Tight Achilles tendons , which are the tendons attaching your calf muscles to your heels, may also result in plantar fascia pain. Simply wearing shoes with soft soles and poor arch support can also result in plantar fasciitis. Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain. During the evaluation, they may ask you to flex your foot while they push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe.
Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your:. An X-ray or an MRI scan may be necessary to check that nothing else is causing your heel pain, such as a bone fracture. Home treatments like rest, icing, and using braces and anti-inflammatory drugs are often the first ways to treat plantar fasciitis.
Your doctor can do this in their office. Your doctor may use an ultrasound device to help determine the best place for the injection. They can also apply corticosteroids to the skin of your heel or the arch of your foot, and then apply a painless electrical current to let the steroid pass through your skin and into the muscle.
Physical therapy is a key part of treatment for plantar fasciitis. It can help stretch your plantar fascia and Achilles tendons. A physical therapist can show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia.
In this therapy, sound waves bombard your heel to stimulate healing within the ligament. Side effects of this treatment can include:. Surgery is the most dramatic therapy. This is done only in cases in which pain is severe or lasts more than 6 to 12 months. In a plantar fascia release, your surgeon partially detaches the plantar fascia from the heel bone. This reduces tension, but weakens the arch of the foot, and full function may be lost. If you have a hard time flexing your feet even after consistent stretching, your doctor may recommend gastrocnemius recession.
This surgery involves lengthening the calf muscle to increase ankle motion and release stress on the plantar fascia. Surgery can result in chronic pain and nerve damage, so it should be considered only after trying other treatment options. Gentle stretches can help relieve and even prevent plantar fasciitis.
Stretching your calves and the plantar fascia itself helps loosen your muscles and reduce heel pain. Swimming and other low-impact activities can let you exercise without worsening your heel pain. When you start running again, be sure to begin slowly. Stop and stretch while exercising to keep the pain from returning. Remember to stretch before beginning your workouts, too. Stretches for plantar fasciitis are easy to do. Learn the right stretches to help heal and prevent plantar fasciitis.
Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, three or four times per day to reduce swelling.
You can also try reducing or changing your exercise activities. Using arch supports in your shoes, replacing worn-out athletic footwear, and doing stretching exercises may also help to relieve pain. Night splints are another treatment that can help stretch your calf and the arch of your foot.
Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and Achilles tendon overnight. This can prevent morning pain and stiffness. Buy a night splint here. Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and they can prevent further damage to the plantar fascia.
A boot cast may immobilize your foot and reduce strain while the plantar fascia heals. You can remove the boot cast, which looks like a ski boot, for bathing. Find arch supports or a boot cast. Carefully following recommendations for home treatment is often enough to heal plantar fasciitis without help from your doctor. Find out more tips for caring for plantar fasciitis at home. Still, some studies suggest that using essential oils may reduce pain and inflammation for certain conditions.
These oils include:. Make sure to dilute your essential oil with a carrier oil, like coconut oil, before using it for massage. You can also inhale the steam from the essential oil mixed with hot water. Wear supportive shoes with good arch support, and replace your athletic footwear regularly. Pain after you stand for long periods. Pain at the beginning of exercise that gets better or goes away as exercise continues but returns when exercise is completed.
What Happens Plantar fasciitis usually develops gradually. As plantar fasciitis progresses: The heel pain gradually gets worse. You may change the way you walk to relieve the pain. This eventually may lead to more discomfort and pain and other problems with your foot, leg, hip, or back. Daily activities or sports may become even more limited. You eventually may have pain with any weight-bearing activity. Running and jumping may no longer be possible.
A heel spur may form as a result of continued stress as the plantar fascia pulls on the heel bone. By itself, a heel spur does not cause plantar fasciitis and does not usually cause problems. And you can have plantar fasciitis and not have a heel spur. What Increases Your Risk You have a greater chance of developing plantar fasciitis if you: Are middle-aged or older.
Walk with an inward twist or roll of the foot pronation or have high arches or flat feet. Are overweight or suddenly gain a lot of weight. Have tight Achilles tendons which attach the calf muscles to the heel bones or tight calf muscles. Have habits or do activities that increase the stress on your feet, such as: Wearing shoes with poor cushioning. Walking or running without being conditioned for these activities.
Changing your walking or running surface for example, from grass to concrete. Having a job that involves prolonged standing on hard surfaces. Are an athlete or a member of the military.
Some athletes, especially runners, are more likely to get plantar fasciitis because of: Things that affect the way their feet strike the ground, such as not having enough flexibility in the foot and ankle or having stronger muscles in one leg than in the other. The repetitive nature of sports activities. Improper training. If you are a runner, you increase your chance of developing plantar fasciitis if you: Abruptly change how hard or how long you run.
Run on steep hills. Wear running shoes that do not have a cushioned sole, lack good arch support, or are worn out. When should you call your doctor? Call your doctor if you have: Pain that continues when you are not standing or bearing any weight on your heel. A heel injury that results in pain when you put weight on your heel. Heel pain that does not getter better after a week, even though you have tried rest, ice, over-the-counter pain medicine such as ibuprofen or acetaminophen , and other home treatment.
Watchful waiting If you have heel pain: First, try resting and icing your heel. If possible, stop or reduce activities that cause the pain, such as running, standing for long periods of time, or walking on hard surfaces.
Try different shoes. Make sure they have good arch support and well-cushioned soles. Or if your current shoes are in good shape, try heel cups or shoe inserts orthotics to cushion your heel. Switch to other activities or exercises that don't put pressure on your heel. After your symptoms are completely gone, gradually resume the activity that was causing pain. If you are an athlete, do not ignore or attempt to "run through" the pain.
This can lead to a chronic problem that is more difficult to treat successfully. Who to see Your family doctor , general practitioner , or podiatrist can evaluate and diagnose plantar fasciitis and recommend non-surgical treatment. The following health professionals can do surgery: Podiatric surgeon Orthopedic surgeon, especially one who specializes in foot and ankle conditions.
Examinations and Tests To diagnose plantar fasciitis, your doctor will ask questions about your symptoms and your past health. Treatment Overview The goals of treatment for plantar fasciitis are to: Relieve inflammation and pain in the heel. Allow small tears in the plantar fascia ligament to heal. Improve strength and flexibility and correct foot problems such as excessive pronation so that you don't stress the plantar fascia ligament.
Allow you to go back to your normal activities. Initial treatment There are many methods you can try to relieve the heel pain of plantar fasciitis.
Limit or, if possible, stop daily activities that are causing your heel pain. Try to avoid running or walking on hard surfaces, such as concrete. To reduce inflammation and relieve pain, put ice on your heel. NSAIDs come in pills and in a cream that you rub over the sore area. Wear shoes with good shock absorption and the right arch support for your foot.
Athletic shoes or shoes with a well-cushioned sole are usually good choices. Try heel cups or shoe inserts orthotics to help cushion your heel. You can buy these at many athletic shoe stores and pharmacies. Put on your shoes as soon as you get out of bed. Going barefoot or wearing slippers may make your pain worse. Do simple exercises such as toe stretches , calf stretches , and towel stretches several times a day, especially when you first get up in the morning. These can help your ligament become more flexible and strengthen the muscles that support your arch.
Ongoing treatment If non-surgical methods such as rest, ice, and stretching exercises help relieve your plantar fasciitis symptoms, continue using them. If you have not improved after 6 weeks, your doctor may recommend that you continue those methods but add other non-surgical treatments, such as: Custom-made shoe inserts orthotics. Custom-made orthotics require a prescription. If your foot has an unusual shape or if you have a certain problem that the device will help, then a custom-made insert may fit better and control pain better than a non-prescription one.
Night splints. A night splint holds the foot with the toes pointed up and with the foot and ankle at a degree angle. This position applies a constant, gentle stretch to the plantar fascia. A walking cast on the lower leg. Casting may be more expensive and inconvenient than other non-surgical treatments.
And after the cast is removed, you will need some rehabilitation to restore strength and range of motion. But a cast forces you to rest your foot. Treatment if the condition gets worse Your doctor may suggest corticosteroid shots if you have tried non-surgical treatment for several weeks without success. What to think about If you are trying to lose weight and you develop plantar fasciitis when you begin exercising, especially jogging, talk with your doctor about other types of activity that will support your weight-loss efforts without making your heel pain worse.
Some questions you may want to ask about exercise include: Should I cut back on my exercise? How many days per week, how long, and what exercise should I do instead? Should I ice my foot after I exercise? If so, for how long each time, and how long should I continue the icing? Are there exercises I can do to make my foot and ankle more flexible? What are they, and how often and how long should I do them?
Prevention The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it: Take care of your feet. Wear shoes with good arch support and heel cushioning.
If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet. Do exercises to stretch the Achilles tendon at the back of the heel. This is especially important before sports, but it is helpful for non-athletes as well. Ask your doctor about recommendations for a stretching routine. Stay at a healthy weight for your height. Establish good exercise habits.
Increase your exercise levels gradually, and wear supportive shoes. If you run, alternate running with other sports that will not cause heel pain.
Put on supportive shoes as soon as you get out of bed. Going barefoot or wearing slippers puts stress on your feet. Home Treatment The first steps your doctor will recommend to treat plantar fasciitis are ones you can take yourself.
Try the following methods: Rest your feet. Stop or reduce any activities that may be causing your heel pain. Wear supportive footwear. Wear shoes that have good arch support and heel cushioning. Or buy shoe inserts orthotics. Shoe inserts may be made of plastic, rubber, or felt. Orthotics can reduce stress and pulling on the plantar fascia ligament. Use ice on your heel. Ice can help reduce inflammation. Contrast baths , which alternate hot and cold water, can also be helpful. Heat alone may make symptoms worse for some people, so always end a contrast bath with a soak in cold water.
If ice isn't helping after 2 or 3 days, try heat, such as a heating pad set on low. Take ibuprofen such as Advil or Motrin , naproxen such as Aleve , or another non-steroidal anti-inflammatory drug NSAID to reduce pain and inflammation.
Be safe with medicines. Read and follow all instructions on the label. A GP might refer you to a physiotherapist for exercises or to see a foot specialist podiatrist , who can recommend things like insoles and the right shoes to wear. Physiotherapy is available free of charge on the NHS throughout the UK but waiting times can sometimes be long. Depending on where you live, you may be able to self-refer or you may need to visit a GP or consultant first. Read more about accessing physiotherapy.
Podiatry may not be available for free on the NHS everywhere and waiting times can sometimes be long. Plantar fasciitis is caused by straining the part of your foot that connects your heel bone to your toes plantar fascia.
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