A real pain in the foot – Signs of plantar fasciitis

September 14, 2022

Orthopedics Primary Care Healthy Aging
Female physiotherapy professional massaging patient's foot

Do you ever experience an ache or stabbing pain in the heel or arch of your foot?

You may have a very common condition called plantar fasciitis. A band of tissue called the plantar fascia runs from your heel to your toes inside your foot. When it becomes irritated and inflamed, the pain can be intense.  

To get a correct diagnosis – and the very best care – it’s a good idea to consult a foot and ankle orthopedic surgeon. 

“Pain in your heel  and the bottom of your foot can signal plantar fasciitis or other issues – such as a fracture, tendinitis, arthritis, nerve irritation or a cyst,” explains Jeffrey Levy, D.O., a fellowship-trained foot and ankle orthopedic surgeon with Riverside Orthopedic & Sports Medicine Specialists. “It’s important to find out what’s causing your heel pain and make sure you have the best treatment.” 

What causes plantar fasciitis heel pain?

Most likely, you can blame your pain on the structure of your foot. People who have very flat feet or very high arches are prone to plantar fasciitis.

Other factors that can contribute to plantar fasciitis include: 

  • Obesity
  • Standing or walking on hard surfaces for long periods (at a job, for example)
  • Running or walking for exercise
  • Tight calf muscles that limit how far you can flex your ankles
  • Shoes with poor support 

These health and lifestyle issues strain that band of tissue under your foot. And that’s what causes pain.

Signs and symptoms of plantar fasciitis

Don’t be surprised if the pain from plantar fasciitis sneaks up on you gradually. For example, you might feel your pain shortly after you get out of bed in the morning – or after you’ve been sitting for a while. 

Your pain may: 

  • Be located on the bottom of the heel 
  • Be located in the arch of your foot 
  • Decrease after walking a few minutes (because the walking stretches the fascia)
  • Return after spending long periods of time on your feet
  • Increase over a period of months

You may also notice swelling on the bottom of your heel.

It’s important to seek treatment for plantar fasciitis. You may walk differently to compensate for the pain in your heel or arch — and that puts you at risk for developing other issues in your foot, back, hip and knees. 

Diagnosis and treatment for plantar fasciitis

To make a diagnosis, a foot and ankle orthopedic surgeon will examine your foot and ask about your medical history. You may also have X-rays or other imaging studies.

Treatment for plantar fasciitis starts at home. First, you may need to rest your foot – keep weight off it – until the initial inflammation goes away. 

Stretch to treat heel pain

Your doctor will probably recommend a few key stretching exercises. 

“Stretching  is the most effective treatment for plantar fasciitis. Stretching eases pain, assists with recovery, and reduces the chance of recurrence,” explains Dr. Levy. “We’ll show you how to stretch out your calf muscles and your Achilles tendon, which connects those calf muscles to the heel bone. We’ll also show you how to stretch the plantar fascia.” 

You can also try these other tips from the American Orthopaedic Foot and Ankle Society and the American College of Foot and Ankle Surgeons:

Use ice to ease the pain and reduce inflammation.
To reduce inflammation, put an ice pack on your heel for 20 minutes several times a day. You can also roll a frozen water bottle on the bottom of your foot. Use a thin cloth to protect your skin from the cold ice. 

Wear supportive shoes.
Wear shoes with good arch support and a slightly raised heel to reduce stress on the plantar fascia.

Consider an anti-inflammatory medicine. 
Your foot and ankle orthopedic surgeon may suggest ibuprofen or naproxen to reduce pain and irritation of the heel.

Most people improve significantly after a couple months of nonsurgical, at-home treatments. But if you still need relief, your doctor may suggest: 

  • Injections of a steroidal anti-inflammatory medicine into your heel
  • A walking cast to rest the foot
  • A special splint that you wear while sleeping to keep your plantar fascia stretched
  • Shoe pads to soften the impact of walking
  • Taping and strapping to support the foot and reduce strain on the fascia
  • Custom orthotic devices that fit into your shoe and help correct underlying structural abnormalities 
  • Physical therapy

Do you need surgery for plantar fasciitis? 

If nonsurgical treatments don’t give you relief, your foot and ankle orthopedic surgeon may suggest a plantar fascia release. 

“With this procedure,  our goal is to relieve the tension on the tissue that connects the heel bone to the toes. We remove or release the diseased portion of the tissue that is responsible for the pain,” explains Dr. Levy. “This procedure is for people who still have severe pain after trying all other nonsurgical treatments.” 

Typically, you’ll go home the same day of surgery with a splint, boot or special shoe. After two or three weeks, you can start normal weight bearing. As you continue your recovery, your surgeon will stress the importance of stretching, good footwear and rest.

To relieve your foot pain – with or without surgery – contact our expert foot and ankle orthopedic surgeons at Riverside.

If you need care for plantar fasciitis and would like to make an appointment with Dr. Levy, please call 757-534-9988.

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