Heel pain typically characterizes plantar fasciitis, most commonly in the first steps of the morning or after prolonged sitting, and may accompany sharp pain in the medial plantar calcaneal region. It can also lead to increased stiffness, and, for many sufferers, it can affect their day-to-day activities, how they walk and can lead to the development of a myriad of other health problems.
What are the signs that i might develop plantar fasciitis?
In a healthy adult, the plantar fascia acts like a shock-absorbing bowstring, supporting the arch of your foot. If the tension on the bowstring becomes too great, you can develop small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed, which can lead to a shooting pain in the heel, with the first steps of the day or after periods of rest.
Ignoring a bout of plantar fasciitis can result in chronic heel pain that may become disruptive to your regular activities. If you try to compensate for your heel pain by changing the way you walk, you may also develop knee, hip, back, and other foot problems.
As such, it’s important to recognize the signs that you may be at risk for developing plantar fasciitis and that you seek medical attention if you believe that you are experiencing the symptoms:
Obesity
If you are overweight or obese, you are at a greater risk of developing plantar fasciitis. This risk factor can be explained by the added weight putting increased pressure on your plantar fascia ligaments, especially in cases of rapid weight gain. Women who are pregnant often experience plantar fasciitis, particularly during late pregnancy.
Excessive Running
If you are a runner, you may be more likely to develop plantar fasciitis, because of the strain that running regularly and for long distances puts on the plantar fascia ligaments.
Prolonged Standing
People who have active jobs or who spend the majority of their days on their feet are at an increased risk of developing plantar fasciitis, including nurses, teachers, factory workers and servers.
Age And Activity Level
Plantar fasciitis can strike anyone, but most commonly affects men and women between the ages of 40 and 70, and plantar fasciitis is slightly more common in women than it is in men.
Other Foot Conditions
If you have another pre-existing foot problems, such as high arches or very flat feet, you may be at an increased risk for developing plantar fasciitis. People who have tight Achilles tendons (the tendons that attach the calf muscles to the heels) may also be at a higher risk for developing plantar fascia pain.
Poor Footwear
Even if you are otherwise healthy and with no genetic predisposition to plantar fasciitis, simply wearing shoes that have soft soles or that have poor arch support can put you at risk for developing plantar fasciitis.
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.
What Are the Symptoms?
The most common complaint from those who suffer from plantar fasciitis is pain and stiffness in the bottom of the heel. This pain develops gradually over time and can range from a dull ache to a sharp, shooting pain, with some people describing a burning or aching on the bottom of the foot that extends outward from the heel.
This pain is typically most severe in the morning, when taking the first steps out of bed, or in the first steps after you’ve been sitting and lying down for a period of time. Climbing stairs can become challenging because of the stiffness that develops in your heel.
After periods of prolonged activity, the pain can flare up due to increased irritation and inflammation of the plantar fascia, although this pain is typically felt only after stopping the activity.
How Is It Diagnosed?
If you suspect that you may have plantar fasciitis, your doctor can make a diagnosis based on your medical history and a physical examination. Diagnostic tests are rarely needed for a diagnosis and are typically reserved for particularly difficult cases or if your doctor needs to rule out another potential heel disorder.
What Can I Do?
There are a number of conservative treatment options that you can try to help ease potentially debilitating pain. Among them, doctors may recommend rest or activity modification, ice, massage, oral analgesics, and/or stretching techniques, which will be put together in a treatment plan that you can try for a period of several weeks. You may be advised to cut back on or eliminate activities in which your feet pound on hard surfaces, such as running or step aerobics.
Rolling your foot over a cold water bottle or ice for 20 minutes is often effective in easing the pain from plantar fasciitis, and this can be repeated three to four times a day during bouts of plantar fascia pain. Stretches that target the calf muscle are also effective in easing the pain and discomfort of plantar fasciitis. Your doctor or physical therapist may also recommend wearing a splint that stretches the calf and the arch of your foot while you sleep, which will hold the plantar fascia and Achilles tendon in a lengthened position overnight.
If your pain has not been managed by these treatments, then your physician may prescribe physical therapy, foot orthotics, night splinting or corticosteroid injections to treat your condition. Ninety percent of patients will see improvement with conservative treatment measures, so your prognosis is good. However, in rare cases, patients who suffer from chronic, recalcitrant plantar fasciitis that lasts six months or longer can consider extracorporeal shock therapy or a plantar fasciotomy.