Plantar fasciitis


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​Plantar fasciitis is a condition which can cause heel pain. It happens when the strong band of tissue on the sole of your foot (fascia) becomes irritated, after repetitive use or due to poor foot posture. Most commonly it occurs in one foot but is possible to have it in both feet at the same time.

What are the symptoms of plantar fasciitis?
There is usually a gradual onset of pain, in a small amount of people there can be sudden damage to the fascia during physical activity.

The main symptoms of plantar fasciitis include:
  • Pain or tenderness in the heel or arch of the foot
  • Pain with initial steps in the morning or after a period of rest
  • Walking short distances may improve pain but longer distances may increase the symptoms again
  • Pain with sudden stretching of the sole of the foot. This could include going up on your toes or upstairs
  • Pain with prolonged standing or when wearing flat or unsupportive footwear 
What causes plantar fasciitis?
Often there may be no obvious cause for the symptoms. However, certain risk factors can are associated such as:
  • Poor cushioning or poor arch support in your shoes.
  • Tightness in calf muscle.
  • Poor foot posture.
  • Being on your feet for long periods of time, especially on hard surfaces.
  • Being overweight
If you are very active it can also be due to sudden stretching or overuse of the sole of the foot; such as when sprinting, jumping and landing on hard surfaces in basketball or after increasing running distance or intensity.

How is it diagnosed?
Diagnosis is usually made from the patient's history and a simple examination without the need for further investigations.

How can I manage plantar fasciitis?
Plantar fasciitis usually fully resolves but it can in some cases take up to 12 months. You should avoid excessive activities that aggravate the pain and walking barefoot on hard surfaces.

There is self-management advice provided below to help minimise symptoms and facilitiate the healing process:

Pain relief
Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or Pharmacist. 

Some people find ice effective in reducing their heel pain. Apply an icepack for 15 minutes regularly. Avoid applying ice directly to your skin, instead use a towel or have a fabric layer in between. Alternatively it can work well to use a frozen water bottle to roll underneath your foot.

Footwear
Shoes with cushioned heels and good arch support are recommended. Various pads and insoles can be bought to cushion the heel or support your arch. These are recommended to be kept in the shoes for the majority of time.

Exercise
Research has shown that exercise can help improve symptoms and stretches are the first line of treatment. Relative rest is recommended to help reduce the pain but you should keep up gentle walking.
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Further management options
If there is no response to the self-management information above within four to six weeks, seek further advice from your physiotherapist or GP.  

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