Plantar fasciitis (PF) is a common foot condition that affects more than 3 million people in the U.S. It is characterized by intense heel pain, particularly with the first steps taken in the morning. In this article, we will explore what it feels like to have plantar fasciitis, how it can interfere with your life if you have it, the causes behind this debilitating condition and what you can do to find lasting relief from it.
What is Plantar Fasciitis?
The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. Its primary role is to support the arch of your foot and absorb the shock generated during walking and running. When this tissue becomes inflamed or irritated, especially when it becomes chronically inflamed, it leads to a condition known as plantar fasciitis.
What It Feels Like
Plantar fasciitis typically presents with a sharp, stabbing pain in the heel, particularly when taking the first steps after getting out of bed in the morning. PF pain can also occur after prolonged periods of sitting or standing. It's often described as a burning or tearing sensation in the heel, which can be quite debilitating.
The pain tends to gradually improve as the day goes on, but it may return after long periods of standing or walking. Some individuals also experience pain along the arch of the foot. The discomfort can range from mild to severe, with some people finding it difficult to walk or engage in daily activities due to the intensity of the pain.
Interference with Daily Life
Plantar fasciitis can significantly disrupt your life, both physically and emotionally. The persistent pain in the heel can make even simple tasks like walking or standing unbearable. This may lead to a decrease in physical activity, which can have a cascading effect on a person's overall health and fitness.
The pain and limited mobility associated with plantar fasciitis can also lead to emotional distress. Many individuals with PF report feeling frustrated, anxious, or depressed due to their reduced ability to engage in their usual activities and hobbies. It may impact your social life, work performance, and overall quality of life.
Causes of Plantar Fasciitis
Several factors contribute to the development of plantar fasciitis. Understanding these causes can help individuals take preventive measures and seek appropriate treatment:
1. Overuse or excessive strain: One of the most common causes is overuse or placing excessive strain on the plantar fascia. This can result from activities like running, walking long distances, or standing for extended periods, especially on hard surfaces.
2. Foot biomechanics: Abnormalities in foot biomechanics, such as flat feet or high arches, can put extra stress on the plantar fascia and increase the risk of developing PF.
3. Age and weight: Plantar fasciitis is more common in middle-aged and older individuals, as well as in those who are overweight or obese. Excess body weight places additional pressure on the feet and can exacerbate the condition.
4. Footwear: Wearing shoes with inadequate arch support or poor cushioning can contribute to the development of plantar fasciitis. Wearing flip-flops or other shoes that do not have a strap across the back can irritate the bottom of your foot as well.
5. Tight calf muscles: Tightness in the calf muscles can pull on the Achilles tendon, which in turn affects the tension in the plantar fascia.
It might be helpful to distinguish between acute plantar fasciitis (foot pain lasting less than a month) and chronic plantar fasciitis (foot pain lasting more than a month.)
Acute plantar fasciitis is a condition that primarily involves an inflammatory condition in which there is damage to the tissues on the bottom of the foot and given enough time, that tissue will heal and the inflammation and pain will resolve.
In these cases, ice, rest and some gentle exercises is frequently enough to get you over the problem in a matter of a week or two.
Chronic plantar fasciitis (better known as plantar fasciopathy) is not primarily an inflammatory condition. Instead, it is a condition in which the tissue develops micro damage and then heals poorly. This continues over and over again and over time the tissue becomes weak, brittle, full of scar tissue and sensitive to pain.
In other words, the plantar fascia becomes degenerative or “pathological.”
Let’s discuss some of the more common treatments recommended for chronic Plantar Fasciitis and why they might not be the best option:
1. Steroid Injection: This is an injection of a medication that will basically stop every step in the process of inflammation. Typically the immediate result is pain relief, which lasts 1-2 weeks and is followed by a return of the pain and in some cases a worsening of the pain. There are two basic problems with steroid injections: 1. They tend to speed up the degenerative process and leave the soft tissues in the bottom of the foot in worse shape than before the shot. In other words, the foot becomes weaker and more prone to pain and injury.
2. Orthotics: Orthotics are devices that you place inside your shoe which provides support for the arch of your foot. They can relieve stress on the degenerated tissues of the foot. Unlike steroid injections, orthotics are not a bad idea and for some people they do the trick in terms of removing stress from the tissues and allowing them to heal. These can be purchased over-the-counter, usually for less than $100 or be custom made for you by a podiatrist. Custom orthotics typically cost several hundred dollars, maybe even up to $1000. There really is no downside to trying them other than the cost and just know that they may or may not provide you with the relief that you are looking for.
3. Night Splints: Night splints are a device that you sleep in. They are basically a sock with a strap on the end of the toe area that can be attached to the leg. The purpose of night splints is to keep the calf muscle in a state of stretch, with the idea that you will not wake up in the morning with super tight calves (tight calf muscles is common with plantar fasciitis and is probably part of the condition). For some people night splints will provide some very temporary relief but does not usually fix the problem.
4. NSAIDS: NSAIDS stands for non-steroidal anti-inflammatory drugs. Common over-the-counter NSAIDS are ibuprofen or Advil and naproxen sodium or Aleve. Common prescription NSAIDS include Celecoxib (Celebrex), Diclofenac (Voltaren, Cataflam), and Meloxicam (Mobic). NSAIDS are not as strong as steroids but they also reduce inflammation. The biggest problem that I have with NSAIDS as a treatment for chronic plantar fasciitis is that chronic PF is NOT primarily an inflammatory problem. Also, long-term use of NSAIDS has been shown to cause a host of problems that can lead to hospitalization and death.
5. Physical Therapy: To be clear, Physical Therapy is a profession and not a treatment. I only put this on the list because it is often listed as a common treatment for PF. I think what they usually mean is exercises, in which case I agree. As with most chronic conditions of the musculoskeletal system, exercises are an integral part of resolving chronic plantar fasciitis. I put this in the “might not be the best option” category because results get better when combined with another treatment.
There is a relatively new treatment option that is showing to be superior to other methods, especially when combined with specific corrective exercise protocols.
Acoustic Wave Therapy (a.k.a. Shockwave Therapy) is a safe, non-invasive treatment that utilizes high-peak sound waves that penetrate into the soft tissues of the foot and stimulate a healing response, which reduces pain and inflammation and stimulates the body to create more blood vessels in the foot, thus allowing for better healing of the tissue. The result is long-term resolution of foot pain and tissue healing without down time or major disruption to the flow of your life.
Acoustic Wave Therapy sessions take about 20 minutes and are performed once per week. It typically takes 6-10 sessions to have significant improvement in pain and maximum improvement usually occurs about 3 months after the last treatment. The reason for this is simple, actual healing takes time and this is not a short-cut.
There is also homework to be done:
1. Don’t wear flip-flops or any other shoe that is not somehow strapped on to the back of your foot.
2. Eccentric Calf raises. Start with 3 sets of 10. Keep doing 30 total repetitions but increase the number of repetitions for the first set and reduce the number of repetitions in sets 2 and 3 until you can perform all 30 repetitions in 1 set. Do these daily. (See video below)
3. Stretch your hamstring muscles. 1 set of 10-15 repetitions. Do these every day. (See video below)
In our office, we specialize in providing Acoustic Wave Therapy for people suffering from plantar fasciitis as well as other musculoskeletal conditions.
If you or someone you care about has been dealing with PF for more than a month and if you have tried other treatments that simply have not given you the relief that you are seeking, perhaps Acoustic Wave Therapy would be a good choice for you.
Feel free to contact our office by calling (417) 545-3635 so you can talk to someone in our office about using Acoustic Wave Therapy for resolving plantar fasciitis
Or click the button below to schedule an appointment online.
If you or someone you care about is dealing with plantar fasciitis, I am so sorry. I know how it can affect your life and create fear that it will never get better.
But take heart. We help people just like to get their life back.
I hope to hear from you soon. God Bless!
This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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