Plantar Fasciitis

Inflammation or degeneration of the plantar fascia, a thick band of tissue connecting the heel bone (calcaneus) to the toes. Leads to heel pain, especially with the first steps in the morning.


Causes:

  • Overuse or repetitive strain from running, jumping, or prolonged standing.
  • Improper footwear (flat, hard, or unsupportive shoes).
  • Foot deformities – flat feet, high arches, or overpronation.
  • Tight Achilles tendon or calf muscles increasing tension on the fascia.
  • Obesity or sudden weight gain.
  • Occupational stress (standing on hard surfaces for long hours).
  • Age-related wear – most common between ages 40–60.
  • Sudden increase in activity or poor training techniques.

Symptoms

  • Sharp, stabbing heel pain, usually at the inner side of the heel.
  • Morning pain – worse with first steps after rest.
  • Pain after long standing or walking.
  • Tenderness at the heel (medial calcaneal area).
  • Pain decreases after light activity but worsens later in the day.
  • Tightness in the sole or calf muscles.
  • Usually no visible swelling or redness.

Treatment:

A. Conservative (first-line):

  • Rest and activity modification – avoid running, jumping, or prolonged standing.
  • Ice application – 15–20 min, 2–3 times/day.
  • Stretching exercises – plantar fascia and calf stretches daily.
  • Supportive footwear with cushioning and arch support.
  • Heel pads or orthotic insoles to reduce pressure.
  • NSAIDs (e.g., ibuprofen, naproxen) for pain and inflammation.
  • Night splints to keep the fascia stretched overnight.
  • Physical therapy – strengthening foot and calf muscles.
  • Weight loss to reduce heel strain.

B. Advanced options (if persistent):

  • Corticosteroid injection – short-term relief (use cautiously).
  • Extracorporeal shock wave therapy (ESWT).
  • Platelet-rich plasma (PRP) therapy for chronic cases.

C. Surgical (rare):

  • Partial plantar fascia release if symptoms persist >6–12 months
  • Heel spur excision only if necessary.