What is plantar fasciitis?
Plantar fasciitis is the inflammation of the plantar fascia, a long ligament beneath the skin on the bottom of your foot that connects your heel bone to the base of your toes. The plantar fascia also supports the arch of your foot. The ligament is a tough, fibrous band designed to absorb the daily stresses and strains you place on your feet. When your foot experiences too much pressure, the tissues of the plantar fascia can become damaged or torn, causing plantar fasciitis.
According to the American Academy of Orthopaedic Surgeons (AAOS), plantar fasciitis is the most common cause of pain on the bottom of your heel. Active men aged 40 to 70 are more often affected than any other group. Approximately 2 million patients are treated for plantar fasciitis every year.
You may experience one or more of the following common symptoms of plantar fasciitis:
- Pain and stiffness in the bottom of your heel (the most common symptom)
- Dull or sharp heel pain
- Achiness or burning on the bottom of your heel
The pain of plantar fasciitis usually worsens at these times:
- In the morning, when you get out of bed and take your first steps
- After standing or sitting
- Climbing stairs
- After intense physical activity
Causes of and risk factors for plantar fasciitis include:
- Foot arch problems: both flat feet (the lack of an arch when standing) and high arches (an arch that is raised more than normal)
- Obesity or sudden weight gain
- Long-distance running, especially downhill or on uneven surfaces
- Occupations that require excessive standing or walking
- Tight Achilles tendon (the tendon that connects the calf muscles to your heel)
- Shoes with poor arch support or soft soles
Beginning a new exercise plan too quickly, the American Orthopaedic Foot and Ankle Society warns, can result in plantar fasciitis as well as stress fractures and ruptured tendons. The society recommends that you increase your distance and speed gradually when walking or running (about a 10 percent increase per week), wear proper footwear and stretch gently to warm up and to cool down.
Plantar fasciitis is commonly thought to be caused by a heel spur (a hook of bone that forms on the bone at the back of the foot), but research has proven that to be untrue. The AAOS reports that one out of 10 people has heel spurs, but only one out of 20 people (5 percent) with heel spurs has foot pain. Because the spur is not the cause, the painful symptoms of plantar fasciitis pain can be treated without removing the spur.
More than 90 percent of patients with plantar fasciitis will improve within 10 months of starting simple nonsurgical treatment methods, such as rest, icing, anti-inflammatory medicines, a night splint and specific plantar fasciitis exercises. A small percentage of patients may need plantar fascia release surgery or shockwave therapy.