PLANTAR FASCIITIS - WHAT YOU NEED TO KNOW
/PLANTAR FASCIITIS - WHAT YOU NEED TO KNOW
BY Gregory Tamagnini, DPM
Searing pain in the arch of your foot when you stand up in the mornings? It might be plantar fasciitis. As an ankle and foot care specialist and surgeon, it is one of the most common conditions I see. It occurs when the foot develops tears in the plantar fascia ligament along the bottom of the foot. The result is inflammation and pain.
Most sufferers feel it in the morning because the fascia ligament tightens up during the night while we sleep. When we climb out of bed and place pressure on the foot, the ligament becomes taut and the pain is particularly acute. The pain usually decreases as the tissue warms up but may easily return again after long periods of standing or weight-bearing, physical activity or after getting up after long periods of sitting down.
What Causes Plantar Fasciitis?
The plantar fascia ligament is like a rubber band and loosens and contracts with movement. It also absorbs significant weight and pressure. One of the most common causes is excessive physical activity, exercise or repetitive use. Athletes are particularly prone to plantar fasciitis and commonly suffer from it. Excessive running, jumping or other activities can easily place repetitive or excessive stress on the tissue and lead to tears and inflammation, resulting in moderate to severe pain.
Arthritis is another common cause of plantar fasciitis. Certain types of arthritis can cause inflammation to develop in tendons, resulting in plantar fasciitis. This cause is particularly common among elderly patients. A person is also at a greater risk of developing plantar fasciitis if they are overweight or pregnant due to the added strain on the body.
How Do you Treat Plantar Fasciitis?
In most cases, plantar fasciitis does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required. However, every person's body responds to plantar fasciitis treatment differently and recovery times may vary. Treatment for plantar fasciitis should begin with rest, icing and over-the-counter medications for pain and inflammation.
If rest does not help, there are other options to consider. Your doctor may recommend custom orthotics which can be slipped into your shoes to add support and distribute weight during movement.
Night splints are worn for an extended period of time, keeping the plantar fascia stretched to promote healing.
Physical therapy has also become a common option for treatment of plantar fasciitis. With this conservative treatment alternative, a physical therapist designs an exercise plan intended to address your specific needs in order to promote healing.
More invasive procedures to treat plantar fasciitis are usually considered only after conservative treatment options have failed to produce desired results. Corticosteroid injections deliver medicine into the injured fascia to reduce pain. It’s important to note this helps temporarily relieve the pain but does not cure the condition.
Extracorporeal shock wave therapy (ESWT) is another option to treat this condition. Extracorporeal shockwave therapy is basically a high-intensity ultrasound that breaks up the inflammatory cells and stimulates blood flow to the area in order to increase healing. I’ve personally had great results with this technology and my patients have responded very well to it.
Surgery is the final option for those suffering from chronic or severe plantar fasciitis. There are of course things you can do to help avoid this condition. Minimize walking barefoot, wear shoes that are supportive, always warm up properly before exercise and don’t forget to cool down afterward. The importance of stretching cannot be over-emphasized.
I often find my patients respond very well to treatment and they are able to resume normal activity in a reasonable timeframe. Remember to warm up gradually when working out, and if pain persists, listen to your body and call your doctor.
There are many options available to you if you suffer from this condition. It’s important to see a doctor if this pain persists because left untreated, the ligament will continue to worsen.
Dr. Tamagnini is a graduate of the University of Rhode Island and the New York College of Podiatric Medicine in New York City. He completed his residency training at New York Downtown Hospital (now known as New York Presbyterian / Lower Manhattan Hospital) in New York City where he was honored as Chief Resident. Dr. Tamagnini currently practices at Metro Ankle and Footcare Specialists in Totowa, New Jersey.
