Plantar fasciitis: An expert's guide to prevention and treatment

In his latest online article, leading consultant in orthopaedics Mr Paul Hamilton explains plantar fasciitis in detail. He explains the causes symptoms, diagnosis and treatment of this common but painful condition.

What is plantar fasciitis?

Plantar fasciitis, or plantar fasciopathy, is a term used to describe the pain and occasionally inflammation of a normal thick band of tissue that runs along the bottom of the foot from the heel to the toes. The pain is usually under the heel or arch and occurs when this structure is strained or irritated.

What are the causes of plantar fasciitis?

Many factors can cause plantar fasciitis including overuse, repetitive impact, flat feet, high arches, obesity and calf tightness. Plantar fasciitis can also occur if none of these factors are present. A heel spur is not the cause of pain in plantar fasciitis.

What are the symptoms of plantar fasciitis?

Symptoms include heel pain which is often worse first thing in the morning or getting up after sitting. The pain is often worse after a prolonged period of standing, usually at the end of the day. Swelling is a very unusual symptom of plantar fasciitis.

How is plantar fasciitis diagnosed and treated?

Diagnosis can usually be made by a discussion and clinical examination by an experienced foot and ankle orthopaedic surgeon. If symptoms are unusual, such as swelling, or prolonged, then an MRI scan can be used to confirm the diagnosis. Ultrasound scans can also be used but this may not pick up other conditions which present in a similar fashion.

Treatment aims at identifying the cause and treating the condition.  Initially, treatment involves activity modification (rest and avoiding impact activities), physiotherapy and orthotics (insoles). In some cases, ESWT (shockwave therapy), injections or surgery to release the calf muscle may be required if simple measures do not solve the problem.

Can plantar fasciitis be prevented?

There are several ways to prevent plantar fasciitis.

1. Using supportive shoes with a good arch and cushioning.
2. Stretch your calf and plantar fascia regularly to prevent tightness along both structures.
3. If increasing your activity levels, do this gradually and take appropriate rest to prevent overuse and to allow the plantar fascia to adapt to the increased loading. Ensure you are performing the activity correctly to reduce injury risk.
4. Maintain a healthy weight.

If you would like to book a consultation with Mr Paul Hamilton, you can do so today via his Top Doctors profile.