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Foot Pain

Overview

Plantar fasciitis is that pain in the bottom of your foot usually felt around your heel. That pain is especially strong with the first few steps in the morning as you are getting out of bed and standing on your feet, or after sitting and resting for awhile. The name Plantar fasciitis comes from: “Plantar” which means something that belongs to the foot, “fascia” which is a band or ligament or a connective tissue, and “itis” which means inflammation. The band connects the heel bone to the bones of the toes. The pain is caused by injuring this tough band on the bottom of the foot.


Causes

Because the plantar fascia supports your foot and gets used every time you take a step, it has to absorb a large amount of stress and weight. If too much pressure is put on the plantar fascia, the fibers can become damaged or start to tear. The body responds by causing inflammation in the affected area. This is what causes the pain and stiffness of plantar fasciitis. Things that can increase the risk of plantar fasciitis include tight calf muscles. Tight calves make it harder to flex your foot, and this puts more stress on the plantar fascia. Weight. Carrying a few extra pounds puts added pressure on your feet every time you take a step. Activities that put a lot of stress on the feet. This includes things like running, hiking, dancing, and aerobics. Bad shoes. Footwear that doesn’t give your foot the support it needs increases your risk of plantar fasciitis. You’ll want to ditch any shoes that have thin soles or inadequate arch support, or ones that don’t fit your feet properly. Routinely wearing high heels can also cause your Achilles tendon to contract over time, making it harder to flex your foot. Jobs that involve a lot of standing or walking on hard surfaces. Jobs that keep you on your feet all day, like waiting tables or working in a store, can cause damage to your plantar fascia. High arches, flat feet, or other foot problems. The shape of your foot can affect the way your weight is distributed on your feet when you stand. If weight distribution is a bit off, it can add to a person’s risk of plantar fasciitis. How someone walks can increase the stress on certain parts of the foot too.


Symptoms

Symptoms of the plantar fasciitis include a gradual onset of pain under the heel which may radiate into the foot. Tenderness is usually felt under and on the inside of the heel which is initially worse first in the morning but eases as the foot warms up only to return later in the day or after exercise. Stretching the plantar fascia may be painful.


Diagnosis

A physical exam performed in the office along with the diagnostic studies as an x-ray. An MRI may also be required to rule out a stress fracture, or a tear of the plantar fascia. These are conditions that do not normally respond to common plantar fasciitis treatment.


Non Surgical Treatment

The initial treatment of plantar fasciitis focuses on reducing pain and inflammation. Resting the affected foot is the most important aspect of this treatment. Other initial treatment may include, aplying ice to the sole of the foot, Anti-inflammatory medications. Gentle stretching of the plantar fascia and Achilles tendon. Physiotherapy. Taping the foot and ankle to provide adequate support and alignment, Wearing supportive footwear with shock-absorbing soles or inserts. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Brufen) and diclofenac (Voltaren) are often used to treat plantar fasciitis. It is unclear whether NSAIDs assist in the healing process but they are useful for controlling pain during treatment. If the condition does not respond to initial treatment, a corticosteroid therapy may be recommended. This involves the injection of corticosteroid medication such as hydrocortisone (Solu-Cortef) directly into the affected area in order to treat the inflammation and thus relieve the pain. Night splints to prevent the plantar fascia tightening during sleep may also be recommended at this stage.

Pain Of The Heel


Surgical Treatment

When more conservative methods have failed to reduce plantar fasciitis pain, your doctor may suggest extracorporeal shock wave therapy, which is used to treat chronic plantar fasciitis. Extracorporeal shock wave therapy uses sound waves to stimulate healing, but may cause bruises, numbness, tingling, swelling, and pain. When all else fails, surgery may be recommended to detach the plantar fascia from the heel bone. Few people need surgery to treat the condition.


Prevention

Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it’s present. To prevent plantar fasciitis, run on soft surfaces, keep mileage increases to less than 10 percent per week, and visit a specialty running shop to make sure you’re wearing the proper shoes for your foot type and gait. It’s also important to stretch the plantar fascia and Achilles tendon.

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