An illustration of a right foot from the side, up on their toes. The inflamed plantar fascia is shown, just past the heel..
Plantar fasciitis is a painful condition that is usually successfully treated with medications and stretching exercises.

What is it?

Plantar fasciitis is an inflammation of the plantar fascia, a piece of strong, thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, supporting the arch of the foot.

This illustration shows three examples of inflamed plantar fascia, two from the side, and one from the bottom.
https://www.firstaidforfree.com/first-aid-for-plantar-fasciitis/

Standing on your foot exerts pressure on your plantar fascia. Pressure distribution is on all five toes and the heel. 

Prolonged, excessive traction can produce a heel spur.

A schematic illustration of plantar fasciitis, showing the inflamed fascia and the associated heel spur.

The spur doesn’t occur on the toes because the force is distributed over five areas, whereas on the heel side, there is only one area.

Plantar fasciitis is an extremely common cause of foot pain.

Symptoms 

Pain appears in the bottom of the heel. It is especially bad when you first wake up and stand on your foot. This is due to the plantar fascia becoming relatively tight through the night when you’re not standing on it. As soon as you stand on your foot, the plantar fascia stretches, which can be extremely painful.

A photograph of a person holding their right foot, pointing to the bottom of the heel with their thumb.

Pain from plantar fasciitis becomes noticeable after prolonged standing or sitting, or after intense activity.

Diagnosis of Plantar Fasciitis

The diagnosis of plantar fasciitis is a relatively easy one to make clinically. The use of x-rays usually rules out any other causes for heel pain. The x-rays will often show a heel spur.

Treatment 

Like most entities in orthopedic medicine, plantar fasciitis should initially receive treatment in the form of anti-inflammatory medication (either all natural or NSAIDS such as Ibuprofen), rest, and ice.

The most important treatment in my opinion is stretching. When the plantar fasciitis is active, stretching as soon as you wake up is of utmost importance. The easiest stretch is the wall stretch.

A woman stretching her right plantar fascia against a wall.

Stretching is most effective with the knee out straight and as far away from the wall as possible. This maximizes the stretch. You should hold this for 30 seconds and repeat x3.

Arch support shoe inserts can also provide relief in this condition.

If the pain is severe and persists despite the stretching, then a cortisone injection is very beneficial.

Rarely, surgery is necessary when you don’t respond to these treatments.

The plantar fascia at the insertion into the heel is excised with surgery. The heel spur remains untouched, as it is a secondary phenomenon and not the cause of the pain.

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