What is Plantar Fasciitis?

Plantar fasciitis is a progressive condition that describes inflammation along the plantar fascia. The plantar fascia is a tissue band connecting the heel bone (calcaneus) to the toes. It’s an essential structure because of its ability to provide arch support to the foot and absorb impact from the ground. Changes to this tissue can lead to pain and put pressure on the feet. Plantar fasciitis is the leading cause of heel pain. According to the Australian Family Physician, over 900,000 Australians will experience heel pain [1]. Those between the ages of 45-64 are the most likely to develop this condition. Another term used to describe plantar fasciitis is plantar fasciopathy. More research suggests that more cases of plantar fascia conditions are related to the thickening and degenerative changes rather than inflammation [2]. This may change the testing and treatment needed for this condition.
 

Plantar Fasciitis Symptoms

Symptoms of plantar fasciitis may vary, depending on the severity of the condition and how long someone has had it. Common symptoms include:

• Heel and foot pain, especially under the sole of the feet
• Difficulty putting weight through the foot (especially in the morning or after a period of inactivity)
• Swelling
• Tenderness to touch

 

Plantar Fasciitis Causes

Plantar fasciitis or fasciopathy is usually caused by progressive changes to the plantar fascia, including tearing, inflammation and thickening. The most common reason for these changes is overuse, such as walking or jogging more than usual. Often, these changes happen gradually, mainly due to overuse. However, there are risk factors that can increase the likelihood of developing plantar fasciitis, including [1]:

• Being overweight or obese
• Having stiff ankles and/or tight calves
• Having flat feet
• Being a runner or participating in other activities with repetitive impact
• Having heel spurs

 

Tests and Diagnosis

Your doctor may perform specific tests if they suspect you have plantar fasciitis. A detailed medical history (e.g. occupation, symptoms, etc.) will be taken initially. A physical examination of the foot and heel may also be taken, including observations of standing posture, redness and swelling.

Imaging Investigations

Your doctor may recommend imaging such as ultrasounds, x-rays and MRIs. They provide detailed images of the structures inside the foot, including ligaments, tendons and bones. These tests can provide a diagnosis and rule out any other potential conditions. Additionally, they may be able to pick up other essential features, such as the presence of bone spurs and the thickening of the plantar fascia. These findings can impact the treatment that you receive.
 

Plantar Fasciitis Treatment

Treatment of plantar fasciitis can vary depending on the severity of the condition, findings from the tests, etc. Initially, most cases are managed conservatively, and more persistent and severe conditions may require other forms of treatment. Examples of treatments may include:

Medication

Medication prescribed by your doctor may provide short-term relief from pain and other symptoms. They may be used in combination with the other treatments below for additional benefits.

Lifestyle Changes

Plantar fasciitis can be caused or aggravated by certain lifestyle activities. Your doctor or other health professionals may recommend changing these habits, including:

• Temporarily reducing physical activity (e.g. running, walking, etc.)
• Using ice and/or heat
• Footwear recommendations
• Improving nutrition

Physiotherapy

Your doctor may refer you to see a physiotherapist. These are health professionals who focus on treating physical conditions. They may recommend several treatments to help improve your plantar fasciitis, including:

• Corrective exercises for plantar fasciitis
• Managing your training volume
• Taping techniques
• Finding alternative activities that are less likely to aggravate this condition
• Manual therapy techniques to help ease pain

Podiatrist

Your doctor may refer you to see a podiatrist. These are health professionals who focus on treating foot injuries and conditions. They have different types of treatments that may complement the remedies listed here, including:

• Prescribing orthotics
• Footwear recommendations
• Exercises for plantar fasciitis
• Hands-on techniques to relieve symptoms
• Strategies for improving foot posture

Shockwave therapy

Shockwave therapy is a non-surgical treatment that is used by orthopaedic surgeons, physiotherapists, podiatrists and other health professionals to help relieve pain for specific conditions. High-pressure shockwaves are delivered through the affected area to help block pain signals and improve blood flow.

Corticosteroid Injections

Your surgeon can also recommend corticosteroid injections to help relieve pain and inflammation. For the best effect, corticosteroid injections should be accompanied by other treatments above. There may be a period after your injection where you may need some rest.

Surgery

For persistent and/or severe cases of plantar fasciitis, your doctor may refer you to an orthopaedic and/or podiatric surgeon. They may recommend undergoing surgery to help release the plantar fascia.
 

Recovery

About 75% of people with plantar fasciitis will have symptoms resolved within one year [3]. Those who undergo treatment, such as shockwave therapy and physiotherapy, can help improve recovery [4]. However, around 5% may require surgery, which often leads to mixed outcomes [3].
 

Complications

The main complication of plantar fasciitis is pain and limited mobility. Many patients will report that plantar fasciitis pain can restrict the ability to move (e.g. exercise, play sports, work, etc.). As this condition can slow recovery, a rest period may be required from the aggravating activity. This can impact workers and athletes who rely on being physically active. Additionally, long-term plantar fasciitis can lead to long-term problems, such as:

• Tendon tears and ruptures
• Conditions of the fat pad
• Flattening of the foot arch

 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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References

1. Pollack, A., & Britt, H. (2015). Plantar fasciitis in Australian general practice. Australian family physician, 44(3), 90-91. Monteagudo, M., de Albornoz, P. M., Gutierrez, B., Tabuenca, J., & Álvarez, I. (2018). Plantar fasciopathy: a current concepts review. EFORT open reviews, 3(8), 485-493.
2. Buchanan, B. K., & Kushner, D. (2017). Plantar fasciitis.
3. Grecco, M. V., Brech, G. C., & Greve, J. M. D. A. (2013). One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy. Clinics, 68, 1089-1095.