduce the swelling associated with plantar fascia pain. This can be applied twice a day for ten to 15 minutes.
Physical therapy can also be highly effective in strengthening a damaged tendon. This program will involve several specified stretches and other exercises that target the injured ligament. Night splints to be worn while the patient is sleeping, along with ensuring proper footwear is worn, may significantly reduce the patient’s pain and discomfort. It is important for individuals to have adequate cushioning and proper arch support to avoid any risk for injury. Some cases of chronic plantar fasciitis pain may require the patient to wear a boot, cast, or brace. This provides extra support for the plantar fascia ligament to protect it from any undue stress or overuse, allowing it ample time to heal.
Over-the-counter pain relievers with anti-inflammatory qualities (NSAIDs, such as ibuprofen or naproxen) can be very beneficial for patients with plantar fasciitis. These medications are believed to be effective because of their anti-inflammatory characteristics. Other medications, such as oral corticosteroids like prednisone and cortisone, may be recommended in instances where the patient’s pain was not significantly reduced using an over-the-counter pain reliever.
Plantar fasciitis can be associated with chronic or severe pain that causes significant interference with a patient’s ability to perform necessary daily functions. Patients with these more significant symptoms may wish to try more aggressive forms of pain management that are available. For instance, highly effective and almost immediate options for managing the pain associated with injury to the plantar fascia are steroid injections, such as intraarticular steroid injections. These procedures involve the injection of an anaesthetic medication into affected area.
For instances of plantar fasciitis that have been unresponsive to other treatments, surgery may be recommended. In most instances, it may be recommended that the patient cut the plantar fascia ligament in order to release the pain-causing tension.
Plantar fasciitis is a relatively common chronic pain condition that affects the heel and the bottom of the foot. The condition itself can arise from injury, swelling, and weakness in the connective tissue that runs along the bottom of the foot, called the plantar fascia. There are a number of genetic factors that can place an individual at increased risk for developing plantar fasciitis pain; however, it is generally linked with injury to the plantar fascia ligament.
There are several treatment options available for assisting patients with managing their pain associated with plantar fasciitis. In general, it is recommended that patients attempt conservative, at-home pain management options before attempting the more interventional strategies. Specifically, corticosteroid injections have been shown to be very effective in managing the pain associated with plantar fasciitis. Patients should speak with their doctor about their specific condition and to learn about the treatment options available for managing their pain.
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