Is there intense pain at the bottom of your foot? If this ache begins after an intense day of hiking or dancing, it should usually subside in a few days. However, if the pain persists, it could indicate a condition called plantar fasciitis

What is plantar fasciitis?

Plantar fasciitis occurs when the plantar fascia is strained and inflamed. The plantar fascia is a thick piece of tissue at the bottom of the feet that connects the toes to the heel bone and supports the arch of your foot.

Heel pain due to plantar fasciitis is relatively common. It usually affects people who stand, jump or run for an extended period. Most people with this type of heel pain recover within a year, even if they are not given specific treatment.

What are the symptoms of plantar fasciitis?

Following are some of the symptoms of plantar fasciitis:

• Pain at the bottom of the foot and under the heel.
• Pain is worst in the morning after getting out of bed or after a long period of rest. However, the pain subsides within a few minutes of walking.

What are the risk factors of plantar fasciitis?

Risk factors of developing Plantar Fasciitis include:

• Overweight
• Excessive training
• Flat feet
• High arches
• Unsuitable footwear: Wearing high heels or tight shoes may put excess stress on the plantar fascia.
• Overuse: Excessive use of the foot in activities such as hiking, walking, dancing, or running extremely long distances on uneven surfaces or downhill.
• Medical conditions: Type 2 Diabetes Mellitus, psoriatic arthritis, ankylosing spondylitis

How is plantar fasciitis diagnosed?

Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination and investigations.

If you exhibit typical plantar fasciitis symptoms, you may not need X-rays, an ultrasound, or other tests. However, depending on the nature and degree of pain as well as other factors, your doctor may recommend X-rays or magnetic resonance imaging (MRI) scans to determine if other conditions are causing the heel pain.

How is plantar fasciitis treated?

Many individuals with plantar fasciitis do not require specific treatment since the condition improves on its own, although some individuals may require treatment for pain management.

The following are commonly used treatments for plantar fasciitis:

1. Rest: Limit any athletic activities and get extra rest to relieve symptoms.
2. Ice: Ice the area for at least 20 mins a day up to 4 times a day to relieve pain.
3. Medications: Some of the most commonly used medications are non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, paracetamol. and naproxen. Topical NSAIDs may also be used.
4. Use of night splints: Stretches the plantar fascia and Achilles' tendon while the patient sleeps at night. People with plantar fasciitis often experience intense pain while taking the first few steps in the morning, mainly due to the sudden pressure on the fascia. Using night splints helps prevent the sudden stress of the first few steps in the morning.
5. Use of orthotics and protective footwear: use athletic shoes or arch-supporting shoes. Shoes with gel pad inserts or heel cups may temporarily alleviate pain.
6. Taping: If you experience pain in your affected foot first thing in the morning, "low-Dye taping" may be helpful.
7. Steroid injection: A steroid injection in your foot can help relieve pain fast. However, the effects are temporary and wear off after a few weeks.
8. Surgery: Only recommended if other treatment methods were ineffective at relieving pain.
9. Physiotherapy: Guided physical therapy can effectively reduce stress in the heel and improve foot biomechanics.

What are the exercises for plantar fasciitis?

In addition to the treatment options above, exercises are strongly recommended for pain management in plantar fasciitis. Following are some easy exercises to begin with.

1. Standing calf stretch

   Lean against a chair that you position in front of yourself. Extend one leg behind you until you feel a stretch. Bend out the other leg slightly in the front. Hold for a few seconds and return to the starting position.

2. Gastrocnemius muscle stretch

   Use a wall as support for this exercise and place your foot flat on the floor. Keep one leg straight, and lean forward, reducing the angle between your foot and shin until a stretch is felt at the calf muscle in the leg you have placed behind.

   Hold this position for 1 minute and remember not to let your heel off the floor.

3. Tennis ball/frozen bottle rolling

   Sit comfortably on a chair and place your bare foot on a tennis ball. Roll the tennis ball forwards and backward for 1 minute.

   If you do not have a tennis ball, the next best thing to do is take a filled-up bottle and freeze it. Once frozen, wrap it with a towel to prevent ice burn. Then, repeat the same steps as for the tennis ball.

4. Plantar fascia: Sitting exercise

   Sit with the affected leg crossed over the unaffected leg. Hold the toes of the affected leg and bend them backwards until you feel a stretch in the sole of your foot. Make sure to hold the stretch for 1 minute.

5. Plantar fascia: Standing exercise

   In this simple exercise, place the front of your foot ad toe against a wall. Then, lean forward and hold for 1 minute.

What not to do with plantar fasciitis?

Various activities can aggravate plantar fasciitis pain, so it is recommended to take preventive measures. Avoid doing the following:

• Standing for extended periods.
• Wearing uncomfortable shoes.
• Participating in intense activities such as mountain climbing, trekking, and running.
• Walking barefoot on hard surfaces.
• Bearing the pain without seeking medical/professional help.

Book an appointment at Pantai Hospitals

Early detection of Plantar Fasciitis makes it easier to treat the condition with effective and appropriate treatment. A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding Plantar Fasciitis. We assure you the best possible care tailored to your specific needs.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.