What Is Plantar Fasciitis?

Plantar fasciitis occurs when connective tissue becomes inflamed to the point of pain. The thick tissue that connects the ball of the foot to the heel is called the fascia. This tissue is responsible for the arch of the foot.

Patients who have plantar fasciitis often limp out of bed first thing in the morning with sharp pain. When the fascia loosens with use — walking — the pain will subside a bit. The first few steps of the day are often the most painful because the fascia is not stretched or used during sleep.

Achilles FootRisk factors for this foot condition include arch problems, both flat and high can cause fascia issues. Also, obesity or sudden weight gain is often to blame. The fascia can adjust only so far before it is stretched to the point of pain. Long-distance running, running on uneven surfaces, or having a tight Achilles tendon are also causes. Finally, wearing shoes without proper arch support can cause fascia inflammation.

This condition is most commonly found in men age 40-70 and is the leading cause of orthopedic care for the feet. While heel spurs — calcium deposits — are commonly found in plantar fasciitis patients, they are not the cause of the pain. They are a reaction by the bone to the fascia’s inflammation.

Foot DiagramSymptoms of plantar fasciitis are stiffness on the bottom of the heel, an ache on the arch, and a sharp pain or burn when first putting weight on the foot. The pain may be more severe if climbing stairs or performing intense activity. This pain may come on with time or may be intense and sudden. It is not uncommon for swelling and redness to also be present.

To diagnose plantar fasciitis, a pain physician will take a series of X-rays of the foot. If a bone spur is present, plantar fasciitis is a likely diagnosis. Additionally, physicians will look for a thickening and inflammation of the fascia from the ball of the foot to the heel. The physician may also look for hairpin fractures in the bones around the foot that are also common in those experiencing this type of pain.

Treatment options range from over-the-counter NSAIDS, such as acetaminophen and ibuprofen, to reduce inflammation and stretching to cortisone shots and sonic wave procedures. Depending on the severity of the inflammation, the patient may respond favorably to stretching, ice, rest, and wearing orthotics when standing. Additionally, there is athletic tape and splints manufactured for fascia stretching and ease of plantar fasciitis-related pain.

You might also want to read our article on foot pain.

At Arizona Pain, our goal is to relieve your pain and improve function to increase your quality of life.
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References

  1. Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine.3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section F.
  2. Abu-Laban RV, Ho K. Ankle and foot. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 55.
  3. Review Date: 2/19/2011.
  4. Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.