Plantar Fasciitis: What Is, Symptoms, Causes & Treatment

Marcelle Pinheiro
About the author: Marcelle Pinheiro
Physiotherapist
September 2021

Plantar fasciitis is a condition in which the tissue that runs across the bottom of the foot, the plantar fascia, is inflamed. This usually causes pain in the bottom of the foot, burning sensation, or a slight discomfort, especially after waking up or after doing exercises that causes impact on the foot, such as walking or running.

This condition is more common in women who wear high heels for a long time, runners, and people who are overweight.  

Treatment for plantar fasciitis usually lasts for about one year to 18 months and it normally includes the use of analgesics, anti-inflammatory medication, and physiotherapy sessions.

Main Symptoms

The most characteristic symptom of plantar fasciitis is a pain in the middle region of the heel when stepping, however other symptoms are usually present:

  • Pain in the bottom of the foot that gets worse when wearing high heels or running;
  • Burning sensation on the bottom of the foot;
  • Tingling sensation when pressing the bottom of the foot.

Symptoms are related to the thickening of the plantar fascia due to inflammation and the presence of fibrosis and calcification.

Diagnosis is usually done by an orthopedist or physiotherapist, by taking into consideration the symptoms and some specific tests that cause pain in the affected area. Image exams such as x-rays do not directly show fasciitis, but they can be used to rule out other conditions. 

What Causes Plantar Fascitis 

The causes of plantar fasciitis are normally related to long walks or runs when using very hard shoes. Plantar fasciitis may also be related to the person's foot being very flat or it can happen do to overweight. These factors alltogether can contribute to an inflammation of the plantar fascia, which, if not treated, can cause intense pain.

Regular use of high heels leads to a decrease in mobility in the Achilles tendon, which can also lead to fasciitis. It's also common for a heel spur to also be present when there is fasciitis.  

Treatment Options

Treatment for plantar fasciitis can be done with anti-inflammatory medication, under the supervision of an orthopedist and physiotherapist, where the objective is to reduce the inflammation in the area, improve blood flow and undo the nodules formed in the tendons, if that's the case.  

Other useful tips for treating plantar fasciitis include:

  • Applying an ice compress to the bottom of the feet for 15 minutes, twice a day;
  • Use a special insole recommended by your orthopedist or physiotherapist;
  • Do a stretch of the bottom of the foot and the calf muscle by standing on a slightly inclined surface, like a ramp. To know if the stretch is being well done, you should feel your calf stretching. Keep this position for at least one minute, three to four times in a row.
  • Use comfortable shoes that support the feet adequately, and avoid hard shoes.

This condition is very common in runners due to shoes that are not suitable for running. Usually, it is recommended that you use the same running shoes for only 600 km (372 miles), and then change to different ones. However, you can still use the old running shoes for daily activities.

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References

  • DA SILVA, Rafael Henrique; PONTIN, José Carlos B.; COSTA, Thiago R. Manual de Exercícios e Orientações para Pacientes com Fasciíte Plantar. Acta Fisiatr. 2014;21(2):75-79. Vol 21. 2 ed; 75-79, 2014
  • Revista Brasileira de Ortopedia. Talalgias: fascite plantar. FERREIRA, Ricardo C. Vol 49. 3 ed; 213-217, 2014
About the author:
Marcelle Pinheiro
Physiotherapist
Physiotherapist degree provided by the University of Estácio de Sá (Brazil). Licensed to practice under CREFITO #170751.