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Plantar Fasciitis
Plantar Fasciitis
Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia).
Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.
The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight
Risk Factors
Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:
- Age. Plantar fasciitis is most common in people between the ages of 40 and 60.
- Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
- Foot mechanics. Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you’re standing and can put added stress on the plantar fascia.
- Obesity. Excess pounds put extra stress on your plantar fascia.
- Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can be at increased risk of plantar fasciitis.
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Causes
The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking.
Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the facia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.
Diagnosis
Plantar fasciitis is diagnosed based on your medical history and physical examination. During the exam, your health care provider will check for areas of tenderness in your foot. The location of your pain can help determine its cause.
Imaging tests
Usually no tests are necessary. Your health care provider might suggest an X-ray or MRI to make sure another problem, such as a stress fracture, is not causing your pain.
Sometimes an X-ray shows a piece of bone sticking out (spur) from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.
Treatment
Medications
Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) can ease the pain and inflammation of plantar fasciitis.
Therapies
Physical therapy or using special devices might relieve symptoms.
- Physical therapy. A physical therapist can show you exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist might also teach you to apply athletic taping to support the bottom of your foot.
- Night splints. Your physical therapist or health care provider might recommend that you wear a splint that holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching while you sleep.
- Orthotics. Your health care provider might prescribe off-the-shelf or custom-fitted arch supports (orthotics) to distribute the pressure on your feet more evenly.
- Walking boot, canes or crutches. Your health care provider might recommend one of these for a brief period either to keep you from moving your foot or to keep you from placing your full weight on your foot.