What is Plantar Fasciitis?
Plantar fasciitis occurs due to the inflammation of the plantar fascia, a strong, thick tissue that runs down the sole of the foot. It forms the foot's arch by joining the heel bone to the toes.
Heel discomfort is frequently noticed in patients with plantar fasciitis, which can be caused by overuse, overstretching or a medical condition.
Although many people experience heel spurs without any pain, plantar fasciitis is frequently linked to a heel spur, a bone spur that protrudes from the heel bone.
According to NCBI, the origin of the plantar fascia in the medial calcaneal tuberosity of the heel, as well as the adjacent perifascial tissues, are subject to degenerative irritation that causes plantar fasciitis.
There are three segments that make up the plantar fascia, which originate from the calcaneus and play a significant part in the normal biomechanics of the foot. In addition to supporting the arch and absorbing trauma, the fascia plays a crucial role in these processes. This illness is noticeably characterised by a lack of inflammatory cells, despite the diagnostic containing the segment "itis".
Causes of Plantar Fasciitis
Fascia, a thick band of connective tissue on the bottom of the foot, can swell if it is overstretched or overused. It may hurt and be more challenging to walk as a result.
The risk of developing plantar fasciitis increases in the following conditions.
- Have issues with the foot arch (both flat feet and high arches)
- Run across a distance, downhill or over an uneven surface.
- Are overweight or unexpectedly gain weight
- Achilles tendon is tight (the tendon connecting the calf muscles to the heel)
- Wear footwear with inadequate arch support or soft soles.
- Vary the degree of activity
- Both men and women have plantar fasciitis. This is one of the most prevalent orthopaedic foot issues.
Heel spurs were frequently believed to be the cause of plantar fasciitis. Research has shown that this is untrue. Heel spurs can be visible on x-rays in patients with and without plantar fasciitis.
Symptoms of Plantar Fasciitis
A dull or severe discomfort under the heel is the primary sign of plantar fasciitis. The heel could be slightly enlarged, and the sole of the foot could hurt or burn.
Pain is frequently worse,
- Following a vigorous activity.
- As soon as one sets foot outside in the morning.
- Following extended periods of standing or sitting.
Risk factors of Plantar Fasciitis
Predisposing conditions for plantar fasciitis are
- Pes planus,
- Pes cavus,
- Restricted ankle dorsiflexion,
- Excessive pronation and
- Supination.
Patients may experience higher tension as a result of pes planus. Due to the foot's inability to adequately evert or absorb shock, pes cavus can put excessive strain on the heel.
Heel spurs are present in about 50% of people with this illness, although they are not the root of the problem.
Other risk factors include
- Obesity,
- Heel pad atrophy,
- Ageing,
- Occupations requiring extended standing and
- Weight-bearing.
It is frequently linked to runners and elderly persons. Numerous seronegative spondyloarthropathies have been related to plantar fasciitis, although, in about 85% of cases, no recognised systemic causes are present.
Diagnosing Plantar Fasciitis
The doctor will perform a physical examination and question about the symptoms experienced by a person, which may include
- Experiencing pain at the bottom of the foot.
- Pain running along the foot's sole.
- High arches or flat feet
- Mild foot redness or swelling.
- The arch at the bottom of the foot is tight or stiff.
- The Achilles tendon may feel tight or stiff.
To rule out any potential causes of heel pain, they could also recommend getting an ultrasound or x-ray.
Plantar Fasciitis treatment
Options for treating plantar fasciitis include
- Medicine and icing
To reduce discomfort and inflammation, repeatedly applying ice to the sore area on the sole may help. A doctor may also prescribe nonsteroidal anti-inflammatory drugs.
- Shock wave therapy
This therapy works by applying low- or high-energy shock waves to a particular area. The body's natural healing process is triggered by the microscopic trauma that the shock waves cause. The plantar fascia may heal more quickly as a result of this procedure.
- Physical Therapy and Stretching
The best way to treat plantar fasciitis is through stretching. The plantar fascia and Achilles tendon should be the main targets of stretching. One can perform stretching exercises at home on a daily basis. The exercises can strengthen the lower leg muscles in addition to stretching, which will aid in stabilising the ankle.
- Orthotics, activity and rest
While the plantar fascia is healing, it is beneficial to keep some of the weight and strain off of the foot. A combination of the following may be advised by the doctor.
- Reduced running or walking distances.
- Using night splints to keep stretching the foot at night.
- Modifying the exercise surface to one that is more shock-absorbing.
- Trying heel cups or other orthotics to cushion the heel, switching to shoes with arch support.
- One can support the muscles and ligaments by wrapping the foot in athletic tape.
- Switching from running and jumping to swimming or cycling.
- Gastrocnemius Recession
Surgery is not usually recommended for mild to moderate cases of plantar fasciitis but is an option for severe cases. Gastrocnemius recession or gastrocnemius release refers to the surgical procedure performed to treat plantar fasciitis.
The goal is to lengthen the gastroc tendon, a component of the Achilles tendon. The tension in the Achilles tendon and the plantar fascia are related to each other. Patients with an equinus contracture—tightness in the calf muscles and tendons that makes it impossible to hold a foot in a neutral position (a 90-degree angle to the leg)—may be advised to undergo this surgery.
- Steroid Injections
After a few months of stretching, plantar fasciitis typically gets better. The doctor can suggest steroid injections to reduce inflammation if the symptoms persist after two months of treatment.
Prevention
Maintaining flexibility in the calf muscles, Achilles tendon and ankle will assist in preventing plantar fasciitis. Before waking up from bed in the morning, stretch the plantar fascia. Moderate activity can also be beneficial.
Prognosis
An NCBI article states that in around 75% of instances, the condition resolves spontaneously within a year. Surgery is required in 5% of cases. However, the outcomes are not always favourable.
Even with treatment, symptoms might take weeks or months to go away. Plantar fasciitis is extremely morbid and causes time away from work, sports and other activities. To refrain from bearing weight, some people need an ambulatory device.
Complications
The following are some complications of plantar fasciitis.
- Fat pad necrosis
- Tendon rupture, especially if corticosteroid injections have been administered.
- Arch flattening, which elevates the strain.
Conclusion
Many people, usually athletes and young people, suffer from plantar fasciitis. If not treated properly, the disease may become disabling. Education of the patient is essential.
The nurse, pharmacist, physical therapist and rehabilitation specialist are the key factors in the recurrence of symptoms. Although plantar fasciitis may be benign, it can be disabling and cause moderate to severe pain if it is not treated properly.
Before beginning an exercise regimen, losing weight and stretching are crucial. Patients with severe symptoms should be advised to refrain from going barefoot and to reduce repetitive movements that strain the heel. A referral to an orthopaedic surgeon is the last choice if all of the treatments are unsuccessful.
FAQs
How to cure plantar fasciitis in one week?
2. To minimise inflammation, consider applying 20 minutes of ice to the heel several times daily.
3. To relieve any tightness, frequently stretch the Achilles tendon and calf muscles.
4. Finally, to relieve pressure on the heel, put on a supportive shoe or insert.
