Plantar fasciitis occurs when the plantar fascia, a long, thin ligament that lies directly beneath the skin on the bottom of your foot, becomes irritated and inflamed. This strong band of tissue connects the heel to the front of your foot, and supports the arch of your foot.
The plantar fascia absorbs the high stresses and strains placed on our feet and too much pressure can damage or tear the tissue. The body’s natural response to injury is inflammation, which results in the heel pain and stiffness of plantar fasciitis. Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain and surgery to remove the heel spur is not required.
You are more likely to get plantar fasciitis if you:
- Have foot arch problems (both flat feet and high arches)
- Run long distances, downhill or on uneven surfaces
- Are obese or gain weight suddenly
- Have a tight Achilles tendon (the tendon connecting the calf muscles to the heel)
- Wear shoes with poor arch support or soft soles
- If you participate in exercises regularly that stress your feet
The most common symptom is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain may develop slowly over time, or come on suddenly after intense activity. You may also experience stiffness, tenderness, swelling or increased warmth along the bottom of your foot.
The pain is often worse:
- In the morning when you take your first steps
- After standing or sitting for awhile
- When climbing stairs
- After intense activity
- During walking, running, and jumping sports
Diagnosis and Treatment
The skilled physicians at Augusta Foot & Ankle usually diagnose plantar fasciitis by examining your feet, looking for localized tenderness on the soles of your feet, especially on the heel and inside your arch. We also employ state-of-the-art technologies like digital X-rays and ultrasound imaging. These tests can reveal heel spurs, fractures, and other issues that may contribute to your discomfort.
More than 90 percent of patients with plantar fasciitis will improve within months after starting simple treatment methods. Your doctor will usually recommend these steps first:
- Prescription NSAIDs or OTC ibuprofen (Advil, Motrin) to reduce pain and inflammation
- Physical therapy to treat and prevent future injury
- Exercise including calf stretch and plantar fascia stretch
- Night splints to wear while sleeping to stretch the plantar fascia and Achilles tendon
- Resting as much as possible for at least a week
- Ice by rolling your foot over a cold or frozen water bottle for 15-20 minutes three or four times a day
If these treatments do not work our team may recommend:
- Wearing a walking boot cast for three to six weeks. It can be removed for bathing.
- Custom-made orthotic insoles
- Steroid shots or injections into the heel
- Laser treatment
- Stem cell injections
The doctors of Augusta Foot & Ankle offer a new plantar fasciitis treatments. This treatment consists of ultrasonic debridement of the diseased tissue with a device from Tenex Health TX. This is a minimally invasive, minor surgical treatment that uses high-frequency vibrations and a specialized tool to remove accumulated scar tissue from a damaged tendon (or in cases of plantar fasciitis, a damaged plantar fascia ligament). Tenex Health TX is especially effective for plantar fasciitis that hasn’t responded to more traditional and conservative treatment options.
Surgery is generally considered only after 3-6 months of aggressive nonsurgical treatment.