Overview
Plantar fasciitis is a common condition characterized by pain and inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. This condition typically causes sharp, stabbing pain in the heel, especially with the first steps in the morning or after long periods of rest. Plantar fasciitis is prevalent among runners, people who are overweight, and those who wear shoes with inadequate support.
Symptoms
- Sharp pain in the bottom of the heel, especially with the first steps in the morning
- Pain that worsens after prolonged periods of standing or sitting
- Pain that intensifies after exercise or activity, rather than during it
- Stiffness and tenderness in the heel and arch of the foot
Causes
- Overuse: Repetitive strain on the plantar fascia from activities such as running, dancing, or prolonged standing.
- Foot Structure: Flat feet, high arches, or an abnormal walking pattern can put extra stress on the plantar fascia.
- Improper Footwear: Wearing shoes with inadequate arch support or soft soles can increase the risk.
- Obesity: Excess weight puts added pressure on the plantar fascia.
- Age: Plantar fasciitis is most common between the ages of 40 and 60.
Medical Treatments
Initial Care
- Rest: Reducing activities that cause pain and avoiding long periods of standing.
- Ice: Applying ice to the affected area to reduce inflammation and pain.
- NSAIDs: Nonsteroidal anti-inflammatory drugs like ibuprofen to relieve pain and inflammation.
- Orthotic Devices: Custom-made or over-the-counter shoe inserts to support the arch and reduce strain on the plantar fascia.
Advanced Care
- Corticosteroid Injections: In some cases, corticosteroids may be injected to reduce inflammation and provide pain relief.
- Shockwave Therapy: Extracorporeal shockwave therapy (ESWT) uses sound waves to stimulate healing in the plantar fascia, especially in chronic cases.
- Laser Therapy: Low-level laser therapy can reduce inflammation and promote tissue healing, particularly in stubborn cases of plantar fasciitis.
- Surgery: Surgery is considered a last resort and is only recommended if conservative treatments fail after 6-12 months.
Role of Physiotherapy
Physiotherapy plays a crucial role in managing plantar fasciitis by focusing on pain relief, improving foot mechanics, and preventing recurrence.
- Stretching Exercises: Targeted stretches for the plantar fascia, Achilles tendon, and calf muscles to improve flexibility and reduce strain.
- Strengthening Exercises: Strengthening the muscles of the foot and lower leg to support the arch and improve foot mechanics.
- Manual Therapy: Techniques such as massage and mobilization to relieve tension in the plantar fascia and improve blood flow.
- Activity Modification: Advice on modifying activities and selecting proper footwear to reduce stress on the plantar fascia.
- Shockwave Therapy: Shockwave therapy can be used to promote tissue repair, reduce pain, and enhance the healing process in cases of chronic plantar fasciitis.
- Laser Therapy: Laser therapy can help reduce inflammation and stimulate the healing of the plantar fascia, particularly when combined with other treatments.
- Custom Orthotics: Physiotherapists can recommend and fit custom orthotics to provide proper arch support and distribute pressure more evenly across the foot.
Frequently Asked Questions (FAQs)
What is plantar fasciitis?
Plantar fasciitis is an inflammation of the plantar fascia, the thick band of tissue that runs across the bottom of the foot, causing pain in the heel.
How long does it take to recover from plantar fasciitis?
Recovery time can vary, but with consistent treatment, most people see improvement within a few months. Chronic cases may take longer and require more intensive treatment.
Can I continue exercising with plantar fasciitis?
While it’s important to rest and avoid activities that exacerbate the pain, low-impact exercises such as swimming or cycling can be beneficial during recovery.
Is surgery necessary for plantar fasciitis?
Surgery is rarely needed and is considered only when other treatments have failed after several months to a year.
How can physiotherapy help with plantar fasciitis?
Physiotherapy can reduce pain, improve flexibility and strength, and help prevent future occurrences by addressing the underlying causes of plantar fasciitis.
Are shockwave and laser therapies effective for plantar fasciitis?
Yes, both shockwave and laser therapies have shown effectiveness in reducing pain and promoting healing in cases of chronic plantar fasciitis.
What can I do to prevent plantar fasciitis from returning?
Preventive measures include wearing supportive footwear, using orthotics if needed, maintaining a healthy weight, and performing regular stretching and strengthening exercises for the feet and lower legs.
When should I see a doctor for plantar fasciitis?
If you experience persistent heel pain that doesn’t improve with rest and self-care, it’s important to consult a healthcare provider for a proper diagnosis and treatment plan.
References
1. Tseng, W. C., Chen, Y. C., Lee, T. M., & Chen, W. S. (2023). Plantar fasciitis: An updated review. Journal of Medical Ultrasound, 31(4), 268-274.
2. Song, Y. (2024). A Review of Common Interventions and Preventive Options Used in the Treatment of Plantar Fasciitis. Transactions on Materials, Biotechnology and Life Sciences, 3, 602-612.
3. Boob Jr, M. A., Phansopkar, P., & Somaiya, K. J. (2023). Physiotherapeutic interventions for individuals suffering from plantar fasciitis: a systematic review. Cureus, 15(7).
4. Peña-Martínez, V. M., Acosta-Olivo, C., Simental-Mendía, L. E., Sánchez-García, A., Jamialahmadi, T., Sahebkar, A., … & Simental-Mendía, M. (2024). Effect of corticosteroids over plantar fascia thickness in plantar fasciitis: a systematic review and meta-analysis. The Physician and Sportsmedicine, 52(3), 217-228.
5. Guimarães, J. D. S., Arcanjo, F. L., Leporace, G., Metsavaht, L. F., Conceição, C. S., Moreno, M. V., … & Gomes Neto, M. (2023). Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clinical Rehabilitation, 37(6), 727-746.
6. Cortés-Pérez, I., Moreno-Montilla, L., Ibáñez-Vera, A. J., Díaz-Fernández, Á., Obrero-Gaitán, E., & Lomas-Vega, R. (2024). Efficacy of extracorporeal shockwave therapy, compared to corticosteroid injections, on pain, plantar fascia thickness and foot function in patients with plantar fasciitis: A systematic review and meta-analysis. Clinical Rehabilitation, 02692155241253779.
7. Koz, G., Kamanli, A., Kaban, N., & Harman, H. (2023). Efficacies of extracorporeal shockwave therapy and low-level laser therapy in patients with plantar fasciitis. Foot and Ankle Surgery, 29(3), 223-227.
8. Lumpkin, K. J., Fuchs, E. J., & Lowes, J. N. (2023). The Efficacy of Dry Needling in Combination With Electrical Stimulation on Pain Reduction and Improved Function in Chronic Plantar Heel Pain: A Critically Appraised Topic. International Journal of Athletic Therapy and Training, 1(aop), 1-10.
