Plantar Fasciitis

Plantar fasciitis typically manifests as sharp or stabbing pain localized in the heel or along the underside of the foot, particularly noticeable during the initial steps after prolonged periods of rest, such as upon waking in the morning or after sitting for extended periods. The discomfort may gradually lessen with movement but can intensify after prolonged weight-bearing activities, such as standing or walking. In some cases, the pain may radiate along the arch of the foot. Patients may also experience stiffness and tenderness in the affected area, which can impair mobility and impact daily activities.

Plantar fasciitis arises from a combination of factors contributing to the overuse and irritation of the plantar fascia, a thick band of tissue that supports the arch of the foot and absorbs shock during walking and running. Repetitive strain from activities such as running or walking on hard surfaces, inadequate footwear lacking proper arch support, tightness or weakness in the calf muscles and Achilles tendon, excessive body weight, and structural abnormalities of the foot (e.g., flat feet, high arches) can all predispose individuals to develop plantar fasciitis. These factors lead to micro-tears and inflammation in the plantar fascia, resulting in pain and discomfort.

The diagnosis of plantar fasciitis begins with a thorough evaluation of the patient's medical history and a comprehensive physical examination, focusing on eliciting symptoms, assessing foot mechanics, and identifying potential contributing factors. Diagnostic maneuvers may include palpation of the affected area to elicit tenderness, evaluation of foot posture and gait, and assessment of range of motion in the ankle and foot joints. Imaging studies such as X-rays or ultrasound may be utilized to confirm the diagnosis, rule out other causes of heel pain (e.g., stress fractures, heel spurs), and evaluate the severity of the condition by visualizing changes in the plantar fascia thickness and integrity.

Management strategies for plantar fasciitis aim to alleviate pain, reduce inflammation, improve foot biomechanics, and promote healing of the affected tissues. Initial treatment typically involves conservative measures, including rest, ice therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and reduce inflammation. Stretching exercises targeting the calf muscles, Achilles tendon, and plantar fascia are commonly recommended to improve flexibility and reduce tension in the affected structures. Supportive footwear with adequate arch support and cushioning can help redistribute pressure on the foot and alleviate strain on the plantar fascia. Orthotic devices, such as arch supports or heel cups, may be prescribed to provide additional support and promote proper foot alignment. Surgical intervention, such as plantar fascia release or heel spur removal, is reserved for refractory cases that do not respond to conservative treatments.