Anyone who spends a great deal of time on their feet knows how uncomfortable soreness and pain in the feet can be. Of all the feet-related conditions, a shooting or burning pain across the soles of the feet, running from the heel to the toes, is one of the worst. It may be so bad as to make it impossible for a person to place weight on the affected foot or to walk. This is a condition known as plantar fasciitis. It is the result of the plantar fascia (a band of tissue connecting the heel with the toes) becoming inflamed. The pain typically occurs when a person awakens in the morning and places weight on the feet, but it can occur at any time, especially after the person has spent extended hours standing or gets up after being seated. The pain may occur in one or both feet. The pain may remain for varying periods of time and once it subsides, can return again without warning.
Causes
The plantar fascia runs across the sole of the foot and along with connecting the heel and toes, also supports the arch of the foot. Over time and with misuse of the feet, the pressure on the tissue can result in small tears developing. If the pain is ignored and the feet are not given enough rest, the tearing can increase and become inflamed, resulting in increased pain and sensitivity. The reason why some people are more susceptible to the condition than others is unclear, but those who run long distances or are overweight have increased chances of developing plantar fasciitis. The condition can affect anyone at any age.
Several risk factors for developing plantar fasciitis have been identified. Among these are:
- Increasing Age – The problem is prevalent among the age group of 40 to 60.
- A Few Forms of Exercise – Running, aerobic exercises, dancing and other such activities increase the risk of developing this type of foot pain.
- Occupation – Any job that keeps a person on his feet for long periods of time increases the risk of plantar fasciitis.
- Obesity – Excess body weight places increased stress on the feet, resulting in a greater risk of foot pain.
- Foot Shape – Both flat feet and high arches increase the risk of the problem occurring.
- Incorrect Ways of Walking - Unusual patterns of walking or foot movement increase the pressure on the feet and the risk of foot pain.
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Potential Complications
If plantar fasciitis is ignored for any length of time, the condition may become chronic and limit foot movement and mobility. It is also possible that the pain may change the way a person walks and this in turn may place extra stress on the feet, knees, hips and back, causing other medical conditions to develop in these places.
Diagnosis
Diagnosis is often done simply by a physical examination of the feet. The doctor will check for the places of tenderness or sensitivity on the soles of the feet. The location of the pain will often be enough to confirm a diagnosis of plantar fasciitis. If there is any uncertainty, the doctor may order imaging tests like x-ray or MRI to confirm the diagnosis and rule out any other cause such as stress fractures.
Treatment
Many over-the-counter medications can relieve the pain of plantar fasciitis. However, these only suppress the pain and do not treat the condition. They may be used to provide temporary pain relief while other treatments are being done.
The first step is normally to try conservative treatments such as stretching exercises, icing the soles of the feet, correcting walking patterns that cause the problem and avoiding activities that cause inflammation of the plantar fascia. Among the options available are:
- Physical Therapy – A physical therapist will train the patient in various exercises designed to stretch the plantar fascia to reduce stress on it and to strengthen ligaments and muscles.
- Taping – Athletic taping may be placed on the soles of the feet to provide support and reduce tissue stress and tension.
- Orthotics – Arch supports may be prescribed to allow for better distribution of pressure on the feet and to reduce stress.
- Walking Supports - Crutches, canes or special walking boots may be prescribed for a short time to keep weight and pressure off the feet and to allow the plantar fascia to heal.
- Splints – A special splint that holds the foot in a lengthened position overnight to allow the plantar fascia to stretch and relax may be prescribed for a short time.
If conservative treatments are not effective, then the next stage normally involves the following:
- Shock Wave Therapy – Sound waves are focused on the painful areas to promote tissue healing.
- Injections – Platelet-rich plasma (PRP), taken from the patient’s own blood, can be injected into the soles of the feet to promote tissue repair and healing.
- Surgery – In the worst case, if the damage to the plantar fascia is severe, surgery may be done to repair the damage or even detach the tissue from the heel bone so that further stress is not placed on it.
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Once the treatment is complete, the patient will be advised on precautions to be taken to prevent a recurrence of the problem.
Many people tend to ignore pain in the soles of the feet thinking it is a passing problem. This idea gains strength when the pain fades. When it does return, the knowledge that it is temporary leads many to continue ignoring it. It is only when the pain becomes unbearable that they seek medical attention. By this time the condition is so advanced that treatment is more complex and may even involve surgery. Early diagnosis and treatment of plantar fasciitis will provide quick and long-lasting relief from the problem. Going to a multispecialty hospital, where a range of advanced medical services are available, to be examined by a specialist and to get an accurate diagnosis will ensure that the best treatment is provided and that any contributory factors are also diagnosed and treated.