Plantar Fasciitis

Understanding Plantar Fasciitis

Plantar fasciitis, often referred to as plantar heel pain, affects a significant portion of the population, with 9.6% experiencing this condition and 7.9% of adults over 50 suffering from disabling plantar heel pain (“CKS,” 2020). This condition involves the thickening and inflammation of the plantar fascia, a crucial band of tissue that extends from the heel to the toes, providing essential support to the arch and absorbing shock during weight-bearing activities. The onset of plantar fasciitis is typically marked by "first-step pain," a sharp discomfort felt when taking the initial steps after rest, which may vary in intensity from mild to severe. Although the pain often subsides as the day progresses, it can worsen with prolonged standing or walking.

It is important to note that not all heel pain is attributed to plantar fasciitis. Various other conditions can cause similar symptoms, so a thorough assessment is necessary to diagnose plantar fasciitis accurately. This ensures that the treatment plan is tailored to address the specific causes of your heel pain, whether it be stress fractures, hallux valgus, or other foot-related issues.

By understanding the nature of plantar fasciitis and differentiating it from other forms of heel pain, individuals can take the necessary steps to seek appropriate treatment. This may involve stretching exercises, wearing shoes with good arch support and cushioned heels, or considering more advanced options like corticosteroid injections or extracorporeal shockwave therapy for refractory cases. Recognising the symptoms and seeking early intervention can significantly improve recovery outcomes and enhance quality of life.

Differentiating Heel Pain Causes

Heel pain can stem from various conditions, and it's crucial to differentiate between them for effective treatment. Plantar fasciitis is a common cause, characterized by inflammation of the plantar fascia, leading to plantar heel pain. However, other conditions may mimic its symptoms, such as stress fractures, which are tiny cracks in the bone caused by repetitive force or overuse, often seen in athletes or those who engage in high-impact activities. Hallux valgus, another condition, involves a deformity of the big toe joint, which can alter gait and contribute to heel pain.

It is essential to conduct a thorough assessment to diagnose plantar fasciitis accurately. This involves examining the patient's medical history, performing a physical examination, and sometimes utilising imaging techniques like X-rays or ultrasound to rule out other causes such as stress fractures or bone spurs. Identifying the correct source of heel pain allows for a targeted treatment plan, which may include stretching exercises to improve flexibility, wearing shoes with good arch support and cushioned heels to reduce stress on the plantar fascia, and considering interventions like corticosteroid injections or extracorporeal shockwave therapy for persistent pain.

By distinguishing plantar fasciitis from other heel pain causes, patients can receive tailored treatments that address their specific condition, leading to better recovery outcomes. Early diagnosis and intervention are key to managing symptoms effectively and preventing chronic pain. Understanding the various potential causes of heel pain empowers individuals to seek appropriate care and take proactive steps towards healing.

Effective Treatments for Plantar Fasciitis

Treating plantar fasciitis focuses on reducing inflammation and relieving pain while promoting healing. Initial steps include rest, ice application, and NSAIDs to manage discomfort. Stretching exercises targeting the calf muscles and Achilles tendon can help alleviate tension on the plantar fascia.

Supportive footwear with good arch support and cushioned heels is essential. Orthotics may also be recommended for additional support. For persistent pain, corticosteroid injections and extracorporeal shockwave therapy might be considered to stimulate healing.

Symptoms of Plantar Fasciitis

Pain over the heel bone

Pain worse when standing and eases when sitting

'First step pain' is particularly worse which eases as you begin your day.

Sometimes there may be pain in the arch

The pain is often described as a sharp pain, and specific to one or two areas.

What Should You Do About Your Heel Pain?

At Dunford Health, we recommend an initial Foot and Ankle pain assessment to identify the cause of your heel pain and give you a diagnosis. Once you have a diagnosis, it can be much easier to treat your heel pain as you will be confident in the treatments available to you. We will guide you through the treatment step-by-step until you are pain-free.