Time to Read
- What causes plantar fasciitis?
- Spotting symptoms
- How to self-manage it
- When to seek medical treatment
In the feet there are 26 bones, and over 33 joints that all have varying degrees of flexibility.
Plantar Fasciitis is the most common cause of pain and discomfort in the bottom of the foot, around the heel and arch, as it results from inflammation of the site where the fascia (a band of fibrous tissue) connects to the underside of the heel bone. With the calf muscle, the fascia creates a system around the heel that maintains the arch of your foot, and pain from plantar fasciitis is linked to damage to this connection point.
It can affect anyone, but it’s especially frequent for people who suffer from inflammatory arthritis, obesity, or those who wear shoes with inadequate foot support. The mechanics of the foot also play a role, as plantar fasciitis is more likely to develop in people with abnormal walking patterns or arch structures (a ‘flat foot’ or high arch) – both affect weight distribution when upright and place stress on the fascia. It’s a common complaint for active sportspeople - runners in particular - due to the constant stress placed on the heel and attached tissue.
The pain is often described as sharp and stabbing and is usually at its worst in the morning or after a period of sedentariness like standing or rising from sitting. Sufferers of plantar fasciitis may also have difficulty raising their toes from the floor when the foot is flat on the floor.
Often the pain will subside during exercise and with use of the affected foot but return once you have rested.
It is possible - even recommended - that you treat the symptoms yourself at home, using exercise, rest and some other tools. Research has shown that one cause of plantar fasciitis is the shortening of the Achilles tendon, which can be lengthened with exercises.
The CSP (The Chartered Society of Physiotherapy) has compiled a list of exercises that are recommended for plantar fasciitis, which is available as a pdf here.
Most symptoms can be eased by finding footwear that is more comfortable, supportive and roomy. Padded soles to support the arch can also help, and if you are a runner or your job involves being on your feet for long periods it’s worth searching for more supportive shoes for everyday use - high heeled or slip-on pump shoes should be avoided.
If you wish to treat or manage the pain with medication, over-the-counter painkillers like paracetamol and ibuprofen can help when taken regularly and at the correct dosage, doing so will allow you to continue to exercise the foot. Ibuprofen should however be avoided within the first 48 hours. As the issue stems from inflammation, it’s also helpful to massage anti-inflammatory cream directly onto the painful area as both the massaging motion and the cream will relieve some of the pain.
The NHS recommends that you seek medical advice from your GP if the pain shows no sign of improving after two weeks.
Doctors or physiotherapists may offer you a steroid injection to reduce swelling, but it’s sensible to exhaust other avenues of treatment first.