Plantar Fasciitis (Heel Pain)

Plantar Fasciitis (Heel Pain)

What is Plantar Fasciitis?

Plantar Fasciitis is the most common cause of foot and heel pain and affects millions of people around the world every year. Individuals with plantar fasciitis will typically experience sharp, stabbing pain, especially during the first step in the morning or after long rest periods. It is often misdiagnosed as a heel spur, which is a common finding in patients with heel pain but is not usually the cause of the pain.

Plantar fasciitis is the inflammation of the plantar fascia and can occur due to an acute injury from sudden high-impact activity or a chronic injury from long-term overuse. It is very common for individuals to ignore the pain at its initial stages and only seek help months later.

Plantar fasciitis is diagnosed based on the presenting symptoms and diagnostic ultrasound imaging. The use of diagnostic ultrasound imaging is important to rule out any plantar fascia tears, which are often discovered in many individuals.

Causes of Plantar Fasciitis

The plantar fascia is a band of connective tissue (much like a rubber band) that originates from the heel and attaches to the ball of the foot. Its primary function is to hold our heel and forefoot together to support the arch and stabilise the foot during standing or walking.

Each time we stand or walk, our body weight on the foot causes the plantar fascia to be stretched. Over time, the plantar fascia fibres may repeatedly suffer micro-tears and then heal, forming layers of scar tissue and thickening the plantar fascia band. This causes the plantar fascia to be chronically inflamed and weakened, resulting in heel pain.

Risk Factors of Plantar Fasciitis

The risk factors of plantar fasciitis include:

  • Flat feet (pes planus) or high arch feet (pes cavus)
  • Poor choice of footwear
  • Calf tightness or reduced ankle range of motion
  • Sudden increase in activity
  • Job nature (e.g long standing or walking hours)
  • Leg length discrepancy
  • Obesity or high BMI
  • Tight plantar fascia band

Signs and Symptoms of Plantar Fasciitis

  • Sharp, stabbing heel pain on the first step in the morning or after prolonged periods of sitting/resting,
  • Pain often feels better after a few steps
  • Aching pain under the heels after prolonged walking or after activity
  • Occasional pain in the back of the heel
  • Snapping or “popping” sound under the foot (usually indicates a sudden plantar fascia tear)
  • Redness or swelling may be present during the early days of injury

Plantar Fasciitis Treatment

The treatment of plantar fasciitis involves treating the thickened or torn plantar fascia and addressing the underlying risk factors that led to the injury.

Treatment options for plantar fasciitis include:

 

Surgery may be needed in severe cases such as a complete plantar fascia tear. Steroid injections should be avoided as they increase the plantar fascia tear risk.1

Other Possible Diagnoses of Heel Pain

Heel pain can be caused by many conditions other than plantar fasciitis, hence diagnosis is the key to receiving effective treatment. Your podiatrist should assess you carefully to ensure that the diagnosis is right.

Other possible diagnoses of heel pain include:

Contact Us