Plantar fasciitis is a cause of heel pain that affects adults of all ages. A number of treatment methods are available. Some are suitable for self-treatment.
Plantar fasciitis is the most frequent cause of heel pain. Its exact incidence is not known but it can affect adults of all ages and is twice as common in women as in men.
It is usually experienced as a sharp or gnawing pain on the underside of the foot where the long arch meets the heel. The pain is at its worst on first standing such as on getting out of bed in the morning.
The cause is unknown. At one time it was felt that certain activities such as climbing ladders or wearing unaccustomed shoes were likely to lead to this condition but no one has found any convincing evidence of this. It is possible that excessive running may be a factor.
The name fasciitis suggests that the thick band of tissue that forms the long arch of the foot (the fascia) has become inflamed but microscopic analysis of the tissue does not bear this out. What seems to be the case is that the fibrous band becomes thickened and loses elasticity.
Treatment Methods
These range from simple rest to surgery.
Rest
This seems to help some people especially if the condition is caught early on. However complete rest is not always possible, there’s a limit to how long most of us can stay in a chair or in bed.
Stretching Exercises
There are quite few of these involving stretching of the Achilles tendon and the sole of the foot by standing on the toes or rolling a ball or a can under the foot. Another method is to place towel over the ball of the foot and with the leg straight pull the forefoot towards the knee.
Massage
This complements the stretching exercises. The massage needs to be quite deep along the sole of the foot and into the tender areas near the base of the heel.
Not a conventional therapy but some have found it useful. Needles are placed in the affected area and sometimes the lower leg.
Night Splints
These are worn at night and set the foot so as to stretch the fascia during sleep.
Shoe Insoles and Orthotics.
These work by setting the foot at an angle that takes the strain off the fascia whilst walking.
Steroid Injections
Used when the above treatments have not worked. Beneficial but entail some small risk in that they can increase the likelihood of rupture of the fascia.
Surgery
Normally the last resort. Robert D Glatter reports in Medscape October 2007 that a large number of patients do well in the first year but in the longer term the results are not so good.
Glatter also notes the lack of high quality research studies on any treatment for plantar fasciitis.
Self-Help for Heel Pain?
Firstly make sure that it probably is plantar fasciitis. If there is any marked redness in the area, swelling or heat, then it isn’t plantar fasciitis and you should seek professional advice.
If the foot seems normal, except for the pain try some stretching techniques and staying off your feet as much as possible.
Get a friend or relative to massage the area.
If the problem persists for more than a week despite this, then consult a health professional.
