Plantar fasciitis – inflammation of the plantar fascia in your foot - is a painful condition characterised by discomfort under your heel when walking and is sometimes called ‘jogger’s heel’ although you do not have to be a jogger to develop it! It is quite common and is believed to affect up to 5-7% of adults at some stage in their lives, being slightly more likely to develop in women. The condition is common in middle age, typically developing in people aged 40-60 and although the majority of cases improve on their own, it can cause significant discomfort in some people, having a huge impact on them.
Plantar fasciitis is a condition that seems to be caused by repetitive micro-tears of the plantar fascia - a very strong layer of tissue on the sole of the foot that connects the heel to the toes and which serves an important role in normal foot function, helping to maintain the shape of the arches of the foot. Why some people develop plantar fasciitis is poorly understood but certain factors have been identified as potential causes of plantar fasciitis including obesity, repetitive activities such as running, an abrupt increase in activity levels, calf tightness, and poor quality or unsupportive footwear. In a very small proportion of people with plantar fasciitis, there may be evidence of an underlying inflammatory arthritis.
Sufferers of plantar fasciitis most often experience pain under the heel when bearing weight. The pain is classically worst with the first few steps in the morning and then gradually improves through the day. The pain can, however, be made worse after periods of exercise.
The majority of people with plantar fasciitis see improvement in their symptoms without needing any treatment although it often takes a number of months to settle. Simple self-help measures can be very effective at relieving symptoms caused by plantar fasciitis, including;
· Stretching exercises of your calf and Achilles tendon · Wearing supportive, padded shoes · Weight loss if you are overweight · Anti-inflammatory medications · Application of an ice pack after periods of exercise
If your symptoms have failed to improve despite these simple measures after six weeks you should contact your doctor. Your doctor may refer you to a physiotherapist or podiatrist for further management. You may be offered a structured stretching and exercise programme which is very effective at relieving your symptoms. Additional treatment options include wearing a specialised splint at night, ultrasound shockwave therapy and steroid injections.
The doctor will ask you about your symptoms and examine your foot. If they are satisfied that you have plantar fasciitis they may refer you to see a physiotherapist or podiatrist, depending upon local services available.
Very rarely, if your symptoms fail to improve despite physiotherapist/podiatry input, you may be referred to an orthopaedic surgeon. An orthopaedic surgeon may be able to offer additional treatments although surgery is seldom performed unless symptoms have persisted for more than a year and all other treatment options have failed.
Read more about Foot pain
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