Kevin Lutz, MD, FACP
Sep 1 2018

The plantar fascia is a long, thin ligament present along the bottom of the foot that supports the arch of the foot. When this becomes swollen or inflamed, it is called plantar fasciitis.

InjurySkeletal System

The plantar fascia is a long, thin ligament present along the bottom of the foot that supports the arch of the foot. It extends from the heel bone, and then splits and fans out to attach itself to the toes. When this fascia becomes swollen or inflamed, it is called plantar fasciitis. This can be painful and make walking more difficult. It is one of the most common orthopedic foot complaints.

What are the causes and risk factors of Planter Fasciitis?

Plantar fasciitis can occur from injury or may be related to underlying diseases that cause arthritis such as reactive arthritis, ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis. Sometimes plantar fasciitis occurs for unknown reasons. The pain associated with plantar fasciitis was commonly thought to be caused by a heel spur; however, research has found that this is not the case.

Risk factors for plantar fasciitis include female gender, being overweight, or working a job that requires a lot of walking or standing on hard surfaces. You’re also at risk if you walk or run long distances downhill or on uneven surfaces, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches also are more prone to plantar fasciitis.

What are the symptoms of Plantar Fasciitis?

The most common symptom is pain and stiffness in the bottom of the heel. The heel pain is described as a burning pain, is often sharp, and can be severe. This heel pain can lead to difficulty in weight-bearing on the involved foot making it difficult to walk, especially the first few steps after awakening from sleep. The symptoms may come on gradually or appear suddenly following intense activity. The pain is usually worse after activity, not during it. It can also be triggered by long periods of standing or rising from sitting.

What is the treatment for Plantar Fasciitis?

Fortunately, 90% of all cases can be successfully treated with conservative, nonsurgical therapies. Treatment usually begins with medication to manage the pain and underlying inflammation associated with the condition. Common over-the-counter medications, such as Advil and Aleve, can help reduce plantar fasciitis pain and swelling. For severe pain and inflammation that do not respond to nonsteroidal anti-inflammatories, the next step can be cortisone injections. Once treatment begins, plantar fasciitis usually takes several months to improve. It can take between 6 and 18 months for the pain to subside.

There are also several conservative treatment options that can be done at home. They involve a combination of resting the foot, icing the foot, avoiding activities that can aggravate the condition and techniques to strengthen foot muscles during recovery.

  • Resting the Foot: Roughly one quarter of plantar fasciitis cases have shown that rest as the treatment that works best. Avoiding weight-bearing activities and pressure applied to the foot helps relieve pain during the healing process.
  • Icing the Foot: Like certain medications, ice can be an effective anti-inflammatory. Typically, cold is applied to the area that hurts or is inflamed for intervals of 15 to 20 minutes. Icing can be especially helpful after exercise or at the end of a workday.
  • Stretching and Strengthening Exercises: Exercise can help relieve plantar fasciitis pain, while also loosening tight muscles, increasing flexibility, and building muscle strength in the foot. Simple stretching techniques may incorporate stairs, walls, boards, and objects that the arch of the foot can be rolled over.
  • Surgery: The American Academy of Orthopedic Surgeons recommends surgery for plantar fasciitis only if aggressive nonsurgical treatment has been attempted for 12 months and the condition persists or worsens.