Plantar fascia is the band of tissue along the sole of your foot and is responsible for supporting your arch. Most problems with the plantar fascia does not involve inflammation although the term fasciitis (“itis” refers to inflammation). The symptom for plantar fasciitis is a sharp pain under your heel. It is caused by an overuse injury, brought on by repeated trauma over time.
The actual problem tends to be deterioration in this strong ligament, which then impacts the way it functions. When it’s damaged, the tissue doesn’t expand and contract properly. While you are at rest (asleep or sitting for a long period), the tissue contracts and tightens up. When you first put weight on it again, the fascia can’t relax as it should to absorb your weight. Instead, it pulls against the heel bone, causing a stabbing pain under your heel. Sometimes bone spurs form on the heel bone where the fascia is attached.
After you move around a bit, and the fascia limbers up, the pain disappears, only to come back again after the next period of inactivity. This gradually gets worse as time goes on, until you are unable to walk any distance without pain.
Fortunately, conservative treatment is often quite effective for this problem. This could include rest from activity, stretching, night splints, anti-inflammatory medication, “shoe therapy” (changes to the types of footwear you normally choose), orthotics to correct any biomechanical factors, radio pulse therapy (lower shockwave therapy), laser therapy, or possibly cortisone injections for pain. Rarely is it necessary to use more invasive treatments like surgery to correct the condition.
Other Sources of Heel Pain
Your pain and discomfort could also be attributed to any of a number of other problems, such as:
- Bruise or contusion (usually from landing on something hard)
- Bursitis (inflamed bursa sac between bone and tendon)
- Fracture of the heel bone
- Haglund’s deformity or bone growth at the back of the heel
- Rheumatoid arthritis or gout
- Sever’s disease – a growth plate problem causing pain in pre-teen and teen years
The good news when it comes to these various conditions is that they are often successfully resolved with the use of conservative (nonsurgical) treatment. There are many different options and methods we may use when creating our unique treatment plan specifically for you. Some of the components include rest, ice, medication, stretches, physical therapy, footwear changes, orthotic devices, and corticosteroid injections. In some cases, we may also recommend effective laser therapy to reduce pain and encourage faster healing within the area. Your diagnosis will determine which options we use.