Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thin, web-like ligament that connects your heel to the front of your foot. It supports the arch of your foot and helps you walk.
Plantar fasciitis is one of the most common orthopedic complaints. Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Normally, these ligaments act as shock absorbers, supporting the arch of the foot. Too much pressure on your feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
The major complaint of those with plantar fasciitis is pain and stiffness in the bottom of the heel, although some experience pain at the bottom mid-foot area. This develops gradually over time. It usually affects just one foot, but it can affect both feet. Some people describe the pain as dull, while others experience a sharp pain, and some feel a burning or ache on the bottom of the foot extending outward from the heel.
The pain is usually worse in the morning when you take your first steps out of bed, or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to heel stiffness.
After prolonged activity, the pain can flare up due to increased inflammation. Pain isn’t usually felt during the activity but rather just after stopping.
Reducing inflammation in the plantar fascia ligament is an important part of treatment, but this doesn’t address the underlying damage to the ligament.
Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, three or four times per day to reduce swelling. You can also try reducing or changing your exercise activities. Using arch supports in your shoes and doing stretching exercises may also help to relieve pain.
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin or Advil) and naproxen (Aleve), often reduce inflammation in the ligament.
If home treatments and over-the-counter, anti-inflammatory drugs don’t ease the pain, an injection of a corticosteroid directly into the damaged section of the ligament can help. Your doctor can do this in their office. Your doctor may use an ultrasound device to help determine the best place for the injection. Your doctor can also apply corticosteroids to the skin of your heel or the arch of your foot, and then apply a painless electrical current to let the steroid pass through your skin and into the muscle.
Physical therapy is an important part of treatment for plantar fasciitis. It can help stretch your plantar fascia and Achilles tendons. A physical therapist can also show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia.
Night splints are another treatment that can help stretch your calf and the arch of your foot. Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and Achilles tendon overnight. This can prevent morning pain and stiffness.
Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and they can prevent further damage to the plantar fascia. A boot cast may immobilize your foot and reduce strain while the plantar fascia heals. You can remove the boot cast, which looks like a ski boot, for bathing.