Heel pain is a common condition, especially among women. Of the various causes of heel pain, plantar fasciitis is the most common cause. It is mainly due to prolonged standing and poor choice of footwear, but can also develop in those who have hurt that area of the foot through exercise.
The plantar fascia
Plantar fasciitis refers to the inflammation of the plantar fascia when it gets damaged or irritated. So, what is the plantar fascia? It is a touch band of tissue at the bottom of your foot connecting the toes to the heel bone.
Symptoms of plantar fasciitis
The most common symptom of plantar fasciitis is, of course you’ve guessed it, pain at the heel as well as at the bottom of the foot. The pain is typically described to be worse in the morning when the patient gets out of bed or after periods of resting the feet. It also worsens when walking barefoot and climbing stairs but subsides when standing.
Doctors diagnose this condition mainly through examination of the leg and the symptoms described by the patient. Blood tests and x-rays are usually not necessary.
There are many things a patient can do to alleviate the pain from plantar fasciitis such as:
- Rest. Because the plantar fascia is inflamed and irritated by prolonged standing giving it ample rest will allow it to heal. However, do not be completely inactive as that can also cause pain and stiffness.
- Foot exercises that will complement rest as mentioned above would be helpful.
- Icing the foot for 20 minutes up to 4 times daily might help relieve the pain in addition to massaging it.
- Wear shoes with good arch, heel support and cushion.
- Wear night time splints specifically for plantar fasciitis which aids in keeping the foot straight when sleeping. These are widely available in pharmacies.
- Pain medications may be used when pain is unbearable. Paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be taken to reduce pain and inflammation. Always speak to your pharmacist or doctor to make sure it is safe for you to take these medications, especially the NSAIDs.
Fortunately, most people with plantar fasciitis recover within a year even when no treatment was instituted.
When to seek help?
When symptoms are severe, or the self-help suggestions do not improve your condition, it is prudent to consult your doctor or a podiatrist. They may start some of the following treatments:
- Shoe inserts tailor- made for your foot to support it
- Tapes which are attached to your foot in a way that supports it. (photo)
- Steroid injections may also be used to reduce the inflammation at the plantar fascia.
- Surgery is usually reserved for those who do not respond well to other treatments.
Certain therapies such “shock wave therapy” are not proven to work. It produces pain and should be avoided.
Prevention is better than cure
There are several ways to avoid getting plantar fasciitis again and they are similar to the self-help suggested above.
Firstly, wear good comfortable shoes with ample support and cushion. Avoid slippers, poorly fitted shoes and high heels. Furthermore, avoid activities that can cause heel pain such as standing for prolonged duration, overdoing exercises, etc.
- Kasper D, Harrison T. Harrison’s Principles of internal medicine. New York: McGraw-Hill Education; 2015.
- Patient education: Heel pain (caused by plantar fasciitis) (The Basics) [Internet]. uptodate.com. 2017 [cited 18 September 2017]. Available from: https://www.uptodate.com/contents/heel-pain-caused-by-plantar-fasciitis-the-basics