Plantar Fasciitis

It is believed to be caused by repeated small tears in the plantar fascia. If the tension in this area becomes too strong, it will become weak, swollen and inflamed. That’s why it will hurt when you stand or walk because you are stretching the plantar fascia for these actions. Some of the risk factors include:

• Certain types of exercise: Long-distance running and ballet dancing are putting a lot of stress on your heel and attached tissue. 
• Foot problems: If you have flat feet or have an abnormal pattern of walking, it can affect how the weight is distributed when you stand. 
• Overweight: Being obese or overweight will put extra stress on your plantar fascia. 
• Occupations: Teachers or factor workers who spend most of their time standing can damage their plantar fascia. 
• Poor posture

Symptoms include a gradual onset of pain under the heel radiating into the foot. You may feel tenderness under and on the inside of the heel, which is usually worse in the morning. When your feet warm up, the pain eases. However later in the day or after exercises, the pain comes back. It may be painful to stretch the plantar fascia. 

Usually physical examination and medical history are good enough to make a diagnosis. Your doctor will check your feet when you stand and walk, and also the points of tenderness in your feet, aiming to find out the location of your pain and its cause. He or she may ask the following questions:

• Your medical history, such as illnesses or injuries you had
• Your presentation of symptoms, such as where the pain is, and what time of the day it hurts most
• The activities that you are engaged in

Imaging tests such as x-ray or magnetic resonance imaging (MRI) test is often done to exclude other medical possibilities, such as stress fracture or a pinched nerve. An x-ray can even show a bone spur, which may cause heel pain and should be removed by surgery. 

People with plantar fasciitis are often treated and recovered with very basic approaches, for example, some simple self-help approaches, medications and physiotherapy. 

Self help

• Rest your foot as much as possible
• Stretch your calf muscles and the plantar fascia
• Apply ice pad to the injured area until the swelling goes down
• Massage your foot by rolling a golf ball on the sole
• Wear good quality and well-fitted shoes or insoles
• Ignoring the pain may take you longer to heal. 
• Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging.
   

Medications 

Pain relievers such as ibuprofen may help to ease your pain and inflammation in your feet. Steroid shots may be used to the tender area, which provides temporary pain relief. However, it produces side-effects such as weakening of plantar fascia for prolonged use.

Physiotherapy 

Stretching and strengthening exercises tailored specifically to you by a physiotherapist will ease your condition. Your physiotherapist will provide an exercise program to stretch your plantar fascia and Achilles tendon, and to strengthen your lower leg muscles, aiming to stabilize your ankle and heel. Sometimes, an athletic taping may be used to support the bottom of your feet. Wearing a splint at night to stretch your calf and the arch of your foot will be recommended. This holds the plantar fascia in a lengthened position overnight for stretching. 

Extracorporeal shock wave therapy

It is a therapy using sound waves at the infected area to promote healing. It is often used for plantar fasciitis that has no response to conservative treatments. However, it may cause swelling and pain that has not been shown very effective. 

Surgical management

Your doctor may recommend a surgery based on your situation if all the conservative treatments do not work. Some people may need a surgery to detach the plantar fascia from the heel bone. However, it may cause side effects such as weakening of your foot arch.