Plantar fasciitis is one of the most common heel pain conditions. It
is the inflammation of a thick band of tissue called plantar fascia attached to the heel bone and base of toes. Plantar
fasciitis causes stabbing pain in the heel, especially in the morning time and
subsides after some painful walking. It is common in runners and in those
who wear non-adjustable footwear or in those who are obese.
Causes
Causes of plantar fasciitis include excessive running, flat feet,
standing on hard surfaces or wearing unsuitable footwear and high arches of
feet. Actually plantar fascia works as a shock-absorber and when tension is
increased, small tears occur in its tissue leading to inflammation and heel pain.
Tests
Usually, no test is required and the diagnosis is clinical. However,
physicians may advise x-ray foot or magnetic resonance imaging (MRI). X-ray foot may show bony spurs.
Treatment
Treatment of plantar fasciitis is simple and easy. Just rest your feet and cut your daily activities. Reduce your extra pounds if you are obese.
Painkillers
Painkillers like NSAIDS (e.g. Ibuprofen) relieve pain and inflammation
in most of the cases.
Physical Therapy
Physical therapy includes several types of exercises before getting
out of bed. One can perform the following exercise in the morning before
getting out of bed:
1. Scrunch and splay - Flex and extend your toes, keeping the ankle joint
still. Do it thirty times.
2. Ankle pump – Flex and extend at the ankle joint, keeping the toes
still. Do 30 repetitions.
3. The roll-out – It is a kind of massage. Place a soft ball under your
feet and roll your feet over it, applying minimum to moderate pressure in sitting
position and moderate to high pressure in standing position. Do 30 repetitions.
4. Self mobilization – Support your heel with your left hand and perform
flexion and extension at toes with your right hand. Do it 30 times.
5 & 6. Heal and toe raise – Raise your toes and heel in alternative manner. It
means raise the distal part of your foot extending the ankle joint and then
raise the proximal part of your foot extending the toes. Do 30 repetitions in
sitting position and 30 times in standing position.
(Why to do the above exercise before getting out of bed? It prevents
the plantar fascia from getting irritated while walking or in weight bearing
position. It offers two benefits: increases blood circulation to the plantar area
and extensibility to the tissue).
Night Splints and Orthotics
Your physician may advise you to wear night splints and orthotics. These night splints stretch your plantar fascia and Achilles tendon, and prevent them to get tight at night.
Steroid Shots
Steroid injections are given to those with chronic plantar fasciitis.
Injection is given into the painful plantar area. Options for steroid injection include Celestone (Betamethasone) 6mg (1ml) or Solu-Medrol (Methylprednisolone) 40mg (1ml).
Extracorporeal Shock Wave Therapy
In this therapy, sound waves are directed to the painful plantar area
to enhance the healing.
Surgery
Surgical treatment is reserved only for those who do not respond to
medical or conservative management.
Keywords: Plantar fasciitis, Painful heel, Treatment, Physical therapy, Exercises, NSAIDS, Painkillers, Ibuprofen, Night splints, orthotics, Extracorporeal shock wave therapy, Surgery
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