Plantar Fasciitis: Symptoms, Causes, Tests, and Treatments

Plantar Fasciitis (PF) is an inflammation of the thick band of connective tissue (plantar fascia) that runs across the bottom of our feet, connecting the heel bone to the toes. According to the Journal of American Family Physicians, 1 in 10 people will experience plantar fasciitis at some point in their lifetime. PF can be excruciatingly painful, and a hallmark symptom is severe pain that occurs when you take the first step out of bed in the morning.

Long periods of standing, especially on hard surfaces such as asphalt or concrete, can exacerbate this condition, particularly without proper supportive footwear. Plantar fasciitis is more common in runners and overweight individuals.

Here’s what you need to know about plantar fasciitis.

Symptoms

Typically, the symptoms of PF include a dull to sharp, stabbing pain in the bottom of the foot near the heel, although pain can manifest anywhere along the length of the plantar fascia. Also, it may cause a burning pain extending from your heel through the bottom of your foot.

As we mentioned, a strong indicator that you have plantar fasciitis is pain and stiffness, which is at its worst with the first steps after waking up in the morning. Pain can be triggered by a long period of standing, walking, or standing up after sitting for a while.

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Causes

Plantar fasciitis can be caused by:

• A sudden increase in activity, such as beginning a new, intensive running program or other activities that strain the part of your foot that connects your heel bone to your toes. This can include pregnancy since you're carrying an increased load on your feet as the baby grows.
• Being on your feet all day, particularly on hard surfaces.
• Wearing shoes that do not support your feet well enough, such as flip flops or flat sneakers.
• Walking barefoot while you are at home.

Plantar Fasciitis Tests

Diagnosing plantar fasciitis can require everything from a verbal history describing your pain to more involved imaging tests to take pictures of your feet. Some diagnostic methods are:

• X-ray: Physicians may use a lateral non-weight bearing X-ray to confirm a diagnosis of PF. X-ray is a good way of detecting bone and joint damage in the foot.
• Ultrasound: Ultrasound is an effective diagnostic tool. It will show a thickening of the plantar fascia that's indicative of inflammatory changes.
• MRI: Magnetic resonance imaging provides details on soft tissues. The images will show a thickening of the plantar fascia, but it is most useful when the above two tests have not definitively diagnosed plantar fasciitis, if there has been limited to no response to initial treatment, and to rule out more severe diagnoses.

Treatment Options

Some ways to treat plantar fasciitis include:

• Physical therapy: PT is generally recommended as the first line of treatment for PF. It involves targeted gentle stretches and strengthening exercises for the feet, all to decrease pain and speed up the healing process. Physical therapists may also use pain-relieving modalities such as ultrasound (different from the diagnostic ultrasound mentioned in the test section) and electric stimulation.
• Rest and icing: Resting to take pressure off your feet is recommended, as well as avoiding or limiting activities that make your foot hurt. Applying a bag of ice or a cold pack wrapped in a towel to your heels and the bottom of your arch is a simple way to relieve pain and decrease inflammation.
• Insoles: Supportive insoles for your shoes can sometimes relieve pain instantly. Insoles can provide added cushioning and arch support, which takes the pressure off of the plantar fascia, and that's all your feet need sometimes. Custom orthotics are the best, as they are made especially for your feet and designed to address your unique needs.

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Rid Yourself of Plantar Fasciitis Pain

PF is a highly treatable condition. Most people with this condition will improve within 12 months, but treating it can take months off of that time. One of the most important things you can do for plantar fasciitis is to wear supportive insoles in your shoes that optimize the biomechanics of your ankles and feet.