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The plantar fascia is a thick band of tissue attached to the heel bone. It supports the arch of the foot. Plantar fasciitis is inflammation of the plantar fascia.
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Plantar fasciitis is caused by small, repetitive trauma to the plantar fascia. This trauma can be due to activity that puts extra stress on the foot.
Plantar fasciitis is most common in people who are 40-60 years old. Other risk factors that increase your chance of getting plantar fasciitis include:
Physical exertion, especially in sports such as:
- A sudden increase in exercise intensity or duration
- Physical activity that stresses the plantar fascia
- People who spend a lot of time standing
- A sudden increase in activities that affect the feet
- Obesity or weight gain
- Pre-existing foot problems, including an abnormally tight Achilles tendon, flat feet, or an ankle that rolls inward too much
- Poor footwear
- Heel spurs
Symptoms of plantar fasciitis may start gradually or happen suddenly. They include:
- Pain on the sole of the foot near the heel
- Heel pain when taking the first steps in the morning
- Tenderness when touching the sole or heel
- Pain that increases over a period of months
You will be asked about your symptoms and medical history. A foot exam will be done. This will usually make the diagnosis.
Imaging studies of the foot may be done to help rule out stress fractures or other bone abnormalities. These include:
- MRI scan
Talk to your doctor about the best treatment plan for you. Options include:
Your foot will need time to heal. Supportive care may include:
- Rest—Activities, such as running, may need to be restricted.
- Ice—Ice therapy may help relieve pain.
- Night splint—A night splint helps to hold the foot in a neutral position while sleeping.
- Orthotics—Special shoe inserts will help to support the mid-arch region of the foot.
Stretches to lengthen the Achilles tendon and plantar fascia may be advised when pain has lessened.
Over-the-counter or prescription pain medication may be advised. Steroid injections may also be used in some cases if other treatments do not provide relief.
A physical therapist will assess the foot. An exercise program will be created to help recovery. Therapy may include manual therapy techniques of joint mobilization and soft tissue mobilization to reduce pain and improve function.
A special type of sound wave called extracorporeal shock wave may also be considered in certain cases. This treatment happens under the care of your doctor. At this time, this is generally a treatment for long-term cases that do not respond to other treatments. Massage therapy or acupuncture may also be effective for long-term cases.
In a few cases, basic treatments don't help. Surgery may be performed to cut the tight, swollen fascia.
To reduce your risk of getting plantar fasciitis take these steps:
- Wear appropriate and well-fitted footwear during sports and exercise.
- Do stretching exercises for the Achilles tendon and plantar fascia.
- Increase the intensity and duration of exercise gradually.
- Maintain an appropriate weight.
American Academy of Physical Medicine and Rehabilitation
OrthoInfo—American Academy of Orthopaedic Surgeons
Ontario Podiatric Medical Association
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Fraser JJ, Corbett R, Donner C, Hertel J. Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review. J Manual Manipul Ther.2017;0(0):1-11.
Ibrahim MI, Donatelli RA, Hellman M, Hussein AZ, Furia JP, Schmitz C. Long-term results of radial extracorporeal shock wave treatment for chronic plantar fasciopathy: A prospective, randomized, placebo-controlled trial with two years follow-up. J Orthop Res.2017;35:1532-1538.
Plantar fasciitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116406/Plantar-fasciitis . Updated July 12, 2017. Accessed February 22, 2018.
Plantar fasciitis. Focus on the basics. Mayo Clin Health Lett. 2012;30(8):7.
Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00149. Updated June 2010. Accessed February 22, 2018.
Pommering TL. Ankle and foot injuries in pediatric and adult athletes. Prim Care. 2005;32:133-161.
6/5/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116406/Plantar-fasciitis : Baldassin V, Gomes CR, et al. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Arch Phys Med Rehabil. 2009;90:701-706.
4/24/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116406/Plantar-fasciitis : Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed March 2, 2015.
- Reviewer: EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS
- Review Date: 03/2018
- Update Date: 07/17/2017