Greater Washington
Arthritis, Rheumatology and Osteoporosis Center

Plantar Fasciitis


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Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It is caused by inflammation of a thick band of tissue that runs across the bottom of your foot to toes. It is more common in runners, overweight and those people who wear shoes with inadequate support. in many cases of plantar fasciitis, the cause isn't clear. The plantar fascia acts like a shock-absorbing bowstring, supporting the arch in the foot. If tension and stress on that bowstring become too great, small tears can arise in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.


Plantar fasciitis causes very sharp and stabbing pain that usually occurs with the first steps in the morning after patient wakes up and the pain typically decreases with more walking but it might return after long periods of standing or after rising from sitting; in runners typically worse after exercise. 

Risk factors  

As we said earlier the exact cause of plantar fasciitis is not clear, however there are factors that can increase the risk of developing plantar fasciitis such as Age (usually between 40-60), exercises or activities that place a lot of stress on the heel and plantar fascia such as jumping activities and long distance running. Foot mechanics also are important, having a high arch, being flat-footed, can affect the way weight is distributed when a person is standing and put added stress on the plantar fascia. Obesity also is a risk factor by putting extra pressure on the fascia. 


The diagnosis is made based on the medical history and physical examination; usually there is tenderness with pressure at the area of inflammation and usually no imaging tests are necessary, however X-ray or MRI may be necessary to rule out other etiology of pain such as a stress fracture or a pinched nerve. 


Conservative treatments such as resting, icing the painful area and stretching, athletic taping to support the bottom of your foot or Night splints that stretches your calf and the arch of the foot may result in improving of symptoms however the other measures may be considered such as pain such as naproxen. Orthotics also help distribute pressure to your feet more evenly and improves the symptoms. Sometimes in chronic plantar fasciitis sound waves are directed at the area of heel pain to stimulate healing.

If the conservative managements fail, Steroid medication into the tender area may provide temporary pain relief. More recently, platelet-rich plasma (PRP) has been used to provide pain relief.

Surgery Is reserved in severe cases of plantar fasciitis by detaching the plantar fascia from the heel bone.