Plantar fasciitis is a common source of heel pain, especially for runners and athletes. But even non-athletes can develop this nagging injury which impacts daily functions. Understanding the condition and available treatments empowers patients.

What is Plantar Fasciitis?

Plantar fasciitis refers to inflammation of the plantar fascia – the thick band of connective tissue spanning the bottom of the foot from the heel bone to the base of the toes. This tissue band normally flexes to absorb shock and adapt to surfaces. When overstressed by repetitive pressure and pounding activities over time, small tears induce localized inflammation and subsequent heel pain.

Most Common Plantar Fasciitis Symptoms

Classic symptoms signaling plantar fasciitis include:

• Sharp heel pain worsened taking first steps after periods of inactivity

• Pain typically concentrated in the inner or central heel area by the arch

• Foot pain increasing after long periods on feet or upon rising

• Tight, tense sensation across the bottom of foot

• Swelling, bruising, or slight heel spur visible on x-ray

Pain may ease somewhat after warming up but worsen following activities. Limping and compensating to avoid pressuring the heel can exacerbate tightness. Night splints may help stretch the plantar fascia and reduce morning pain.

Risk Factors for Developing Plantar Fasciitis

Runners represent an at-risk population given repeated pounding. Additional risk factors include:

• Excess weight/obesity placing extra stress on feet

• Jobs requiring extensive walking or standing on hard floors

• High arches or flat feet influencing biomechanics

• Sudden increases in activity levels

• Advancing age decreasing tissue elasticity

But even young, fit people can develop plantar fasciitis from overuse – especially rigid arches or improper footwear.

Conservative Treatment Approaches for Plantar Fasciitis

Before considering more invasive treatments, patients should focus on conservative at-home approaches for several months through:

Rest

Take pressure off heels to calm inflammation by minimizing standing/walking. Explore working remotely or discuss options with your employer.

Ice

Ice heels for 20 minutes especially after activity to reduce swelling and pain. Do not place ice directly on skin.

OTC Medications

Anti-inflammatory gel caps like ibuprofen can ease discomfort. Some patients utilize topical NSAID creams.

Supportive Footwear

Wear shoes with adequate cushioning and arch support. Replace older athletic shoes. Consider orthotics.

Stretching

Perform foot and calf stretches gently several times per day to maintain tissue mobility.

Conservative treatment may resolve symptoms over time. But if home care for 6-12 months proves ineffective at managing persistent moderate to severe pain, advanced therapies facilitated by podiatrists and physical medicine clinicians can provide relief.

Advanced Treatment Pathways to Overcome Chronic Heel Pain

Custom treatment plans for stubborn plantar fasciitis are often multi-modal incorporating various therapies simultaneously including:

Medications

Oral steroids or injectable options combined with activity modification. Topical Diclofenac approved for acute pain.

Physical Therapy

Focused stretching, cross friction massage, ultrasound therapy, custom orthotics, balancing exercises, gait training.

Night Splints

Overnight splints keeping ankles at 90 degrees stretch plantar fascia allowing morning symptom relief. Must be work consistently.

Extracorporeal Shock Wave Therapy

Sound waves stimulate localized blood flow to accelerate healing. Multiple sessions usually needed.

Surgery

Severing a portion of the plantar fascia to decrease tension and strain as a last resort option.

Appropriate therapy combinations lasting 6-12 weeks may optimize outcomes long term. Patients must commit fully to treatment plans.

Key Takeaways for Coping with Plantar Fasciitis

Recovery from plantar fasciitis requires patience and diligent self-care. Treatments aim first to manage pain in the short term while correcting underlying dysfunction contributing to tissue strain over months. Working with podiatrists and sports medicine specialists improves access to medications, devices, customized massage therapy, and advanced modalities proven to resolve heel pain when more conservative measures fail. Staying active with modified activities is important during recovery.

Conclusion

Plantar fasciitis can be extremely debilitating, especially for athletes or those in occupations requiring extensive time on feet. Myriad treatment options now exist beyond simply resting. By fully understanding their condition, staying patient through the stepwise treatment paradigm, and utilizing available specialty resources, most patients achieve full pain relief and return to higher function. Combining therapies tailored to each individual optimizes outcomes.