A 40-year-old woman had been complaining of pain in her heels for over a year. She used to wake up with the stabbing sharp pain at the bottom of centre of her heels. The pain usually returned after long periods of standing or after she moved from a seated position. The lady had shown it to a few surgeons who prescribed her painkillers. With the help of analgesics the pain subsided, but only for a while. After examining her condition, it was found out that the lady had a high arched foot and tight calf muscles which accowas the main cause of pain in her heels condition as plantar fasciitis. The lady’s high arch tissues of sole were under constant tension due to plantar fasciitis and the tension only increased as she walked. In such cases patient are recommended to perform stretching exercises of plantar fasciitis and the calf. Also to wear supportive shoe wear for arch support. After about a week’s time the patient returned back fairly happy and satisfied. There was no pain in her foot for the first time in over 13-14 months. And, within a month, the lady was totally pain-free and the best part, she was not on any analgesic or any kind of medication. Thus, the diagnosis of the cause or abnormality of plantar fasciitis is more important than diagnosing plantar fasciitis itself. So, if your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis. A lot of times, many of us tend to ignore the stabbing pain assuming it’s going to subside as the day ends. But this could be an early sign of plantar fasciitis.
Understanding Plantar Fasciitis
The plantar fascia is the thick tissue on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis. Classically, it is worse in the morning with the first few steps and at the beginning of any sporting activity. Though it is common in runners and dancers, plantar fasciitis can affect men and women alike between 40-60 years. Also, people with very flat feet or very high arches are more prone to plantar fasciitis.
Causes and Symptoms
Several structural causes can contribute to plantar fasciitis. These may include:
* A misaligned and weak first toe
* Weak intrinsic foot muscles
* Tight, shortened calf muscles
* Tight plantar fascia
Other contributing factors may include:
* Increased mechanical stress from running/dancing, etc.
* Obesity
* Occupations that keep people on their feet. For instance, factory workers, teachers, etc.
* Poor walking and running mechanics
Ignoring plantar fasciitis may result in chronic heel pain. It can even change the way you walk. The common symptoms of plantar fasciitis are:
* Stabbing or sharp pain and stiffness in the bottom of the heel, although some experience pain at the bottom mid-foot area.
* Plantar fasciitis usually affects just one foot, but it can affect both feet
* Pain is usually worse in the morning when you take your first steps out of bed
* Pain while climbing stairs or while performing any sport activity
Treatment
Once the cause of plantar fasciitis is diagnosed, it’s easy to cure the condition. Stretching is the best treatment for plantar fasciitis. It may help to try to keep weight off your foot until the initial inflammation goes away. You can also apply ice to the sore area for 20-30 minutes several times a day to relieve your symptoms. Home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treatment and reduce the chance of recurrence. If your condition has developed recently, anti-inflammatory/ analgesic medication (in tablet form), coupled with heel pads may be all that is necessary to relieve pain and reduce inflammation. In case there’s no relief in pain or your condition, speak to your ankle and foot doctor. If surgery is rarely required for plantar fasciitis. It would be considered treatment if the pain is still incapacitating after at least 12 months of treatment. However, during recovery, loss of excess weight, good shoes and sedentary activities- all help the injury to heal.
(The author is Orthopedic & Podiatric Surgeon (Foot and Ankle), at Breach Candy Hospital, Mumbai [email protected]).
