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.
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.
The risk factors of plantar fasciitis include:
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
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: