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Plantar Fasciitis

Pronounced: plan-tar fah-shee-eye-tis

Definition

The plantar fascia is a thick band of tissue attached to the heel bone. It supports the arch of the foot. Plantar fasciitis is inflammation of the plantar fascia.

Plantar Fasciitis

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Causes    TOP

Plantar fasciitis is caused by small, repetitive trauma to the plantar fascia. This trauma can be due to activity that puts extra stress on the foot.

Risk Factors    TOP

Plantar fasciitis is most common in people who are 40-60 years old. Other risk factors that increase your chance of getting plantar fasciitis include:

  • Physical exertion, especially in sports such as:
    • Running
    • Volleyball
    • Tennis
  • A sudden increase in exercise intensity or duration
  • Physical activity that stresses the plantar fascia
  • People who spend a lot of time standing
  • A sudden increase in activities that affect the feet
  • Obesity or weight gain
  • Pre-existing foot problems, including an abnormally tight Achilles tendon, flat feet, or an ankle that rolls inward too much
  • Poor footwear
  • Heel spurs

Symptoms    TOP

Symptoms of plantar fasciitis may start gradually or happen suddenly. They include:

  • Pain on the sole of the foot near the heel
  • Heel pain when taking the first steps in the morning
  • Tenderness when touching the sole or heel
  • Pain that increases over a period of months

Diagnosis    TOP

You will be asked about your symptoms and medical history. A foot exam will be done. This will usually make the diagnosis.

Imaging studies of the foot may be done to help rule out stress fractures or other bone abnormalities. These include:

Treatment    TOP

Talk to your doctor about the best treatment plan for you. Options include:

Supportive Care

Your foot will need time to heal. Supportive care may include:

  • Rest—Activities, such as running, may need to be restricted.
  • Ice—Ice therapy may help relieve pain.
  • Night splint—A night splint helps to hold the foot in a neutral position while sleeping.
  • Orthotics—Special shoe inserts will help to support the mid-arch region of the foot.

Stretches to lengthen the Achilles tendon and plantar fascia may be advised when pain has lessened.

Over-the-counter or prescription pain medication may be advised. Steroid injections may also be used in some cases if other treatments do not provide relief.

Procedures

A special type of sound wave called extracorporeal shock wave may also be considered in certain cases. This treatment happens under the care of your doctor. At this time, this is generally a treatment for long-term cases that do not respond to other treatments. Massage therapy or acupuncture may also be effective for long-term cases.

Surgery    TOP

In a few cases, basic treatments don't help. Surgery may be performed to cut the tight, swollen fascia.

Prevention    TOP

To reduce your risk of getting plantar fasciitis take these steps:

  • Wear appropriate and well-fitted footwear during sports and exercise.
  • Do stretching exercises for the Achilles tendon and plantar fascia.
  • Increase the intensity and duration of exercise gradually.
  • Maintain an appropriate weight.

RESOURCES:

American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org
OrthoInfo—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Ontario Podiatric Medical Association
http://www.opma.ca

References:

Plantar fasciitis. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated September 23, 2014. Accessed March 2, 2015.
Plantar fasciitis. Focus on the basics. Mayo Clin Health Lett. 2012;30(8):7.
Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated June 2010. Accessed March 2, 2015.
Pommering TL. Ankle and foot injuries in pediatric and adult athletes. Prim Care. 2005;32:133-161.
6/5/2009 DynaMed's Systematic Literature Surveillance
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Baldassin V, Gomes CR, et al. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Arch Phys Med Rehabil. 2009;90:701-706.
4/24/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed March 2, 2015.
Last reviewed March 2015 by Michael Woods, MD
Last Updated: 4/24/2014