Plantar fasciitis is a medical disorder of the feet that affects the sheet of tissues (the plantar fascia) connecting the heel and toes. It is marked by inflammation and a stabbing pain that most often originates in the heel’s center. Roughly 80 percent of Americans experiencing heel pain at any point in time are suffering from plantar fasciitis. In the most serious cases, the plantar fascia can rupture, leading to severe pain and difficulty in standing and walking.

Plantar fasciitis may require treatment by a podiatrist (foot surgeon) or an orthopedic foot specialist. The health care providers at Baptist Health have been treating foot problems for more than 90 years.

How Do I Know If I Have Plantar Fasciitis?

The primary indicator of plantar fasciitis is foot pain. Symptoms may include:

• Sharp pain located mostly in the heel but also sometimes the arch or ball of the foot
• Pain that is greatest early in the morning after rising from sleep
• Increases in pain following exercise, long periods of standing, or carrying heavy loads
• Decreases in pain following periods of rest
• Inflammation and stiffness

The pain associated with plantar fasciitis tends to subside over the course of the day but, paradoxically, increases in intensity over time, if not treated.

What Causes Plantar Fasciitis?

The immediate cause of plantar fasciitis is small tears that develop in the connective tissues at the bottom of your feet. These result naturally from the repetitive shocks absorbed by your body while walking, running, and pursuing day-to-day tasks. Several other factors may contribute to the onset of plantar fasciitis:

• Wearing non-supportive shoes on hard or broken surfaces
• Activities that place unusual stress on the plantar fascia (for example, running and jumping)
• Extremes in foot shape, either high arches or flat feet
• Being overweight

Risk Factors for Plantar Fasciitis

Certain factors may increase your risk for plantar fasciitis:

• Foot shape and mobility mechanics: An unusual foot shape can alter the way you walk, adding to the risk of tears in the plantar fascia.  
• Obesity: Extra weight places pressure on your heels and feet, which must support you when standing upright, walking, or running.
• Sports activities and exercise: Physical activities that greatly increase stress on the heel and its connective tissues increase the likelihood of plantar fasciitis.
• Long periods on your feet: Conversely, jobs such as assembly-line work or teaching that require long hours standing up can also encourage the onset of this condition. 
• Increased age: Most people with plantar fasciitis first develop it between ages 40 and 60.

How Do I Prevent Plantar Fasciitis?

Although there is no sure means of preventing plantar fasciitis, there are steps you can take to reduce the risk of developing it:

• If you are obese: make lifestyle changes that allow you to lose weight.
• If you wear heels, flats, or non-supportive shoes: replace them with cushioned, well-fitting footwear.
• If you exercise regularly: include pre-workout stretches that target the bottoms of your feet.
• If your exercise involves high-impact movements: switch to a low-impact regimen instead.
• If you’ve already developed plantar fasciitis: place supportive shoes on your feet before stepping out of bed.

How Is Plantar Fasciitis Diagnosed?

Diagnosis is typically based on a foot examination and medical history. X-rays are rarely required, except in those cases where your physician wants to rule out an alternative cause or identify a possible contributing factor, such as a bone spur.

How Is Plantar Fasciitis Treated?

Physicians have had considerable success in treating plantar fasciitis with conservative, non-surgical procedures. These may include:

• Over-the-counter pain-relief medications
• Ice packs and stretching exercises
• Physical therapy
• Night splints
• Orthotics, such as custom-fitted arch supports

In cases where a conservative approach proves ineffective, more intensive options are available. These may include:

• Steroid injections
• Shock-wave therapy
• Tenex, a minimally invasive surgical procedure for removing scar tissue from tendons and other connective tissue

In the most extreme cases, severe pain relief comes from the surgical detachment of the plantar fascia from the heel bone.

Complications

Failure to treat plantar fasciitis opens you to the possibility of long-term chronic pain. In addition, any changes in your gait that compensate for heel discomfort can lead to other medical problems in the ankles, knees, hips, and back.

Though developing plantar fasciitis can be an unpleasant experience, non-surgical treatment methods are frequently effective in reducing pain and diminishing and even eliminating symptoms.