What is it?
Plantar fasciitis is a condition characterized by localized swelling, irritation, and/or bursitis affecting the thick, fibrous bands that support the bottom of the foot. These bands extend from the heel and spread out toward the metatarsal heads or fat pad area. Typically, pain is felt near the point where these bands attach to the heel. When standing, these fibrous bands stretch and pull on the heel, and over time, a heel spur or calcium deposit may form as a response to this persistent pulling. Commonly, individuals with plantar fasciitis experience pain upon getting out of bed in the morning, with the first few steps being particularly painful, though the pain often diminishes as the day progresses. Pain may also be felt after sitting and then standing up again, primarily affecting the heel and arch, with occasional discomfort radiating up the back of the leg. While well-padded shoes can offer some relief, they rarely resolve the condition entirely.
What causes it?
The exact cause of plantar fasciitis remains unclear, but several factors may contribute, including trauma, repetitive stress, excessive weight, genetic predisposition, and various soft tissue abnormalities. The pain often worsens after periods of inactivity, such as when rising from a sitting position. While seated or lying down, the plantar fascia bands are relaxed and not under tension, leading to minimal pain. However, upon standing, these bands stretch and exert strain on the heel, potentially triggering pain. Given that this strain accumulates over time, symptoms can eventually develop.
How is it treated?
Initial treatment for plantar fasciitis typically involves stretching exercises, adjustments to footwear, foot taping, padding, anti-inflammatory injections, physical therapy, and oral medications. Orthotics, which provide support and stability, help with weight distribution and lower extremity function, are often a crucial part of the treatment plan. With appropriate management and support for the arch during weight-bearing activities, approximately 90% of cases can achieve symptom relief. If conservative treatments fail to alleviate the discomfort and disability, surgical options may be considered as a last resort.
