If you are suffering from the pain of plantar fasciitis, you are not alone. The most common cause of heel pain, plantar fasciitis often plagues long distance runners, dancers, soccer players – anyone whose activities present constant pounding to the feet. It is important to know the warning signs to treat the condition before it becomes chronic.
Plantar fasciitis, which affects more than 2 million Americans each year, is the result of inflammation of the thick band of tissue – the plantar fascia – that runs across the bottom of the foot and connects the heel to the front of the foot. Designed to maintain the integrity of the arch and absorb the stress and strains placed on the foot, too much pressure combined with tightness of the calf or Achilles tendon can cause inflammation of the fascia.
The result is sharp pain or a deep ache in the heel or along the arch of the foot. You will likely feel pain with your first steps in the morning or after long periods of sitting. The plantar fascia stretches as a person moves throughout the day and then regenerates and tightens as the foot is in a relaxed position while sleeping. This overnight tightening is what makes plantar fasciitis most painful first thing in the morning.
The good news is, with treatment, 90% of patients will feel a 90% reduction in their pain within three months. Early intervention is important because the longer you have the condition, the more nagging it will become.
One of the most effective at-home treatments is proper stretching of the calf muscles before and after exercise. Even something as basic as changing shoes or adding simple inserts can help to relieve the stress on the plantar fascia. Icing, avoiding walking barefoot and the use of anti-inflammatories are effective when used as symptoms begin to develop.
If pain persists for more than two weeks while utilizing at home treatments, it is likely time to see a physician. I often recommend a night splint that keeps the foot at a 90-degree angle while sleeping to stretch the calf muscle and the Achilles tendon. For patients with flat feet, high arches or even an abnormal pattern of walking, the weight on the feet is often distributed in a way that places additional stress on the plantar fascia.
Cortisone injections are a powerful anti-inflammatory to reduce acute pain. Surgery is considered in rare cases and only after 12 months of aggressive nonsurgical treatments.
It is important while treating plantar fasciitis to remain patient – it is not an overnight fix. It took months, or even years, for the soft tissues to develop and cause inflammation, so it will take time for the body to adjust.
Dr. Matthew Levy writes about orthopedics for the Cleveland Jewish News. He is an orthopedic surgeon at St. Vincent Charity Medical Center and practices in Solon, Independence and downtown Cleveland.