Walking on Pain: Understanding Plantar Fasciitis – Causes, Symptoms, Treatments, and the Crucial Role of Prevention

Plantar fasciitis is a common condition that affects a large number of people causing them foot pain. It is characterized by inflammation of the thick band of tissue, called the plantar fascia, which runs across the bottom of the foot, connecting to the heel. Pain caused by plantar fasciitis is often a stabbing pain in the heel, bottom of the foot, or arch. Morning or after a long period of rest or inactivity are typically the worst. Plantar fasciitis is one of the most common causes of heel pain, and affects over the eight million people annually, states Trojian and Tucker (2019).

Many causes may lead to the onset of plantar fasciitis. One of the common causes is obesity because, from a biomechanical point of view, obesity can cause an increased strain on the plantar fascia. Athletes are also more prone to this type of injury, particularly those that participate in sports that involve running or repetitive stress on the feet. In addition, overuse of the feet, such as during intense training sessions without adequate recovery, can lead to inflammation and foot pain (Petraglia, Ramazzina & Costantino, 2017). Finally, patients who wear shoes with inadequate arch support or shock absorption are also at risk for this type of injury.

There are many possible causes of plantar fasciitis. Age and occupation are also important. As we get older our plantar fascia becomes less elastic and is therefore more prone to injury. Some occupations can also cause plantar fasciitis. Those that involve standing for long periods of time or weight-bearing activities like heavy lifting can cause increased stress on the feet. Workers in jobs such as nursing, teaching and building and construction are most affected by foot-related issues and are more likely to experience symptoms of plantar fasciitis (Morrissey et al., 2021).

It is important to know the causes of plantar fasciitis so that steps can be taken to prevent it. Being aware of the factors that lead to this condition will empower individuals to make lifestyle modifications, choose appropriate footwear, and engage in activities that do not put them at risk of developing this condition. If left untreated, this condition can lead to chronic pain that makes it very difficult for individuals to walk and affects their quality of life., Plantar fasciitis is associated with certain symptoms that can make it easy to identify and seek treatment. One of the most common symptoms associated with this condition is pain in the heel. Usually, the pain starts as a sharp stab that intensifies when the individual takes the first few steps. Pain can also be felt after a long period of inactivity, such as after sitting for hours on end. According to Martin et al. (2014) and Thompson et al. (2014), the pain caused by plantar fasciitis tends to be most intense in the morning, and it can subside as the individual continues to walk around. However, the pain tends to return with intensity after a while, especially after a long day of standing, walking, or climbing stairs. Individuals with this condition often have trouble performing daily activities at work or at home, or even just playing with their kids. In some cases, they may even find it challenging to participate in certain sports or activities that they used to enjoy.

When suspecting plantar fasciitis, it is important to receive a proper diagnosis early on because similar heel pain can be caused by other conditions such as heel spurs, bursitis or Achilles tendonitis. A proper diagnosis begins with a thorough physical examination of the foot and a consultation with your doctor to review your medical history, activities and the timing of the pain.

Diagnosis of plantar fasciitis is based on clinical evaluation and history. Evaluation of the foot includes assessment of localized pain and swelling, stiffness, limited range of motion, and structural abnormalities. Applying pressure to the medial aspect of the bottom of the foot over the plantar fascia is a common diagnostic maneuver to check for pain production consistent with plantar fasciitis. If clinical evaluation is not diagnostic, x-rays or MRI (Latt et al., 2020) of the foot may be ordered to diagnose or rule out other causes of pain such as bone spurs or fractures. X-rays can help diagnose bone abnormalities, such as a spur on the bottom of the heel. MRI images show more details of soft tissues. They can show if the plantar fascia is inflamed, stretched, or torn.

There is often a temptation to ignore heel pain and hope it will resolve itself. Being unaware of the symptoms and not seeking a proper diagnosis can delay effective treatment and potentially lead to a worsening condition. Familiarising yourself with the symptoms of plantar fasciitis and understanding the importance of consulting with a healthcare professional will enable you to better manage your symptoms and achieve a higher quality of life. Treatment options for plantar fasciitis are numerous and, in the majority of cases, initial treatment is conservative in nature. Allowing your affected foot to rest is important to enable the inflamed fascia to start to heal. Applying ice to the bottom of your foot for 15-20 minutes a few times a day can help reduce swelling and alleviate pain. Gentle stretching of the calf muscles as well as the arch of the foot will help increase flexibility and reduce tension on the plantar fascia (Johnson et al., 2014). Modifying your footwear is another key component in alleviating pain caused by plantar fasciitis. Wearing shoes with adequate arch support and cushioning can help reduce tension and alleviate pressure on the plantar fascia, making it easier to perform day-to-day activities (Landorf, 2015).

In addition to using medical treatments for plantar fasciitis, physical therapy can be of great benefit. A physical therapist can show you the right type of exercise to perform to treat your condition. These exercises can include simple stretches, strengthening, and manual treatment such as massage. By performing these exercises, you can alleviate pain, as well as prevent future complications such as further injury to the foot by improving the function and alignment of the foot (Koc Jr et al., 2023). In some cases, if conservative methods are not successful after a few months, surgery may be discussed. However, surgery is typically a last resort and used to treat more severe cases of pain that persists and interferes with daily activities and doesn’t resolve with other treatment (Motley, 2021).

Untreated plantar fasciitis can have a profound impact on a person’s quality of life and their activities, preventing them from undertaking normal activities of the day or even going to work due to the pain in their foot. In addition, exercise is often reduced due to pain, leading to a sedentary lifestyle which can have further health, psychological and behavioural effects. People with plantar fasciitis also have difficulty sleeping, waking up during the night in discomfort and waking up in the morning with pain in their foot, which can be distressing and exhausting (Griffiths et al., 2021). Early diagnosis and treatment is key to a speedy recovery and preventing the condition from becoming worse. It generally means a person will return to their normal activities a lot sooner than if they delayed seeking help.

Understanding your treatment options and prevention techniques for plantar fasciitis is important to you and the overall health of your feet. By seeking treatment early and incorporating some simple prevention techniques into your lifestyle, you can prevent more pain and keep you active.

Citations:

Morrissey, D., Cotchett, M., Said J’Bari, A., Prior, T., Griffiths, I.B., Rathleff, M.S., Gulle, H., Vicenzino, B. and Barton, C.J., 2021. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British journal of sports medicine, 55(19), pp.1106-1118. https://bjsm.bmj.com/content/55/19/1106.abstract

Trojian, T. and Tucker, A.K., 2019. Plantar fasciitis. American family physician, 99(12), pp.744-750. https://www.aafp.org/pubs/afp/issues/2019/0615/p744.html

Martin, R.L., Davenport, T.E., Reischl, S.F., McPoil, T.G., Matheson, J.W., Wukich, D.K., McDonough, C.M., Altman, R.D., Beattie, P., Cornwall, M. and Davis, I., 2014. Heel pain—plantar fasciitis: revision 2014. Journal of Orthopaedic & Sports Physical Therapy, 44(11), pp.A1-A33. https://www.jospt.org/doi/abs/10.2519/jospt.2014.0303

Koc Jr, T.A., Bise, C.G., Neville, C., Carreira, D., Martin, R.L. and McDonough, C.M., 2023. Heel pain–plantar fasciitis: revision 2023: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy and American academy of sports physical therapy of the American physical therapy association. Journal of Orthopaedic & Sports Physical Therapy, 53(12), pp.CPG1-CPG39. https://www.jospt.org/doi/abs/10.2519/jospt.2023.0303

Thompson, J.V., Saini, S.S., Reb, C.W. and Daniel, J.N., 2014. Diagnosis and management of plantar fasciitis. Journal of Osteopathic Medicine, 114(12), pp.900-901. https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html

Latt, L.D., Jaffe, D.E., Tang, Y. and Taljanovic, M.S., 2020. Evaluation and treatment of chronic plantar fasciitis. Foot & ankle orthopaedics, 5(1), p.2473011419896763. https://journals.sagepub.com/doi/abs/10.1177/2473011419896763

Motley, T., 2021. Plantar fasciitis/fasciosis. Clinics in podiatric medicine and surgery, 38(2), pp.193-200. https://www.podiatric.theclinics.com/article/S0891-8422(20)30135-X/abstract

Petraglia, F., Ramazzina, I. and Costantino, C., 2017. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles, ligaments and tendons journal, 7(1), p.107. https://pmc.ncbi.nlm.nih.gov/articles/PMC5505577/

Johnson, R.E., Haas, K., Lindow, K. and Shields, R., 2014. Plantar fasciitis: what is the diagnosis and treatment?. Orthopaedic Nursing, 33(4), pp.198-204. https://journals.lww.com/orthopaedicnursing/fulltext/2014/07000/Plantar_Fasciitis__What_Is_the_Diagnosis_and.7.aspx

Landorf, K.B., 2015. Plantar heel pain and plantar fasciitis. BMJ clinical evidence, 2015, p.1111. https://pmc.ncbi.nlm.nih.gov/articles/PMC4661045/