Plantar fasciitis is a common cause of pain in heel. It is due to irritation and inflammation of plantar fascia (a long thin band that connects heel to front of toes, and supports the arch of the foot).
The plantar fascia is designed to absorb the stress and strains placed on the feet. The fascia may be inflamed as a result of overuse which results in the heel pain and stiffness of plantar fascia.
Risk factors for heel plantar fasciitis include:
- Faulty foot biomechanics, which place excessive stress on the heel bone, ligaments, and nerves near the heel.
- Running or jogging, especially on hard surfaces.
- Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
Other risk factors associated with plantar fasciitis include:
- Plantar fascia flexibility decreases with age making it prone to wear and tear.
- Malnutrition, causing absorption of fat from cushioning fat tissue of heel.
- Standing and walking work demand on daily basis.
- Sudden increase in activity in lesser active population.
- Flat feet
Heel spurs are present in most of the cases of plantar fasciitis cases but often not the source of pain. Heel spurs are developed as a result of stress produced at the site of attachment of fascia to the calcaneum. This results in formation of new bone at this site.
The most common symptoms of plantar fasciitis include:
- Pain on the bottom of the foot near the heel and on the inner side of heel.
- Heel pain is the first worse thing in the morning, or after a period of rest. The pain subsides after a few minutes of walk.
The initial treatment aims at reducing pain.
This can be achieved through icing. Apply ice 10-15 mins every 3-4 hours alternatively Ice rolling can be done for 15-20 mins trice daily. Contrast bath can be used if persistent swelling is seen.
Physiotherapeutic modalities such as ultrasound, LASER and shock therapy can be used to treat the condition.
Stretching exercises include plantar fascia and calf stretches.
If a hind foot varus deformity is observed, arch support can be prescribed to the patient.
Strengthening exercises of ankle muscles particularly those needed in supporting the arch of the foot. Gripping exercises with toes to strengthen the intrinsic foot muscles.
Thrust manipulation can be used to correct a fixed calcaneum in varus/ valgus position.
Myofacial release techniques are used to release adhesions in soft tissues and to promote proper excursion of tendons smoothly along the fascial planes.
Heel cushions can be used as shoe insert to reduce the pressure on the inflamed tissue.
Non steroidal anti-inflammatory drugs can be prescribed by an Orthopaedician. Corticosteroid injections can be given to resistant cases of plantar fasciitis.