Closeup photo of woman wearing ballet flats instead of high heels

What Is Plantar Fasciitis And How To Manage It

Heel pain is a major cause of foot discomfort, most especially when you’re standing, walking, or running for a prolonged period. But what are the possible causes of heel pain? A common cause of heel pain is plantar fasciitis.

This article will cover plantar fasciitis and how to properly manage it. By reading on below, you’ll know what to do if you experience the signs and symptoms.

What Is Plantar Fasciitis

If you persistently experience heel pain, you probably have plantar fasciitis. This foot problem involves inflammation of fascia or thick band of tissue that connects the heel bone to the toes. The different risk factors contributing to the development of this painful foot problem include age, jobs requiring prolonged walking or standing, obesity, flat feet, and wearing shoes with inadequate arch support

Here’s how plantar fasciitis is diagnosed: 

  • Initial Assessment: Diagnosis of plantar fasciitis is first carried out by obtaining a thorough medical history and complete physical examination. The doctor will check tender areas of the foot. Also, pain is located to help rule out the possible cause of this foot problem. 
  • Imaging Tests: Your doctor may recommend an X-ray of the affected foot or magnetic resonance imaging (MRI). It will help rule out other problems, like a stress fracture, which may also cause heel pain. Also, X-ray of the foot can determine the presence of bone spur or a piece of bone that stick out from the heel bone.

How To Manage Plantar Fasciitis 

1. Foot Supporters 

Short-term relief by taping the affected foot. Orthotics or shoe inserts help decrease abnormal foot motion. Also, supportive footwear help support the arch of the foot to help reduce pressure to the plantar fascia. On the other hand, night splint helps maintain correct toe and ankle positions while you’re sleeping.

2. Medications

There are different treatments for plantar fasciitis, depending on the severity of the problem. Podiatrists usually prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain. Multiple doses of pain reliever taken daily for several weeks help manage inflammation. Some examples of pain relievers include ibuprofen (e.g., Motrin IB or Advil) and naproxen sodium (Aleve).

3. Steroid Injection

For patients experiencing severe pain or those unresponsive to prescribed NSAIDs, the doctor may recommend taking steroid injection, which can help relieve pain for a month. Steroid injection for plantar fascia is administered on the affected foot to help reduce inflammation.

4. Physical Therapy

A physical therapist is trained to assess and treat plantar fasciitis. Once you’re diagnosed with this foot condition, you can work with a physical therapist to develop a program intervention to decrease signs and symptoms. Here are the possible treatment options that physical therapists can provide:

  • Gait (how you walk) assessment and how it impacts your signs and symptoms.
  • Ice application to decrease inflammation and pain.
  • Improve ankle flexibility and the plantar fascia with stretching exercises.
  • Improve the strength of your supporting muscles with strengthening exercises.
  • Gait training improves walking and running ability and reduces signs and symptoms of plantar fasciitis. 
  • Iontophoresis involves the delivery of medication through the skin.

5. Extracorporeal Shock Wave Therapy

This procedure involves sound waves directed at the heel pain area. Extracorporeal shock wave therapy (ESWT) stimulates healing. ESWT is a simple 18-minute procedure, which is commonly used for treating chronic plantar fasciitis that has not responded to more conservative treatments. Also, this procedure is thought to provide long-lasting analgesia for orthopaedic diseases, stimulating the faster healing process.

Here are the good-to-know facts about ESWT: 

  • You will lie back comfortably with the foot to be treated resting on the ESWT machine.
  • Local anaesthesia is used for the patient’s comfort. 
  • Ultrasound scan is used to view and target the exact damaged location of the plantar fasciitis. 
  • Repetitive clicking sounds will be heard during the treatment.

6. Ultrasonic Tissue Repair

A minimally invasive technology using ultrasound imaging — this procedure guides a needle-like probe that vibrates rapidly into the damaged plantar fascia tissue, breaking it up and then suctioned out.

7. Surgery

The recommended surgery for plantar fascia is percutaneous plantar fascia release. It is minimally invasive access to the foot’s plantar fascia using a small scalpel blade to release it. This surgical procedure help minimize nerve injury, infection, skin healing issues, and prolonged recovery time. In this way, you can return to your normal activities early.

Surgical interventions should be considered by individuals with intractable plantar fasciitis showing negative responses of more than six months of conservative treatment. Other surgical treatment options include the following:

  • Open Surgery: It’s a traditional surgical practice in which the surgeon incises or cuts through the affected area.
  • Endoscopic Plantar Fascia Debridement: It is an innovative treatment to reduce chronic heel pain. Endoscopic debridement is a minimally invasive procedure that maintains plantar fascia integrity. 
  • Laser Treatment: Low-level laser therapy or LLLT provides a quick, non-invasive, painless, and side-effect free treatment to relieve the debilitating foot pain of plantar fasciitis. Each laser session usually lasts for about seven minutes. For acute plantar fasciitis, you’ll need three to four laser treatments, whereas chronic plantar fasciitis would require six to eight laser treatments.
  • Radiofrequency Ablation: Radiofrequency nerve ablation or RFNA refers to a minimally invasive procedure employed to relieve chronic pain associated with plantar fasciitis. Thermal damage is created to the nerve to reduce or eliminate the perception of pain.

Preventative Tips For Plantar Fasciitis

Prevent and manage plantar fasciitis by choosing the right shoes or one with adequate space for your feet and proper heel height and arch support. Also, you have to replace your footwear regularly before they even wear out.

Here are the other preventative tips for plantar fasciitis: 

  • Stretch your feet before and after walking or running.
  • Adjust your workout program. Make sure to include a warm-up and a gradual buildup. It will avoid straining your plantar fascia.
  • Maintain healthy body weight.
  • Use a thick mat for prolonged standing in one place for a day.

Conclusion

Plantar fasciitis can be caused by repetitive strain injury impacting the ligament due to excessive walking or running, unfit footwear, and landing jumping injury. Conservative interventions for plantar fasciitis include ice application, wearing supportive footgear, physical therapy, and medications. For severe cases, steroid injection will likely be prescribed. Also, surgical treatment includes laser, radiofrequency ablation, open surgery, and percutaneous plantar fascia release.