FAQs on Plantar Fasciitis Treatment in Philadelphia

Plantar fasciitis is a common reason for heel and foot pain. The plantar fascia is a strong band of tissue that supports the foot arch. When this structure becomes inflamed, injured, or irritated, it causes pain that is perceived in the heel region.

How common is plantar fasciitis?

Approximately 2 million people are treated for plantar fasciitis each year.

What causes plantar fasciitis?

The plantar fascia absorbs the high stresses and strain placed on the feet. Too much pressure, from running or excessive walking, or prolonged standing can lead to damage or tears of the plantar fascia tissues. When this occurs, the body’s immune response is activated, and this leads to stiffness of the plantar fascia and heel pain.

Who is at risk for plantar fasciitis?

Certain people are at risk for plantar fasciitis. Factors that make an individual prone to this disorder are:

  • Obesity
  • A high arch
  • Tight calf muscles
  • New or increased physical activity
  • Repetitive impact activity (sports or running)

Is plantar fasciitis the same as a heel spur?

Around 10% of people in the general people have heel spurs, but only 5% of people with heel spurs have foot pain. Many people with plantar fasciitis also have heel spurs, but this is not the cause of the foot pain.

What symptoms are associated with plantar fasciitis?

The most common symptom of plantar fasciitis is pain on the bottom of the foot near the heel. Other symptoms are pain upon rising in the morning or after a long rest period. Pain also occurs after exercise. Pain is usually not present during activity.

How is plantar fasciitis diagnosed?

The doctor will ask you specific questions about your foot and heel pain. He/she will assess the foot for tenderness, check range of motion of the ankle and foot, and look at your arch. Certain diagnostic tests are used to evaluate the condition. X-rays provide clear images of the foot bones. Magnetic resonance imaging (MRI) and ultrasound are not usually done, but can be ordered to rule out other conditions.

What are the treatment options for plantar fasciitis?

Nonsurgical treatment will relieve pain for the majority of patients. Common therapies include:

  • Resting and icing the foot – Stopping or decreasing activities will reduce the pain for many patients. In addition, ice therapy for 20-minute intervals can be used 3-4 times a day.
  • Medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) are the agents of choice for reduction of pain and inflammation. Topical agents are used for immediate pain relief, such as capsaicin, menthol, and camphor.
  • Physical therapy – For chronic plantar fasciitis, the patient will be taught certain stretching maneuvers to alleviate pain. The calf stretch is done by leaning forward against the wall with one knee straight and the heel of that same foot secure to the ground. The plantar fascia stretch is done by crossing the affected foot over the knee of the other leg and pulling the toes forward. According to one clinical study involving patients with plantar fasciitis, physical therapy was 83% effective.
  • Cortisone injections – Steroids are powerful anti-inflammatory agents. The plantar fascia is injected to reduce inflammation and pain. However, the doctor will not offer many of these, as they lead to tissue thinning and could produce a tear in the plantar fascia.
  • Orthotics, splints, and supportive shoes – Special heel pads, arch supports, and other orthotics are used to relieve pain. Night splints are used to reduce heal pain by stretching the plantar fascia during sleep. Supportive shoes with thick soles are used to cushion the painful heel and foot.
  • Extracorporeal shockwave therapy (ESWT) – The doctor will use a computerized device that delivers high-energy shockwave impulses to the plantar fascia. This stimulates the healing process. This procedure has a 70-90% efficacy rate, according to clinical studies.

Resources

Hyer CF, Vancourt R, & Block A (2005). Evaluation of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. J Foot Ankle Surg, 44(2):137-43.

McMillian, AM, Landorf, KB, Gilheany, MF, et al. (2012). Ultrasound guided corticosteroid injection for plantar fasciitis: Randomised controlled trial. British Medical Journal.

Rome K, Howe T, Haslock I. Risk factors associated with the development of plantar heel pain in athletes. The Foot 2001;11(3):119-125.

Wearing SC, Smeathers JE, Yates B, et al. Sagittal movement of the medial longitudinal arch is unchanged in plantar fasciitis. Med Sci Sports Exerc 2004;36(10):1761-1767.