Plantar Fasciitis 101: Everything You Need to Know

March 28, 2018
By: GraMedica Team

Plantar fasciitis is the most common cause of chronic pain beneath the heel of the foot. The American Academy of Orthopedic Surgeons estimates that 2 million cases of the condition are treated every year.

One in 10 people develop plantar fasciitis at some point in their lives. The condition accounts for between 11 and 15 percent of foot symptoms requiring treatment, according to a review of studies related to the condition.

The majority of heel pain is caused by plantar fasciitis, or an inflammation of the tissue on the bottom of the foot.

What Are the Symptoms of Plantar Fasciitis?

Plantar fasciitis is a foot condition characterized by sharp, stabbing heel pain that typically occurs when a person gets out of bed in the morning or stands up after sitting for a long period of time. While the most common symptom of plantar fasciitis is usually described as a shooting pain, the condition can also cause some swelling in the heel.

While the pain from plantar fasciitis can be extremely intense after rest, it usually eases during the day. But the pain may reappear after exercise or long periods on your feet.

Located on the bottom of the foot, the plantar fascia is a dense band of connective tissue or ligament connecting the heel to the front of the foot. This band of tissue, which supports the arch of the foot, acts like a bowstring on the bow. It is meant to absorb any stresses and strains placed on the feet.

Over time a person can develop a strain or inflammation of the fascia into the heel bone, and it becomes a chronic and repetitive condition. One never really rests their foot enough to heal and get better.


What Causes Plantar Fasciitis?

Plantar fasciitis occurs when the plantar fascia becomes tight from too much pressure on the tissue, which leads to inflammation.

As tension in the plantar fascia increases, tiny tears form in the tissue. The more tension and tearing that occur in the plantar fascia, the more inflammation and irritation there will be. This buildup of tension and tearing causes plantar fasciitis and results in heel pain.

Active men and women between ages 40 and 70 are most likely to experience the condition. The condition is slightly more common among women as compared with men.

It has a higher incidence among athletes — particularly runners, and it is sometimes referred to as “runner’s heel.” A 2002 retrospective study of running injuries found that 7.8 percent of the injuries were plantar fasciitis; and the condition ranked as one of the five most common running injuries.


Are There Risk Factors for Plantar Fasciitis?

Plantar fasciitis usually develops for no specific, clearly identifiable reason. Still, there are a number of risk factors that can increase your risk for plantar fasciitis, including:

  • Obesity or Sudden Weight Gain Excess weight can damage the plantar fascia, making it less able to absorb shock, which can lead to heel pain. Up to 70 percent of patients with plantar fasciitis are obese. There also appears to be a strong association between increased body mass index (BMI) and plantar fasciitis in nonathletes. Pregnancy also raises your risk by increasing weight placed on the feet.
  • Too Much Pressure on the Heels People who walk frequently, run, or have to stand all day at work sometimes have this problem. Certain occupations that involve spending most of the work hours walking or standing, such as factory workers and teachers, are more likely associated with damage to the plantar fascia. Studies have shown that excessive stretching and tightness of the Achilles tendon can lead to overstraining of the plantar fascia.
  • Foot Abnormalities People with overpronation or flat feet (also known as low or fallen arches) are at an increased risk for plantar fasciitis because the entire soles of their feet touch the ground when standing. Similarly, very high arches (cavus foot) raise your risk because an excessive amount of pressure is placed on the heel and the ball of the foot when standing or walking. An unusual running or walking gait can also increase pressure and tension on the plantar fascia.
  • Diabetes and Arthritis Plantar fasciitis and increased thickness of the Achilles tendon have been associated with diabetes. The exact reason that the condition is more common in people with diabetes in not known. Some types of arthritis, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and reactive arthritis (also known as Reiter’s syndrome), can cause inflammation associated with plantar fasciitis.
  • Wearing the Wrong Shoes If shoes don’t fit well, they won’t support the foot. Inadequate footwear can impair walking and put additional stress on the plantar fascia. Old, worn-out shoes can also make plantar fasciitis worse because they do not provide adequate support and protection for your feet.

How Is Plantar Fasciitis Diagnosed?

Searing heel pain is the main symptom of plantar fasciitis and is an often unmistakable sign of the condition. If the heel pain does not go away after a few weeks, it’s a good idea to make an appointment with a podiatrist.

To see a list of HyProCure trained doctors near you, visit our map here.

A podiatrist will talk to you about your pain and symptoms, and examine your foot to rule out other conditions that can cause heel pain. Your podiatrist may order an X-ray or other tests to make sure there isn’t a fracture in your foot, or something else that’s causing your heel pain.

Heel spurs — small, pointed overgrowths on the heel bone (the calcaneus bone) — can sometimes be spotted on X-rays. But heel spurs are not considered to be the cause of the pain in plantar fasciitis. In fact, they are often seen on X-rays of people who do not have heel pain or plantar fasciitis, and are therefore believed to be an incidental finding.

One out of 10 people has heel spurs, but only 1 out of 20 people with heel spurs has foot pain.

What Complications Can Plantar Fasciitis Cause?

Plantar fasciitis requires treatment to prevent it from becoming persistent or growing worse. If untreated, plantar fasciitis can impair mobility and keep you from getting much-needed exercise. It can also lead to back problems, knee and hip problems, and other foot conditions because of how it affects the way you walk.

Surgery performed to treat plantar fasciitis, known as a plantar fasciotomy, can also lead to complications. After surgery, some degree of support to the foot is lost, causing instability that is usually temporary.

What Other Conditions Cause Heel Pain?

Plantar fasciitis is the most common cause of heel pain, but it is not the only one. There are several less common causes of heel pain that should be ruled out before starting treatment for plantar fasciitis. Among these other causes of heel pain are:

Bursitis Bursas are fluid-filled sacs that cushion bones and muscles near large joints in the body. They’re found in the hips, shoulders, and elbow, as well as places like the heel of the foot. Bursas in the foot can become inflamed and painful due to excessive walking, running, or jumping.

Calcaneal Apophysitis The growth plate, or epiphyseal plate, in the heel can become inflamed. The condition, also known as Sever’s disease, usually occurs in children during growth spurts.

Inflammatory Diseases People with systemic inflammatory conditions, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter’s syndrome, and gout, may experience heel pain.

Lateral Plantar Nerve Entrapment Nerves along the central part of the arch can become compressed between bone and tissue, resulting in pain around the heel and ankle area of the foot.

Plantar Fascia Rupture In rare cases, the plantar fascia can rupture. This extremely painful injury usually occurs during high-impact exercise, although some of the risk factors for plantar fasciitis, such as flat feet and obesity, can contribute to its occurrence. It also occurs in patients who have chronic plantar fasciitis.

Sciatica Injury or pressure on your sciatic nerve, which controls muscles in the knees and lower legs, can cause lower back and leg pain. The pain can sometimes be felt in the foot, but it might be more of a tingling or numbness than the pain typically associated with plantar fasciitis.

Stress Fracture A hairline crack or fracture can develop in the heel bone, also known as the calcaneus. It’s usually the result of overuse or an event in which the heel is crushed under the weight of the body (like a fall from a height). Calcaneal stress fractures are rare and account for only about 2 percent of all fractures in adults.

Tarsal Tunnel Syndrome The tarsal tunnel is a space inside the ankle containing nerves, arteries, and tendons. One of these is the tibial nerve, which allows feeling and movement to parts of the foot. Tarsal tunnel syndrome refers to a compression of the tibial nerve that can be caused by an ankle sprain, inflammatory disease, and flat or fallen arches. The possible symptoms include pain and a tingling sensation around the heel.

How Is Plantar Fasciitis Treated?

Most cases of plantar fasciitis can be self-treated with rest and applying ice. Stretching and strengthening can also speed recovery and help avoid other complications, such as tightness or weakness of other foot muscles. Still, complete recovery can take several months.

Over-the-counter and prescription medicines can help reduce some of the pain and inflammation associated with the condition. Orthotics, or shoe inserts that provide support and relieve pressure on the foot, can also alleviate pain in the short term.

When rest, applying ice and over-the-counter and prescription medications just aren’t doing the trick, consider a lasting solution; HyProCure.

How Can HyProCure Help?

HyProCure is a small titanium stent that is inserted into the sinus tarsi fixing hyperpronation at its root by keeping the sinus tarsi in a stable open position as nature intended. This keeps your ankle bone from sliding forward and off of your heel bone and the rest of your body in its natural alignment. It is placed into a naturally-occurring space in between the ankle bone and heel bone through a small incision below the outer ankle bone. There are no pins, screws or drills required.
Unlike other stents that block your range of motion, HyProCure stabilizes the foot and restores natural joint motion. You are able to move your foot freely so that you can easily perform day-to-day activities. Since the procedure is minimally invasive, patients are typically back into their “normal” shoes within a few weeks, if not sooner.

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