Plantar Fasciitis | Heel Pain

One of the most frequent complaints we hear from patients is pain in their arches and heels. While there are several things that could cause this kind of pain – arthritis, infection, fractures, sprains, certain diseases, walking around on your tip toes all the time – the most common culprit is plantar fasciitis (pronounced planter fash-itis). Despite the funny name, it hurts and will probably start hurting more if you don’t get it treated.

To understand plantar fasciitis, here’s a quick biology lesson. There is a thick band of tissue in your foot that stretches from the heel all the way across the arch to your toes, which is called the plantar fascia. It keeps everything in place when you walk and run. But sometimes a person’s natural gait (the way they walk) puts too much stress on the heel bone. This can inflame this plantar fascia tissue. One major cause of that inflammation is over pronation, which just means the foot rolls inward when you walk. Over time, this will cause the arch to flatten and lengthen, which can inflame the plantar fascia…that’s where the plantar fasciitis (and the pain) comes in.

What does it feel like? Here are a few of the symptoms:

• Pain and stiffness in your arch or heel, especially in the morning when you get out of bed or if you’ve been sitting on the couch watching TV for too long
• Pain in the arch or heel that gets worse as the day goes on
• A feeling that your feet are tired and worn out at the end of the day

To diagnose plantar fasciitis, we first do a thorough examination of your feet. Then we’ll take a look at how you walk, the kind of shoes you wear, and what kind of activities and exercises you do most often. All of these factors provide clues to what’s hurting your feet. If it’s plantar fasciitis, we can usually have you feeling much better in a few weeks.

To treat plantar fasciitis, we need to reduce the stress on that tissue to allow it to heal and minimize future problems. Treatment typically involves three steps:

1. Relieve the tightness — You might need orthotics to support your arch, which can be tucked unseen into many shoe styles. If you are in a lot of pain, we might prescribe a walking boot to relieve the pain and allow your foot to heal. Or it could be as easy as changing your shoes. Please bring the shoes that you wear most often to your appointment so we can see if they’re the cause.
2. Reduce the inflammation — We have a few different options here, ranging from ice treatments to anti-inflammatory medications, arch supports, or in more severe cases, steroid injections or physical therapy. It just depends on the severity of the inflammation and pain.
3. Prevent future problems — If plantar fasciitis is caused by how you walk, the problem won’t easily go away. Most likely, you’ve been walking that way since you were a kid, and that’s a hard habit to change. So we can prescribe custom orthotics or arch supports that will prevent your arch from collapsing and lessen the chance that you’ll have this problem again. We might also recommend physical therapy, special exercises or changing the type of shoes you wear.

In rare cases, surgery might be necessary if the foot doesn’t respond to treatment. But again, that’s only the last resort if several months of treatment doesn’t get rid of the pain.

Here is what the American College of Foot & Ankle Surgeons says about Plantar Fasciitis.

The important thing to know is that you don’t have to live with heel or arch pain, and that if you try to, it will most likely get worse. Instead, call our office and make an appointment. We’ll get you on the path to recovery!